Abstract
Despite increasing attention given to the high prevalence and effects of abuse in the severely mentally ill, few studies have looked at its effects among males. While both male and female psychiatric patients report greater abuse history than the general population, studies have focused on females alone. The current study compared the effects of abuse history between 271 severely mentally ill males (n = 160) and females (n = 111). The mean age of participants was 33.7 years (SD = 9.73), and included 129 Caucasians, 120 African Americans, 15 Hispanic-Americans, and 7 “Other” (i.e., Asian and native American descent). Primary Axis I diagnoses included Bipolar disorder (23.2%) major depressive disorder (27.7%) schizophrenic disorder (26.6%), substance-related disorders (10.3%), and miscellaneous disorders (12.1%). Each patient completed a comprehensive assessment, including clinician ratings, self-report measures, clinical and structured interviews. Comparisons between genders revealed that females were more likely to report both physical and sexual abuse, and males were more likely to report no history of abuse. In addition, Caucasians were more likely to report abuse than were African Americans, and voluntary patients were more likely to endorse abuse history than those admitted involuntarily. Few gender differences were found in psychological symptoms among males and females. Satisfaction with the home environment was significantly lower for abused than nonabused females. This was not true for males. However, abused psychiatric patients were perceived by the physicians, nurses, and themselves as having greater emotional disturbance than were nonabused patients, regardless of gender. Clinical implications are discussed.
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REFERENCES
Goodman LA, Rosenberg SD, Mueser KT, et al: Physical and sexual assault history in women with serious mental illness: Prevalence, correlates, treatment, and future research directions. Schizophrenia Bulletin 23(4):685–696, 1997.
Read J: Child abuse and severity of disturbance among adult psychiatric inpatients. Child Abuse and Neglect 22(5):359–368, 1998.
Wurr CJ, Partidge IM: The prevalence of a history of childhood sexual abuse in an acute adult inpatient population. Child Abuse & Neglect 20(9):867–872, 1996.
Kolko DJ: Characteristics of child victims of physical violence: Research findings and clinical implications. Journal of Interpersonal Violence 7(2):244–276, 1992.
Craine LS, Henson CE, Colliver JA, et al: Prevalence of a history of sexual abuse among female psychiatric patients in a state hospital system. Hospital and Community Psychiatry 39(3):300–304, 1988.
Bryer JB, Nelson BA, Miller JB, et al: Childhood sexual and physical abuse as factors in adult psychiatric illness.American Journal of Psychiatry 144(11):1426–1430, 1987.
Read J: Child abuse and psychosis: A literature review and implications for professional practice. Professional Psychology-Research & Practice 28(5):448–456, 1997.
Jacobson A, Richardson B: Assault experiences of 100 psychiatric inpatients: Evidence of the need for routine inquiry. American Journal of Psychiatry 144(7):908–913, 1987.
Jacobson A, Herald C: The relevance of childhood sexual abuse to adult psychiatric inpatient care. Hospital and Community Psychiatry 41(2):154–158, 1990.
Finkelhor D, Hotaling G, Lewis IA, et al: Sexual abuse in a national survey of adult men and women: Prevalence, characteristics, and risk factors. Child Abuse and Neglect 14(1):19–28, 1990.
Coverdale JH, Turbott SH: Sexual abuse of chronically ill psychiatric outpatients compared with a matched sample of medical outpatients. Journal of Nervous and Mental Disease 188(7):445–445, 2000.
Ellason JW, Ross CA: Childhood trauma and psychiatric symptoms. Psychological Reports 80:447–450 1997.
Goodman LA, Dutton MA, Harris M: The relationship between violence dimensions and symptom severity among homeless, mentally ill women. Journal of Traumatic Stress 10(1):51–70, 1997.
Mueser KT, Goodman LB, Trubetta SL, et al: Truama and posttraumatic stress disorder in severe mental illness. Journal of Consulting and Clinical Psychology 66(3): 493-499}, 1998.
Ross CA, AndersonG, Clark P: Childhood abuse and positive symptoms of schizophrenia. Hospital and Community Psychiatry 45(5):489–497, 1994.
Hays JR, Emmons J, Wagner A, et al: Comparison of the Shipley Institute of Living Scale and the WAIS-R IQ scores for a sample of public sector psychiatric inpatients. Psychological Reports 80(3):920–922, 1997.
Iverson GL, Woodward TS, Green P: Base rates of WAIS-R VIQ-PIQ differences in 1593 psychiatric inpatients. Journal of Clinical Psychology 57(12):1579–1587, 2001.
Murphy DL, Pickar D, Alterman JS: Methods for the quantitative assessment of depressive and manic behavior, in Techniques for the Evaluation of the Behavior of Psychiatric Patients. Edited by Burdock EJ, Sudilovsky A, Gershon S. New York, Marcel-Decker, 1980.
Overall JE, Gorham DR: The brief psychiatric rating scale. Psychological Reports 10:799–812, 1962.
Overall JE, Gorham DR: The Brief Psychiatric Rating Scale (BPRS): Recent developments in ascertainment and scaling. Psychopharmacology Bulletin 24:97–99, 1988.
21.Lachar D, Bailley SE, Rhoades HM, et al. New scales for an anchored version of the Brief Psychiatric Rating Scale: Construction, reliability, and validity in acute psychiatric admissions.
Overall JE, Klett CJ: Applied Multivariate Analysis. New York, McGraw-Hill, 1972.
Beck AT, Ward CH, Mendelson M, et al: An inventory for major depression. Archives of General Psychiatry 4:561–571, 1961.
Derogatis LR, Melisaratos N: The Brief Symptom Inventory: An introductory report. Psychological Medicine 13:596–605, 1983.
Frisch MB: Use of the Quality of Life Inventory in problem assessment and treatment planning for cognitive therapy of depression, in Comprehensive Casebook of Cognitive Therapy. Edited by Freeman A, Dattilio F. New York, Plenum Press, 1992.
Frisch MB: Quality of Life Inventory, in The Use of Psychological Testing for Treatment Planning and Outcome Assessment. Edited by Maruish M. Hillsdale, NJ, Erlbaum, 1999.
Tyrer P: Personality disorders and social functioning, in MeasuringHumanProblems. Edited by Peck DF, Shapiro CM. New York: Wiley, 1990.
Casey PR, Tyrer P: Personality functioning and symptomology. Journal or Psychiatric Research 20(4):363–374, 1986.
Spitzer RL, Williams JBW, Gibbon M, et al: User's Guide for the Structured Clinical Interview for DSM-IV. Washington, DC, American Psychiatric Press, 1990.
Cohen J: Statistical Power Analysis for the Behavioral Sciences. New York, Academic Press, 1977.
Romano E, De Luca RV:Male sexual abuse: A review of effects, abuse characteristics, and links with later psychological functioning. Aggression andViolent Behavior 6: 55-78}, 2001.
Pinta ER: The prevalence of serious mental disorders among U.S. prisoners, in Forensic Mental Health:Working with Offenders with Mental Illness. Edited by Landsberg G, Smiley A. Kingston, NJ, Civic Research Institute, 2001.
Kulka RA, Schlenger WE, Fairbank JA, et al: Trauma and the Vietnam War Generation: Report of the findings from the National Vietnam Veterans Readjustment Study. New York, Brunner/Mazel, 1990.
Maeve MK: Speaking unavoidable truths: Understanding early childhood sexual and physical violence among women in prison. Issues in Mental Health Nursing 21(5):473–498, 2000.
Jacobs AE: Child abuse and incarceration: A comparison between recidivists and nonrecidivists in an East Oakland community. Dissertation Abstracts International 59(5B), 1998.
Hutchings PS, Dutton MA: Sexual assault history in a community mental health center clinical population. Community Mental Health Journal 29(1):59–63, 1993.
Briere J: The long-term clinical correlates of childhood sexual victimization. Annals of the New York Academy of Science 528:327–334, 1988.
Finkelhor DL: Early and long-term effects of child sexual abuse: An update. Professional Psychology Research and Practice 21(5):325–330, 1990.
Wyatt GE, Loeb TB, Solis B, et al: Prevalence and circumstances of child sexual abuse: Changes across a decade. Child Abuse & Neglect 23(1):45–60, 1999.
Beckham JC, Moore SD, Feldman ME, et al: Health status, somatization, and severity of posttraumatic stress disorder in Vietnam combat veterans with posttraumatic stress disorder. American Journal of Psychiatry 155(11):1565–1569, 1998.
van der Kolk BA, Pelcovitz D, Roth S, et al: Dissociation, somatization, and affect dysregulation: the complexity of adaptation of trauma. American Journal of Psychiatry 153:83–93, 1996.
Ader R, Cohen N: Behaviorally conditioned immunosuppression. Psychosomatic Medicine 37:333–340, 1975.
Kazdin AE: Research design in clinical psychology, 2nd ed. Massachusetts, Allyn & Bacon, 1992.
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Shack, A.V., Averill, P.M., Kopecky, C. et al. Prior History of Physical and Sexual Abuse Among the Psychiatric Inpatient Population: A Comparison of Males and Females. Psychiatr Q 75, 343–359 (2004). https://doi.org/10.1023/B:PSAQ.0000043510.41919.55
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DOI: https://doi.org/10.1023/B:PSAQ.0000043510.41919.55