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.
Intimate partner violence (IPV) impacts health in several ways. Previous research on IPV focused primarily on cisgender women and their abusive male partners. A focus on cisgender women as victims of IPV resulted in a decreased understanding of and services for gender and sexual minority (GSM) individuals. The focus on cisgender women as victims in IPV led to an association with heterosexual relationships, where women are victims and men perpetrators. This historical link between IPV and gender is problematic. This chapter highlights important issues surrounding IPV among GSM individuals. It addresses primary lesbian, gay, bisexual and transgender subgroup separately to demonstrate the specific and important characteristics of each group in relation to IPV. The chapter presents a case study of Juan to demonstrate issues related to IPV among Latino sexual minority men. It ends with best practices of community-based organizations and recommendations to provide services for GSM individuals experiencing IPV.
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.
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.
A major focus of both realist evaluation and realist review is the construction of middle range theories (MRTs). Pawson describes realist reviews and evaluations as revealing context-mechanism-outcome (CMO) configurations. The realist approach to systematic review and evaluation acknowledges that the effects of interventions, such as programs and policies, are crucially dependent on context and implementation. As a result, the realist review approach is useful for not just identifying whether a program works but more important, identifying “how” and “why” it works. This chapter reviews example for intimate partner violence (IPV) screening programs in health care settings. Similar to a realist approach to systematic review, a realist approach to evaluation is particularly suitable for interventions that address complex health problems with many contributing factors. The chapter presents example for a realist evaluation of a youth engagement tobacco use prevention initiative. The realist approach offers many strengths to community public health research.
Within the field of community health, concept mapping has been used successfully with diverse groups of stakeholders, ranging from adolescent school children to health care providers to community neighborhood residents; it has also been used to address a variety of community health topics, ranging from pregnancy outcomes to school violence. Concept mapping is a process that traditionally involves six steps: preparation, generation, structuring, representation, interpretation, and utilization. This chapter provides the process and guidance related to how concept mapping can be used in person with participants. It also presents an illustrative example of food access that is a multifaceted public health concern that, like many other complex public health problems, requires a social ecological approach to be successfully addressed. Concept mapping is a method that bridges the strengths of qualitative and quantitative techniques to generate hypotheses and theory around complex public health topics.