Interpersonal violence is a common type of trauma experienced by people with opioid use disorder (OUD), especially for people with co-occurring OUD and mental illness (COD). However, little is known about demographic and clinical characteristics of individuals with COD who have experienced an interpersonal violence traumatic event compared to those who have experienced a non-violent trauma, and how experiences of interpersonal violence are associated with treatment utilization. Data presented are from a randomized clinical trial testing collaborative care for COD in primary care. Of the 797 patients enrolled in the larger study, 733 (92%) were included in this analysis because they reported a traumatic event. In this sample, 301 (41%) participants experienced a traumatic event involving interpersonal violence. Participants who experienced interpersonal violence were more likely to be younger and female. Among the 301 people who experienced interpersonal violence, 30% experienced child sexual abuse, 23% experienced physical violence, 19% experienced domestic violence, and 28% experienced sexual assault. Those who experienced physical violence were significantly less likely to be female (28.6% vs 74.2% to 88.2% in other groups). Those who reported domestic violence had significantly fewer days of drug use (4.1 days vs 9.0 to 11.5 in the other groups) and lower opioid use severity scores (mean = 13.0 vs 16.6 to 19.5 in the other groups). Multivariable regression results examining the associations between interpersonal violence experiences on treatment utilization revealed no statistically significant differences. Rates of receipt were high for medication for opioid use disorder (∼80%) in this sample while rates of mental health counseling were around 35% and rates of receiving mental health medication around 48%. These findings make an important contribution to understanding the associations between patient characteristics and traumatic experiences, and receipt of treatment for OUD and mental health problems among a sample of patients with COD.
UNASSIGNED: clinicalTrials.gov ID: NCT04559893.

In Asia, rates of interpersonal violence are increasing, with significant regional disparities. However, long-term, continental-scale research considering regional differences across the Asia regions is limited. Guided by the ecological model, we examined five ecological risk factors (low life satisfaction/happiness, economic hardship, neighborhood disadvantage, patriarchal values, and religiosity) associated with perceptions of justification of interpersonal violence (i.e., intimate partner violence [IPV] against wife, child physical abuse, and violence against others) in five regions in Asia (i.e., East, West, Central, South, and Southeast). Using the World Values Survey (n = 32,307), a multigroup multiple regression model was used with robust maximum likelihood estimation using Mplus ver. 8. In the entire Asia sample model, perceptions of justifiability of IPV against wife were positively associated with low life satisfaction/happiness; economic hardship; neighborhood disadvantage; and patriarchal values, while they were negatively associated with religiosity. Perceptions of justifiability of child abuse were positively associated with low life satisfaction/happiness; neighborhood disadvantage; and patriarchal values, while they were negatively associated with economic hardship and religiosity. Perceptions of justifiability of violence against others were positively associated with economic hardship and neighborhood disadvantage, while they were negatively associated with religiosity. Each region presented unique risk factor associations. Considering the high rates of interpersonal violence in Asia, understanding the risk factors associated with perceptions of justifying specific types of interpersonal violence can provide an initial insight into preventing violence in Asia. Further, as many Asians dwelling outside Asian regions are still influenced by their culture, religion, language, and norms of the region of origin, the study findings may shed light on future studies to consider in the interpersonal violence literature.

Women veterans (WVs) are more likely than men veterans to experience traumatic brain injury (TBI) from causes unrelated to deployment. Yet, current Veterans Health Administration (VHA) TBI screening focuses on deployment. This study examines the utility of the VHA TBI screening tool for WVs. Using the Boston Assessment for TBI-Lifetime (BAT-L) as the gold standard, sensitivity and specificity of the VHA screen were identified for deployment and non-deployment injuries. Injuries missed by the screen were thematically described. Sensitivity and specificity were compared by context (research, clinical). Ninety WVs were included; fifty-three (60.9%) met TBI criteria per the BAT-L. For TBIs occurring during deployment, sensitivity was higher in research (89.1%) compared to clinics (61.7%); specificity was lower in research (60.7%) compared to clinics (93.0%). The BAT-L identified 27 non-deployment TBIs not captured by the VHA screen, most frequently from physical assault or sports. The VHA screen does not include non-deployment events; thus, non-deployment sensitivity and specificity could not be calculated. For lifetime TBIs (deployment + non-deployment etiologies), sensitivity was higher in research (73.5%) compared to clinics (48.9%). Specificity was lower in research (60.0%) compared to clinics (100.0%). Findings can inform improvements to TBI screening among WVs, including expansion for interpersonal violence.

Individuals with serious mental illnesses (SMIs) face safety risks related to their mental health conditions that are often compounded by experiences of trauma, victimization, residence in impoverished neighborhoods, and histories of homelessness. Stigma and safety challenges significantly impact community integration for individuals with SMIs, particularly women, who often bear a disproportionate burden of vulnerability, gender-based stigma, violence, and other inequalities. This study investigates how women with SMIs engage in the meaning-making of their safety and stigma experiences that, in turn, influence their community integration. From a large multi-site study exploring community experiences of racially/ethnically diverse participants with SMIs, a subsample of 28 cis and trans-gender women, who reported experiencing gendered stigma and a lack of safety, were chosen for the current study. The interviews were analyzed using modified principles of Interpretive Phenomenological Analysis (IPA) to understand how women with SMIs made meaning of their safety and stigma encounters in their families, communities, and neighborhoods. IPA analysis resulted in the emergence of themes within a broad category of safety that represented participants\' meaning-making about their physical safety and stigma experiences. Specifically, we used the broad themes from an existing framework of safety called \'Navigating Safety\' model as sensitizing concepts for our analysis. Physical and psychological aspects of safety for this study were experienced in tandem whereby the women made sense of how their experiences of a lack of physical safety in multiple contexts shaped their sense of self, internalized stigma, and their social relationships. Within the broad theme of physical safety, participants described unsafe neighborhoods, exposure to domestic and intimate partner violence, and vulnerability to sexual violence. Additionally, under psychological safety, we identified how gender-based norms, race and ethnicity, sources of stigma (internalized, familial, and societal), and social isolation contributed to their mental health and social relationships (particularly with family). These findings highlight how the compounding influence of the intersection of multiple stigmatized identities exerts safety challenges on the lives and community experiences of women with SMIs. Focusing on access and affordability of appropriate gender-responsive resources for women, including trauma-informed care, could reduce hospitalizations, mental health symptoms, and stigma so they can safely integrate into their communities.

BACKGROUND: Injuries account for a major portion of disability-adjusted life years in children globally, and low-and middle-income countries are disproportionally affected. While injuries due to motor vehicle collisions and self-harm have been well-characterized in pediatric populations in South Africa, injuries related to interpersonal violence (IPV) are less understood. Our study aims to characterize patterns of injury, management, and outcomes for pediatric patients presenting with IPV-related injuries in a South African trauma center.
METHODS: We performed a retrospective review of trauma patients ≤18 y of age presenting to the Pietermaritzburg Metropolitan Trauma Service in Gray\'s Hospital in South Africa from 2012 to 2022, comparing those with injuries resulting from IPV to those with non-IPV injuries. Patients\' and injury pattern characteristics and outcomes were descriptively analyzed.
RESULTS: Out of 2155 trauma admissions, 500 (23.2%) had IPV-related injuries. Among patients with IPV-related injuries, the median age was 16.0 y. 407 (81.4%) patients were male. 271 (54.2%) patients experienced blunt trauma, 221 (44.2%) had penetrating trauma, and 3 (0.6%) suffered both. The most common weapons were knives (21.6%), stones (11.2%), and firearms (11.0%). The most commonly injured regions were the head (56.4%), abdomen (20.8%), and thorax (19.2%). 19.6% underwent surgical intervention, and 14.4% were referred out for subspecialty care. 1.4% patients died, and 1.2% returned to Pietermaritzburg Metropolitan Trauma Service within 30 d of discharge.
CONCLUSIONS: IPV patients are a distinctive subgroup of pediatric trauma patients with different demographics, patterns of injury, and clinical needs. Further research is needed to better understand the unique needs of this neglected population.

UNASSIGNED: Surgical management of firearm-related spinal cord injury (SCI) remains controversial, and there are no clear guidelines. Time to surgery, surgical indications, and patient characteristics on initial presentation in this group are not well understood, and these factors may impact the potential for neurologic recovery after operative intervention.
UNASSIGNED: To understand the timing and factors affecting the timing of operative intervention after firearm-related SCI.
UNASSIGNED: In a retrospective cohort study, patients with traumatic SCI from July 2012 to July 2022 (n = 1569) were identified from our level 1 trauma center Trauma Registry. Data was obtained from the trauma registry and chart review. Rates and timing of surgical intervention, initial injury severity measures, and general hospital outcomes were compared between firearm-related SCI and blunt trauma SCI.
UNASSIGNED: Patients with firearm-related SCI were less likely to undergo surgery compared to other etiologies (24.3% vs. 70.2%, P < 0.0001). Time to surgery for firearm-related SCI was longer than for other etiologies (49.2 ± 92.9 vs. 30.6 h ± 46.0, P = 0.012). Multiple measures of initial injury severity, including Injury Severity Score, Glasgow Coma Score, and emergency department disposition demonstrated more severe injury among patients with firearm-related SCI, and these patients often required other emergent surgeries prior to spine surgery (52%).
UNASSIGNED: There was a longer time to spine surgery among patients with firearm-related SCI compared to blunt trauma SCI, and patients with firearm-related SCI were more severely injured on initial presentation. Further research is needed to understand the complex relationship between patient injury severity, surgical intervention, surgical timing, and outcomes after firearm-related SCI.

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BACKGROUND: The pervasive use of technology, especially among adolescents, has enabled cyber communication and brought many advantages but also led to potential violence. The issue of cyber interpersonal violence (CIV) impacting young individuals is increasingly recognized as a matter of public health; however, little is known about adolescents\' perspectives of the phenomenon. This study explores adolescents\' perspectives on CIV. It seeks to understand their interpretations of abuse, victim impact and reactions, violence escalation, gender issues, victimization and perpetration patterns, and bystander roles.
METHODS: This qualitative study used fifteen focus groups to gather elementary school participants\' perspectives on cyber interpersonal violence. From four Portuguese schools, 108 participants (M = 12.87 and SD = 0.31) participated in the study. A thematic analysis uncovered three themes. The results evidenced adolescents\' perspectives about CIV. Due to the amount of time spent online, adolescents regularly encounter cyber harassment and recognize the importance of help-seeking. Mental health problems and their influence on the social and educational lives of adolescents is arising as a CIV problem.
CONCLUSIONS: Parents play a crucial role in mitigating CIV as well as bystanders. Future programs should promote healthy relationships, raise CIV awareness, involve stakeholders, guide parents, integrate perpetrators into programs, and foster effective networking.

BACKGROUND: Interpersonal violence is a significant contributor to global morbidity, and affects young adults, particularly males. In Kenya, injuries, including those from interpersonal violence, are a leading cause of emergency department (ED) visits.
OBJECTIVE: This study aims to evaluate the frequency, demographics, and types of injuries caused by interpersonal and intimate partner violence among patients presenting to the Kenyatta National Hospital (KNH) ED in Nairobi, Kenya.
METHODS: This was a prospective cross-sectional study among injured adult patients presenting to the KNH ED.
RESULTS: Of 665 enrolled patients, 82% identified as male and the median age was 30 years. Among enrollees, 257 (39%) reported ever having experienced physical, sexual, and/or emotional violence. Seventy-one patients reported a history of intimate partner violence; more than half had experienced intimate partner violence within the past 12 months.
CONCLUSIONS: Research on interpersonal injuries in ED settings is lacking, but data from a single Kenyan ED reveals a significant portion of injured patients with a history of interpersonal and intimate partner violence.

The present study offers novel insight into the topic of experienced and observed emotional abuse by researching factors that affect athletes\' responses to emotional abuse by coaches. The research aimed to explore three main questions: (1) whether athletic identity was associated with the prevalence of emotionally abusive coaching practices, and (2) disclosure of emotional abuse, and (3) whether demographic variations existed in the frequency of emotional abuse, athletic identity, and disclosure of the abuse. Study participants who filled in an anonymous digital survey consisted of athletes from elite to leisure levels living in Finland (N = 3687, aged 12-80, gender 61% female, 37.7% male, 0.8% other genders). The research findings highlighted three key insights. Firstly, Pearson correlations revealed that a salient athletic identity was related to a higher prevalence of emotional abuse. Secondly, ANOVA/Kruskal-Wallis tests between-groups indicated that particularly children were susceptible to the abuse. Thirdly, a mediation analysis showed that self-identity (aspect of athletic identity) influenced the relationship between experienced emotional abuse and disclosure, by reducing disclosure. As a result, holistic identity development is recommended for athletes and particularly children in sports.