_________________________________________________________________ Domestic and Sexual Violence
PEOPLE WITH PHYSICAL AND/OR COGNITIVE DISABILITIES Research indicates that disability predicts recent intimate partner violence victimization in both men and women [85]. National data indicate that women with a disability are signifi- cantly more likely to report experiencing every form of intimate partner violence, including rape, other sexual violence, physical violence, stalking, psychological aggression, and control of reproductive or sexual health [85]. Stalking and psychological aggression by an intimate partner are more likely in men with disabilities. Women with disabilities are 3.3 times more likely to be raped [36]. Most perpetrators are acquaintances of the victim [86]. The type of disability may also be an indicator or risk. In a national sample of victims of sexual assault who were disabled, the majority (60.5%) had a psychiatric disability and 25% had an intellectual/developmental disability; the smallest percentage (15.6%) had physical/sensory disabilities [86]. People with intellectual disabilities are sexually assaulted at a rate seven times higher than those without disabilities [87]. A survey study found that individuals with autism were more likely to have experienced physical and sexual violence when they were children, and they were not likely to have disclosed the incidence(s) [88]. Although persons with disabilities are more likely to be victim- ized, it can be difficult for them to seek and obtain help. Legal action was taken in only 13.6% of cases [86]. Differently able individuals may be less likely to be believed when they report abuse or may be unable to effectively communicate their experi- ences [89]. Police and prosecutors are often reluctant to take these cases because they are difficult to win in court [87]. In addition, there is a lack of coordinated community services and supports for disabled survivors of sexual assault [86]. PEOPLE WITH BEHAVIORAL HEALTH PROBLEMS Behavioral health problems, including substance use disor- ders, eating disorders, and compulsive behaviors, commonly co-occur with intimate partner violence and sexual violence. Substance abuse co-occurs in 20% to 57% of IPV incidents, with several lines of evidence suggesting that substance use/ abuse plays a facilitative role in IPV by precipitating or exacer- bating violence [90; 91; 92]. Both victims and abusers are 11 times more likely to be involved in domestic violence incidents on days of heavy substance use [93; 94]. Opioid misuse and intimate partner violence are correlated; women who have experienced IPV and sexual violence are more likely to use opioids [95]. It is unclear if substance abuse precedes the violence, or vice versa. However, victimization is considered a positive risk factor for substance use disorders, and women in abusive relation- ships have often reported being coerced into using alcohol and/or drugs by their partners [90; 91; 92].
Women with a history of eating disorders are also at increased risk for intimate partner violence [96]. In a study of under- graduate women, recent (i.e., last three months) sexual assault was associated with more severe eating disorder symptoms [97; 98]. In another study, eating disorders were significantly correlated with lifetime intimate partner violence, PTSD, and depression among female participants [99].
CHILDREN AND ADOLESCENTS Dating Violence
Factors related to the perpetration of dating violence among young adults include witnessing interparental violence, experi- encing child abuse, alcohol abuse, adherence to traditional gen- der roles, and relationship power dynamic issues [100]. Female perpetrators are more likely than men to display internalizing symptoms (e.g., depression), trait anger and hostility, and to be victims of past dating violence; young male perpetrators are more likely than women to report lower socioeconomic status and educational attainment, antisocial personality character- istics, and increased relationship length [100]. Cyberdating abuse or violence refers to abusive behaviors perpetrated using technology that occur in the dating con- text. In general, the control tactics are similar regardless of whether technology is involved [101]. Forms of sexual cyber abuse include sending unwanted sexual content, pressuring someone to send nude photos, and using technology to engage in sexual encounters [101]. Technologically mediated sexual violence can predict real-life violence. In fact, sexting has been identified as a unique risk factor for dating violence in young adulthood [102]. Young women are more likely than men to experience dating violence, as is the case among most subgroups. However, non- sexual violence in dating relationships is more likely to involve the reciprocal use of violence by both partners (mutual aggres- sion) than adult abusive relationships [103]. Additional risk factors for dating violence include low self-esteem, substance use disorder, depression, isolation, pornography use, and hooking up for sex [75]. Sexual Assault In contrast to sexual victimization of adolescents and adults, who usually present in the aftermath of an assault, pre-pubertal victimization of children tends to be “discovered” when the child is found to have signs of physical or sexual abuse (e.g. genital injury or scarring) or when a sexually transmissible infectious agent is identified. Gonorrhea, syphilis, and HIV (not linked to prior blood transfusion or maternofetal transmis- sion) acquired during the postnatal period of childhood are indicative of sexual abuse. Chlamydia infection might be indica- tive of sexual abuse in children 3 years of age of older. Sexual abuse should be suspected when genital herpes, Trichomonas vaginalis , or anogenital warts are diagnosed [37]. In cases in which any STD has been diagnosed in a child, further evalu- ation for other STDs and for the possibility of sexual assault/ abuse should be made in consultation with a specialist.
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MDCT2026
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