This chapter defines emerging disabilities; explores medical, psychosocial, and vocational implications of emerging disabilities that distinguish them from traditional disabilities; and provides demographic characteristics of individuals who are most vulnerable to acquiring emerging disabilities. It examines some social and environmental trends that have contributed to the development of emerging patterns and types of disabilities including advances in medicine and assistive technology, globalization, climate change, poverty, violence and trauma, the aging American populace, and disability legislation. Psychological and physical trauma from warfare, violent crime, intimate partner violence, and youth violence can result in permanent physical, cognitive, and psychiatric disabilities. Diagnostic uncertainties, misdiagnoses, and skepticism on the part of medical providers are frequently associated with emerging disabilities. Women also represent a population that is at an increased risk of acquiring emerging disabilities and chronic illnesses. Rehabilitation systems are still not fully prepared to address the multifaceted needs of individuals with emerging disabilities.
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This chapter discusses various types of violence and their impact on human health, functioning, and onset of physical and psychiatric disabilities, and identifies approaches and programs for treating individuals who have sustained disabilities from violent acts. It examines populations that are most vulnerable to violence, and explores trauma-informed approaches to providing services to these clients in all phases of the rehabilitation counseling process. Military sexual trauma (MST) is heavily confounded by military culture, making the decision to report sexual trauma extremely difficult. The functional limitations associated with disabilities acquired through violence can substantially impair survivor’s ability to achieve and maintain competitive employment. Outreach may be particularly necessary to inform individuals with violence-related disabilities about rehabilitation services. Frain et al. emphasized the importance of training in self-management techniques for veterans because they tend to have poor self-management skills.
This chapter discusses how the criminal justice system treats battered women over the past 40 years. In the United States, advocates who began working with battered women in the 1980s believed that the most important step to end threats of violence was to punish the batterer and hold him accountable for his misconduct. To do this the legal system had to be encouraged to take action whenever domestic violence was raised. A study of the needs for victims of intimate partner violence commissioned for the Colorado legislature found that over two thirds of the women in prison stated that they had been abuse victims. Other areas of the civil rights laws have also been used to better protect battered women. The gender bias, including sexism and racism, for women coming before the criminal justice system continues to make it difficult for women to seek safety and protection.
Attachment theory provides a rich conceptual framework for understanding issues that arise in intimate partner violence (IPV) that have not been well studied in adults. Attachment was initially conceived as a neurobiological-based need for the purpose of safety and survival. Moreover, through the attachment process individuals develop an internalized set of beliefs about the self and others, known as “internal working models”. In adult relationships, attachment processes are activated by way of a cognitive-affective-behavioral triad. Woman who engage in the commercial sex industry have a much higher risk of contracting a sexually transmitted disease. An interesting phenomenon that ties use of pornography on the Internet together with the sexual abuse of women and children has been found in the legal community. It is known that early sexualization of children may cause interpersonal difficulties that may make it more difficult to recognize the cycle of violence engaged in by the batterer.
The US Centers for Disease Control and Prevention (CDC) has conducted studies about adverse health conditions and health risk behaviors in those who have experienced intimate partner violence (IPV). The high numbers of women who report childhood abuse and IPV and receive no assistance in healing from the psychological effects obviously will be seen in medical clinics, often too late to stop a disease process that might have been prevented had their posttraumatic stress disorder (PTSD) responses been dealt with earlier. One of the most negative and lasting effects of IPV on women appears to be the impact on the women’s body image, which is related to their self-esteem. Although the health care system has attempted to deal with battered women, in fact both the structure and function are not set up to be helpful, especially when chronic illnesses are exacerbated by environmental stressors such as living with domestic violence.
Women have unique biopsychosocial factors that make them more vulnerable to mental illness. Many of these mental illnesses can elicit enormous physical, emotional, financial, and social barriers. This is books serves as a quick-access clinical guide to the range of mental health issues and diagnoses that commonly affect women across the life span. The book is divided into four sections. The first section deals with the role of cultural competence in mental health and the various types of violence such as sexual assault, rape and stalking perpetrated on women. It emphasizes key stressors specific to women that are precursors to mental illness. The second section looks at the mental disorders affecting special populations among women including girl children and adolescent females, and aged women. Disorders for other unique populations such as disabled women, lesbian and transgendered women, female veterans, women with forensic health concerns, and women who have been the object of violence are also discussed here. In the third section, chapters address childbearing issues, including menstruation-related problems, infertility and its psychological implications, and antepartum, intrapartum, and postpartum psychological disorders. The final section of the book is devoted to the discussion of the various psychiatric issues common to women: anxiety disorders; mood disorders; eating disorders; personality disorders; psychotic disorders; sleep disorders; substance abuse disorders; grief and loss; schizophrenia; and sexual dysfunction.
Family violence, including physical and sexual abuse of a child, child neglect and maltreatment, intimate partner violence (IPV), and elder abuse, affects 2.1 per 1,000 victims annually. Women who are victimized by stalkers experience long-term chronic stress as a result. Homicide is the leading cause of death for Black women aged 18 45. Victims of IPV suffer physical, psychological, and behavioral adverse effects as a direct result of abuse. Abused women are continually exposed to physical and psychological stressors within their daily lives, and behavioral consequences such as substance use and abuse result. IPV during pregnancy can result in spontaneous abortion, preterm labor, premature birth, injury to the fetus, and fetal death. Elder abuse, much like IPV, occurs across all races, ethnic groups, socioeconomic groups, and cultures. Sexual abuse warrants immediate transfer to a sexual assault nurse examiner (SANE) or forensic examiner for a detailed forensic sexual assault examination.
This chapter analyzes the murder-suicide cases through a review of the newspaper reports of murder-suicides in the five major regions of the state of Florida. Guns in the home are the predominant weapons used in the murder-suicides in the United States. In countries where guns are not as accessible in the home, such as Great Britain, there is a lower murder and suicide rate. Jacqueline Campbell suggests that domestic violence is implicated in premature deaths of women from aggravated health conditions such as strokes, heart attacks, and other major illnesses that occur after being choked or strangled. The chapter also presents some murder-suicide case and self-defense case studies of women such as Ed and Linda, Nancy Kissell, Catherine Pileggi and Nellie Mae Madison. A recent study in Chicago offered some new information about the neuropsychological profile of men who killed an intimate partner as compared to those who kill others.
Battered women themselves are terrified about being labeled with a mental illness especially since so many are threatened into silence by their batterers who tell them that everyone will think they are “crazy”. While health service providers are now better trained in identification of both health and mental health needs of battered women and their children, there is still little understanding of what to do after identification. The Public Health Model for community distribution of health and mental health services may be a way to conceptualize all of the health services that battered women need to have in place for both prevention and intervention. The legal system also contributes to the primary prevention and intervention with women who are victims of intimate partner violence. Secondary prevention programs attempt to use the early identification of domestic violence victims as a way to prevent the development of further psychological and physical injuries.
This chapter discusses the agents and processes of gender socialization. Gender can differentially impact “susceptibility and exposure to mental health risks and mental health outcomes” and “deepen disparities associated with important socioeconomic determinants such as income, employment, and social position”. Social learning theorists describe socialization as a result of rewards and punishment for gender-appropriate behavior and vicarious learning through observation and modeling. Primary socialization, occurring in infancy and childhood, is the initial process of learning the ways of a society or group. Four most studied agents of socialization are family, peers, education, and media. Gender roles and stereotypes adversely impact women’s ability to achieve equal representation in some of the more influential leadership positions in society. Violence against women takes many forms including intimate partner violence, sexual assault, and sex trafficking. The division of household labor is a clear example of the feminist tenet that the personal is political.