Impact of Screening for Sexual Trauma in a Gynecologic Oncology Setting

2021 ◽  
pp. 1-7
Author(s):  
Mary E. Gordinier ◽  
Lisa B.E. Shields ◽  
Mary Helen Davis ◽  
Sibyl Cagata ◽  
Douglas J. Lorenz
Keyword(s):  
Sexual Abuse ◽  
Partner Violence ◽  
Sexual Trauma ◽  
Gynecologic Oncology ◽  
Economic Effects ◽  
Cancer Type ◽  
Trauma History ◽  
History Of ◽  
Behavioral Oncology ◽  
The Impact

<b><i>Objectives:</i></b> Sexual trauma poses a significant concern and is associated with heightened stress, negative health repercussions, and adverse economic effects. A history of abuse may increase a woman’s risk of developing cancer, in particular cervical cancer. We analyzed the impact of screening for sexual abuse in a gynecologic oncology population. <b><i>Methods:</i></b> Patients were screened for sexual trauma in a gynecologic oncology clinic over 5 and a half years (April 1, 2011, to September 30, 2016) in this cohort study. The screening questions were selected by behavioral oncology physicians and integrated into the gynecologic history component of the new patient assessment. Patients who screened positive for a history of sexual abuse or intimate partner violence were offered a behavioral oncology referral. Providers were also questioned about the effect of screening on their practice. <b><i>Results:</i></b> Of the 1,423 consecutive patients screened for sexual trauma, a total of 164 patients (12%) disclosed a history of sexual abuse. Of the 133 patients who specified their age at the sexual trauma, the majority (107 [80%]) responded that they were a young child or early teen. Most patients (92%) declined counseling. Among individuals presenting with cancer, the distribution of cancer type was statistically different between those patients with and without a sexual trauma history (<i>p</i> = 0.0001). <b><i>Conclusion:</i></b> Screening for sexual trauma in a gynecologic oncologic population serves as a valuable opportunity to uncover a history of abuse that may increase a woman’s susceptibility to cancer. This study demonstrates that screening for sexual abuse in a gynecologic oncology setting may be integrated into new patient interviews with minimal disruption. Identification of an undisclosed sexual trauma history allows for an opportunity to offer counseling and minimize the emotional distress that may be precipitated by treatment and exams.

Is there a Relationship between Sexual Abuse or Incest and Eating Disorders?

1986 ◽  
Vol 31 (7) ◽  
pp. 656-660 ◽  
Author(s):  
G. Sloan ◽  
P. Leichner
Keyword(s):  
Eating Disorders ◽  
Sexual Abuse ◽  
Anorexia Nervosa ◽  
Childhood Sexual Abuse ◽  
Present Article ◽  
Sexual Trauma ◽  
Early History ◽  
Eating Disordered ◽  
Sexual Conflicts ◽  
History Of

The significance of sexual conflicts in many patients with eating disorders has been well documented. However, even when these have been considered to have some degree of etiological importance, the occurrence of actual sexual trauma or incest in the early lives of these patients has been generally neglected in the literature. At one point in time, it was noted that five of six patients on an inpatient unit for eating disorders revealed an early history of sexual abuse or incest. These five cases are described. A parallel is drawn between the psychological problems experienced by victims of childhood sexual abuse and by patients with anorexia nervosa and/or bulimia. Our suspicion that these experiences may not be atypical led to the present article, which has implications for the investigation and management of eating-disordered patients.

Prospective correlation between clinical and pathologic criteria identification of Lynch syndrome (LS) in endometrial carcinoma (EC) patients and relapse.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1543-1543
Author(s):  
Ignacio Romero ◽  
Zaida Garcia-Casado ◽  
Pedro Martinez ◽  
Carmen Illueca ◽  
Cristina Zorrero ◽  
...  
Keyword(s):  
Gynecologic Oncology ◽  
Gene Mutations ◽  
Type I ◽  
Braf Mutations ◽  
Curative Intent ◽  
Msh6 Mutation ◽  
Prospective Comparison ◽  
History Of ◽  
Complete Sequencing ◽  
The Impact

1543 Background: Prospective comparison of different methods for recognition of LS associated EC is lacking. Microsatellite instability (MSI) has been observed to be inconsistent as a prognostic factor in EC. The aim of this study was to analyze the impact of MSI and Mismatch Repair (MMR)-deficiency on LS identification and prognosis in a prospective series of EC treated in one single institution. Methods: Consecutive and prospective EC patients were included. Clinical data, family history of cancer and criteria for LS were evaluated. MSI and MMR protein expression were performed. When loss of MMR proteins and/or high MSI (MSI-H) was observed, complete sequencing and large genomic rearrangement analysis of germline MLH1, MSH2, MSH6 or PMS2 was done once MLH1 methylation was excluded. Results: Seventy-seven women diagnosed with EC were enrolled from 2009 to 2012 with a median age of 62 (31-87), 84% histological type I, 16% type II and FIGO stages I 83%, II 2.8%, III-IVA 7% and IVB 7%. Among which, 6.6% fulfilled revised Bethesda criteria (rBC), 5.3% criteria defined by the Society Gynecologic Oncology (>20%-to-25% risk of LS) (SGO) and 5.3% Amsterdam II criteria (AII). Seventy-four underwent surgery with curative-intent. Tumor tissue was unavailable in 5 cases for molecular analysis. MSI-H was observed in16 cases (22%) and 18 (24%) had loss of expression of MLH1 (14), MSH2 (2), MSH6 (1) or PMS2 (1). Nine MLH1 hypermethylation, 10 K-RAS and no BRAF mutations were identified. Four (5.5%) pathogenic MMR germline mutations were recognized: 2 MSH2, one MSH6 and one PMS2. One patient (25%) with MSH6 mutation did not fulfil rBC, SGO nor AII criteria and was identified both by MSI-H and loss of MSH6 expression. Median follow-up was 23.4 (0.2-76.3) months. No correlation between MSI-H, MMR gene mutation and relapse was observed in stage I-IVA EC. Conclusions: Based on these results, rBC, AII and SGO criteria for identification of LS in EC do not identify 25% of germline MMR gene mutations. No correlation with relapse and MSI-H could be identified.

Resolution of Depression Among Victims of Intimate Partner Violence: Is Cessation of Violence Enough?

2003 ◽  
Vol 18 (2) ◽  
pp. 115-129 ◽  
Author(s):  
Mary A. Kernic ◽  
Victoria L. Holt ◽  
Julie A. Stoner ◽  
Marsha E. Wolf ◽  
Frederick P. Rivara
Keyword(s):  
Sexual Abuse ◽  
Intimate Partner Violence ◽  
Partner Violence ◽  
Generalized Estimating Equations ◽  
Psychological Abuse ◽  
Intimate Partner ◽  
Relative Risks ◽  
Prevalence Of Depression ◽  
History Of

The objective of this article is to assess the effect of abuse cessation on depressive symptoms among women abused by a male intimate partner. This prospective cohort study of Seattle women with a history of intimate partner violence (IPV) who were classified by history of abuse and abuse status at 3 month, 9 month, and 2 year follow-up interviews. Relative risks (RR) were calculated using generalized estimating equations. Among subjects with a history of psychological abuse only, cessation of abuse was associated with a nonsignificant reduction in the likelihood of depression compared to subjects whose abuse continued (aRR = 0.88; 95%CI: 0.75,1.03). Among subjects with a history of physical/sexual abuse and psychological abuse, cessation of physical/sexual abuse only was associated with a 27% decline, and cessation of both types of abuse was associated with a 35% decline in the likelihood of depression (aRR = 0.73, 95%CI: 0.63,0.86; and aRR = 0.65; 95%CI: 0.55,0.76; respectively). Cessation of abuse among victims of IPV is associated with a decreased prevalence of depression.

scholarly journals The Impact of a History of Sexual Abuse on Health: Data from a Self-Reported Questionnaire from a Sample of French Victims

2017 ◽  
Vol 05 (06) ◽  
Author(s):  
Jean Louis Thomas ◽  
Violaine Guerin ◽  
Pierre Levy ◽  
Maria Carette ◽  
Nathalie Regensberg de Andreis ◽  
...  
Keyword(s):  
Sexual Abuse ◽  
Health Data ◽  
History Of ◽  
The Impact

scholarly journals A Clinical Rationale for Assessing the Impact of Childhood Sexual Abuse on Adjunctive Subcutaneous Esketamine for Treatment-Resistant Depression

2021 ◽  
Vol 12 ◽  
Author(s):  
Eduardo Jorge Muniz Magalhães ◽  
Luciana Maria Sarin ◽  
Lorena Catarina Del Sant ◽  
Ana Cecília Lucchese ◽  
Carolina Nakahira ◽  
...  
Keyword(s):  
Sexual Abuse ◽  
Adult Population ◽  
Positive Family History ◽  
Poor Response ◽  
Depression Symptom ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
History Of ◽  
Resistant Depression ◽  
The Impact

Background: A history of child sexual abuse (CSA) is related to higher suicide rates and poor treatment outcomes in depressed adult patients. Twenty years after the first study investigating the effects of ketamine/esketamine on depression and suicide, there is a lack of data on the CSA effects on this emerging treatment. Here, we assess the impact of CSA on adjunctive subcutaneous (SC) esketamine for treatment-resistant depression (TRD).Methods: A directed acyclic graphic (DAG) was designed to identify clinical confounders between CSA and esketamine predictors of response. The confounders were applied in a statistical model to predict depression symptom trajectory in a sample of 67 TRD outpatients.Results: The patient sample had a relatively high prevalence rate of CSA (35.82%). Positive family history of first-degree relatives with alcohol use disorder and sex were clinical mediators of the effects of esketamine in a CSA adult population. Overall, the presence of at least one CSA event was unrelated to esketamine symptom reduction.Conclusions: Unlike responses to conventional antidepressants and psychotherapy, CSA does not appear to predict poor response to esketamine.

Behavioral Risk, Emotional Risk, and Child Abuse Among Adolescents in a Nonclinical Setting

PEDIATRICS ◽  
1990 ◽  
Vol 86 (6) ◽  
pp. 896-901
Author(s):  
Roberta A. Hibbard ◽  
Gary M. Ingersoll ◽  
Donald P. Orr
Keyword(s):  
Sexual Abuse ◽  
Problem Behavior ◽  
Problem Behaviors ◽  
Risk Scores ◽  
Behavioral Risk ◽  
Laxative Use ◽  
Increased Risk ◽  
History Of ◽  
Negative Feelings ◽  
The Impact

In this replication study of adolescents in a nonclinical setting, the prevalence of reported problem behaviors, emotions, and abuse is evaluated, and the impact of abuse on multivariate emotional and behavioral risk is assessed. A total of 3998 students (69%) in a rural midwestern community in grades 7 to 12 participated in the study. Almost 20% of the students reported some form of physical and/or sexual abuse, with more girls than boys reporting sexual abuse (χ2 = 48.5, P &lt; .001). Some problem behaviors (alcohol use) and emotions (trouble sleeping, difficulty with anger) were common among all adolescents and some were strongly associated with a history of abuse (especially, considering or attempting suicide, running away, laxative use, and vomiting to lose weight). Higher emotional and behavioral risk scores among abused students were confirmed. The effects of physical and sexual abuse on risk scores were independent and additive; no interaction was observed. An interaction of gender and sexual abuse on problem behavior was observed, with problem behavior being significantly greater among sexually abused bosultss. The reults confirm increased risk of problem behaviors and negative feelings among abused adolescents when compared with nonabused peers, and better define influences of gender and abuse type on emotional and behavioral risks.

Context Matters: Posttraumatic Stress Disorder Symptom Associations With Military Sexual Trauma Event Characteristics and Dual Histories of Interpersonal Trauma

2019 ◽  
Vol 34 (1) ◽  
pp. 69-84 ◽  
Author(s):  
Diana C. Bennett ◽  
Edward J. Thomas ◽  
Katherine E. Porter ◽  
Rachel B. Broman ◽  
Sheila A. M. Rauch ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Partner Violence ◽  
Sexual Trauma ◽  
Stress Disorder ◽  
Military Sexual Trauma ◽  
Phenotypic Differences ◽  
Clinical Presentations ◽  
History Of ◽  
Disorder Symptom

Despite the high rates of military sexual trauma (MST) experienced by service members and veterans, little is known about how contextual features of the MST event or concurrent histories of other interpersonal traumas are associated with diverse clinical presentations. This study examined contextual factors of MST events (number of perpetrators, location of MST, relationship to perpetrator, location of MST) and dual history of interpersonal traumas (including sexual abuse or assault throughout the lifespan, repeated MST, and intimate partner violence) in relation to total symptoms and symptom clusters of Posttraumatic Stress Disorder (PTSD). MST involving multiple perpetrators was related to higher avoidance and hyperarousal. MST while combat-deployed was associated with higher hyperarousal. Veterans endorsing a history of partner violence presented with higher reexperiencing and avoidance. Recognition of phenotypic differences may assist providers in treatment planning and optimizing outcomes.

The Impact of History of Sexual Abuse on Weight Loss in Gastric Bypass Patients

2007 ◽  
Vol 48 (3) ◽  
pp. 270-271 ◽  
Author(s):  
Tomasz Stefaniak ◽  
Dominika Babinska ◽  
Magdalena Trus ◽  
Ad Vingerhoets
Keyword(s):  
Weight Loss ◽  
Sexual Abuse ◽  
Gastric Bypass ◽  
History Of ◽  
The Impact

The Focality of Sexual Trauma and Its Effects on Women’s Symptoms and Self-Perceptions

2019 ◽  
Vol 43 (4) ◽  
pp. 472-484
Author(s):  
Hadar Keshet ◽  
Eva Gilboa-Schechtman
Keyword(s):  
Symptom Severity ◽  
Sexual Trauma ◽  
Trauma Studies ◽  
Self Perception ◽  
Trauma History ◽  
Self Perceptions ◽  
Posttraumatic Symptoms ◽  
History Of ◽  
Trauma Types ◽  
Trauma Type

Sexual trauma is associated with particularly harmful consequences in comparison to other types of trauma. Studies investigating differences between trauma-types usually focus on the most distressing (i.e., main) trauma of each participant and do not consider the cumulative effects of multiple traumas, which many individuals experience. We sought to fill this gap by examining the effects of trauma-type (sexual vs. nonsexual), as well as the focality assigned to the sexual trauma (whether it was perceived as a main vs. background trauma), on symptoms and self-perceptions. Our sample comprised 231 Jewish-Israeli women: 96 with a single trauma-type and 135 with multiple (two to three) trauma-types. Women completed online measures of trauma history, symptoms, and self-perceptions. Women who were exposed to sexual trauma reported greater symptom severity and self-perception impairments than women with a history of nonsexual trauma-type(s). Among women with multiple trauma-types, those with a main sexual trauma reported greater symptom severity and self-perception impairments than women with a background sexual trauma. When controlling for levels of posttraumatic symptoms, differences in self-perceptions ceased to be significant. Our findings highlight the importance of collecting a detailed trauma history, with attention to trauma-centrality, and of addressing various symptoms and self-perceptions among sexual trauma survivors.

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