Journal of Social Work, 6(1), April 2006, pp.21-31.
Publisher:
Sage
Somatoform disorders and functional somatic syndromes are defined as the presence of physical symptoms in the absence of sufficient tissue or organ damage to account for the degree of pain or dysfunction. Many people who suffer from these disorders have a history of childhood abuse. Because these individuals may also have a number of other difficulties in living, social workers encounter such clients in diverse fields of practice. Clients who fall into the category of adult survivors of abuse with a somatoform disorder may experience certain interventions by doctors, therapists, and other helping professionals (including social workers) as repeating interactions they had with their abusers. Adult survivors of abuse who have a somatoform disorder often have parallel experiences in terms of their abuse and their somatic symptoms: important others communicate that the abuse and the symptoms are not real, are the client’s fault, and/or that the client is over-reacting to the abuse and symptoms. Furthermore, adult survivors of abuse may experience helping professionals as distinctly non-nurturing and as engaging in distancing behaviours. These interactions may stand in the way of helping members of this population, or even add to the client’s distress. There are specific practices in which the social worker may engage to help avoid these kinds of relations. Social workers in a number of fields of practice may be alerted to dynamics common among adult survivors of abuse with a somatoform disorder. In the event that a client falls into this category, the informed social worker can avoid recapitulating abuse dynamics as well as help clients understand their diagnosis and why interactions with helping professionals may have been upsetting.
Somatoform disorders and functional somatic syndromes are defined as the presence of physical symptoms in the absence of sufficient tissue or organ damage to account for the degree of pain or dysfunction. Many people who suffer from these disorders have a history of childhood abuse. Because these individuals may also have a number of other difficulties in living, social workers encounter such clients in diverse fields of practice. Clients who fall into the category of adult survivors of abuse with a somatoform disorder may experience certain interventions by doctors, therapists, and other helping professionals (including social workers) as repeating interactions they had with their abusers. Adult survivors of abuse who have a somatoform disorder often have parallel experiences in terms of their abuse and their somatic symptoms: important others communicate that the abuse and the symptoms are not real, are the client’s fault, and/or that the client is over-reacting to the abuse and symptoms. Furthermore, adult survivors of abuse may experience helping professionals as distinctly non-nurturing and as engaging in distancing behaviours. These interactions may stand in the way of helping members of this population, or even add to the client’s distress. There are specific practices in which the social worker may engage to help avoid these kinds of relations. Social workers in a number of fields of practice may be alerted to dynamics common among adult survivors of abuse with a somatoform disorder. In the event that a client falls into this category, the informed social worker can avoid recapitulating abuse dynamics as well as help clients understand their diagnosis and why interactions with helping professionals may have been upsetting.
Health and Social Care in the Community, 18(4), July 2010, pp.396-406.
Publisher:
Wiley
For an older person, the ability to carry out activities of daily living (ADL) is essential for independent living. This cross-sectional study examined ADL problems in older cancer survivors compared to a cancer-free control group. Of the 11,899 participants, 911 individuals over 70 years had invasive cancer. Personal and Instrumental ADL (P-ADL and I-ADL) problems were self-rated (P-ADL problems addressed activities such as personal hygiene, dressing and eating, while I-ADL problems concerned household activities, managing finances, shopping and administration of medication). Associations among independent variables and P-ADL and I-ADL problems were examined. P-ADL problems were present in 10% of the cancer survivors and 8% of the controls. Correspondingly, 38% of the cancer survivors had I-ADL problems versus 32% of the controls. Older cancer survivors with co-morbidity showed higher rates of P-ADL and I-ADL problems compared with controls with co-morbidity (14% versus 9%, and 47% versus 39%). Cancer survivors with co-morbidity had more P-ADL and I-ADL problems than survivors without co-morbidity (14% versus 8%, and 47% versus 32%). Results revealed higher incidence of ADL problems among a population of older cancer survivors compared with cancer-free controls, and somatic co-morbidity further increased the prevalence of both P-ADL and I-ADL problems in the cancer survivors. In conclusion, the authors suggest that primary health care providers should pay attention to and assess ADL problems in older cancer survivors.
For an older person, the ability to carry out activities of daily living (ADL) is essential for independent living. This cross-sectional study examined ADL problems in older cancer survivors compared to a cancer-free control group. Of the 11,899 participants, 911 individuals over 70 years had invasive cancer. Personal and Instrumental ADL (P-ADL and I-ADL) problems were self-rated (P-ADL problems addressed activities such as personal hygiene, dressing and eating, while I-ADL problems concerned household activities, managing finances, shopping and administration of medication). Associations among independent variables and P-ADL and I-ADL problems were examined. P-ADL problems were present in 10% of the cancer survivors and 8% of the controls. Correspondingly, 38% of the cancer survivors had I-ADL problems versus 32% of the controls. Older cancer survivors with co-morbidity showed higher rates of P-ADL and I-ADL problems compared with controls with co-morbidity (14% versus 9%, and 47% versus 39%). Cancer survivors with co-morbidity had more P-ADL and I-ADL problems than survivors without co-morbidity (14% versus 8%, and 47% versus 32%). Results revealed higher incidence of ADL problems among a population of older cancer survivors compared with cancer-free controls, and somatic co-morbidity further increased the prevalence of both P-ADL and I-ADL problems in the cancer survivors. In conclusion, the authors suggest that primary health care providers should pay attention to and assess ADL problems in older cancer survivors.
Child Abuse and Neglect, 31(5), May 2007, pp.531-547.
Publisher:
Elsevier
The current study examined the effects of childhood sexual and physical abuse on reports of pain in 1,727 men and women from the United States. Data from the National Comorbidity Survey, a nationally representative sample, were utilized. Childhood experiences of physical and sexual abuse were assessed, and pain reports in relation to current health problems were obtained. Regression and mediation
The current study examined the effects of childhood sexual and physical abuse on reports of pain in 1,727 men and women from the United States. Data from the National Comorbidity Survey, a nationally representative sample, were utilized. Childhood experiences of physical and sexual abuse were assessed, and pain reports in relation to current health problems were obtained. Regression and mediation analyses were used to examine the relationship between childhood abuse and current pain reports and to determine whether depression mediated this relationship. Individuals who experienced abuse reported more health problems compared to those participants without abuse histories. Among participants with a current health problem, those who experienced abuse reported more pain compared to those participants without abuse histories. Because childhood abuse is associated with depression and depression is associated with more reported pain, the influence of depression on the relationship between childhood abuse and adult pain reports was examined. After controlling for differences between the abused and non-abused participants on specific health problems, depression was not found to have mediated the relationship. Childhood abuse was associated with more reported pain. The higher rate of depression found among adults who experienced childhood abuse was not the primary factor for these increased pain reports. Rather, childhood abuse and depression independently contributed to pain reports. Treatment of both underlying problems (i.e., pain and depression) is recommended in addressing the needs of abused individuals with these comorbid disorders.
Subject terms:
pain, survivors, adults, child abuse, child sexual abuse, depression, comorbidity;
KATERNDAHL David A., BURGE Sandra K., KELLOGG Nancy D.
Journal article citation:
Journal of Child Sexual Abuse, 14(3), 2005, pp.91-105.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA
Childhood sexual abuse (CSA) is associated with the development of numerous adult mental disorders. Women with a history of CSA from the United States were surveyed concerning their abuse experience and prevalence of DSM-IV mental disorders. The 63 women in the low morbidity cluster had a mean of 1.02 disorders. The 11 women in the moderate morbidity cluster consisted had a mean of 2.36 disorders. The 16 women in the severe morbidity cluster consisted had a mean of 4.75 disorders. Childhood family environment and CSA during preschool years were important predictors of morbidity cluster membership. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Childhood sexual abuse (CSA) is associated with the development of numerous adult mental disorders. Women with a history of CSA from the United States were surveyed concerning their abuse experience and prevalence of DSM-IV mental disorders. The 63 women in the low morbidity cluster had a mean of 1.02 disorders. The 11 women in the moderate morbidity cluster consisted had a mean of 2.36 disorders. The 16 women in the severe morbidity cluster consisted had a mean of 4.75 disorders. Childhood family environment and CSA during preschool years were important predictors of morbidity cluster membership. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Child Abuse and Neglect, 27(9), September 2003, pp.1075-1082.
Publisher:
Elsevier
Prevalence rates of child sexual abuse (CSA) in the United States emphasize the importance of focusing on common symptom responses and diagnostic considerations for these individuals. Various researchers have highlighted the short- and long-term symptomatology associated with survivors of CSA. However, the varied and sometimes ambiguous literature on the symptom presentation associated with survivors of CSA can make it difficult for clinicians and researchers to assess and effectively treat clients. More concrete detail about the symptom presentations of CSA survivors will be beneficial to assessment, diagnosis and treatment-planning with these individuals. Research expressly focusing on PTSD and common co-occurring diagnoses among CSA survivors is sparse. Therefore, the purpose of this study was to determine the frequency of certain psychiatric disorders co-occurring with PTSD in a treatment-seeking sample of women reporting a history of CSA. Since the sample included women meeting criteria for PTSD, the relationship between PTSD severity and other disorders also was examined.
Prevalence rates of child sexual abuse (CSA) in the United States emphasize the importance of focusing on common symptom responses and diagnostic considerations for these individuals. Various researchers have highlighted the short- and long-term symptomatology associated with survivors of CSA. However, the varied and sometimes ambiguous literature on the symptom presentation associated with survivors of CSA can make it difficult for clinicians and researchers to assess and effectively treat clients. More concrete detail about the symptom presentations of CSA survivors will be beneficial to assessment, diagnosis and treatment-planning with these individuals. Research expressly focusing on PTSD and common co-occurring diagnoses among CSA survivors is sparse. Therefore, the purpose of this study was to determine the frequency of certain psychiatric disorders co-occurring with PTSD in a treatment-seeking sample of women reporting a history of CSA. Since the sample included women meeting criteria for PTSD, the relationship between PTSD severity and other disorders also was examined.
Subject terms:
post traumatic stress disorder, psychiatry, survivors, women, child abuse, child sexual abuse, diagnosis, comorbidity;