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When people speak of the Church’s complicity in the abuse crisis, they usually mean particular things that particular officeholders did or failed to do. I. Th. Eschmann’s study of Aquinas’s Scriptum is widely read as ruling out any Thomist account of collective ecclesial responsibility. What Eschmann denies, I argue, is narrower than has been supposed. He denies that the same sin can be imputed uniformly to every member of a community. He does not deny that individuals can be implicated in others’ sins, in differing degrees, by acts of their own. Aquinas sets this out at ST II–II, q. 62, a. 7, where nine ways of sharing in another’s wrong distribute liability across acts and omissions. Modern moral philosophers arrive at something close to this independently, and where they rely on a standard of culpable ignorance without explaining it, Aquinas does. I also point to a limitation: because the taxonomy is centred on acts, it does not reach the complicity Jaspers and May describe, which runs through membership and shared identity.
Domestic violence is a widespread public health problem and a serious human rights violation. It occurs worldwide, across all generations, nationalities, communities and spheres of societies, irrespective of age, ethnicity, disability or other background. Domestic violence victims have a higher risk of post-traumatic stress disorder and suicide. Despite a critical link between domestic violence and mental health, very few such studies exist in Nepal.
Aims
To investigate the association between depressive symptoms and physical, sexual and emotional domestic violence.
Method
A cross-sectional study was conducted among 429 women aged 30–60 years who underwent cervical cancer screening in Dhulikhel and Banepa municipalities, Kavrepalanchowk District, Nepal. Univariate and multivariate logistic regression models were used to assess the association between depressive symptoms and domestic violence and abuse.
Results
Findings suggest 2.99 times (95% CI 1.57–5.67, p = 0.001) higher odds of having depressive symptoms in women experiencing any type of violence. Similarly, the odds of having depressive symptoms were 2.5 times (95% CI 1.26–4.98, p = 0.009) higher in participants who had experienced physical violence and 6.21 times (95% CI 2.49–15.46, p < 0.001) higher among participants who had experienced sexual violence or emotional abuse.
Conclusions
Women experiencing physical, sexual or emotional abuse are more likely to experience depressive symptoms. To better understand the factors contributing to these symptoms, further in-depth and exploratory studies are needed. Community-based interventions are needed to offer counselling, support groups and safe spaces for women affected by violence.
Young children who experience symptoms of posttraumatic stress disorder (PTSD) rely heavily on caregivers for emotional support. Yet, caregivers who are overwhelmed (or “flooded”) by children’s emotional expressions may not provide effective responses, particularly if they also engage in parent-to-child aggression (PCA). Over 12 months, partnered caregivers (N = 448, Mage = 33.80, 52.5% female, 62.7% non-Hispanic White) of a child age 3–5 years who was eligible for Head Start completed surveys and interviews to assess parental emotional flooding, PCA, and children’s trauma exposure and PTSD symptoms. Most children (89%) were exposed to potentially traumatic events, including 74% during the study. Male caregivers’ emotional flooding predicted maintenance of children’s PTSD symptoms over time, regardless of the degree of PCA engaged in. Female caregivers’ emotional flooding predicted maintenance of children’s PTSD symptoms only among those who engaged in high levels of PCA. Caregivers’ experience of emotional flooding may impact children in ways that maintain their PTSD symptoms, including modeling of ineffective emotion regulatory processes or children’s internalization of emotions to avoid negative parenting behaviors. Even at low levels of PCA, men’s emotional flooding may be impactful, potentially via parental withdrawal. Interventions addressing caregivers’ distress when managing children’s PTSD-related emotions are indicated.
This prospective study of young children (M = 11.62 months, SD = 8.28) with prior child welfare contact examined trajectories of exposure to various types of maltreatment (i.e., domestic violence, emotional abuse, sexual abuse, physical abuse, and neglect) as risk factors for children’s psychopathology sequelae. Data were drawn from 1,059 children (52% male, 48% female; 39% White, 28% Hispanic, 27% Black) in the National Survey of Child and Adolescent Well-Being II. Repeated-measures latent class analysis identified four trajectories of child maltreatment exposure: “Stable Low Multi-Type,” “Increasing Emotional–Physical,” “Stable High Emotional–Physical,” and “Stable High Multi-Type.” Maltreatment trajectories significantly predicted internalizing (χ2[3] = 21.89, p < .001) and externalizing symptoms (χ2[3] = 33.04, p < .001). Children in both the “Stable High Multi-Type” trajectory (M = 18.42, SE = 1.05, p < .001) and the “Increasing Emotional–Physical” trajectory (M = 14.61, SE = 0.53, p < .01) exhibited elevated externalizing symptoms. The “Increasing Emotional–Physical” trajectory was associated with elevated internalizing symptoms (M = 13.27, SE = 0.93, p < .001). Findings indicate the need for continuous, comprehensive assessment of maltreatment exposure and underscore the value of early, targeted interventions in enhancing children’s well-being.
Many in the founding generation believed that a virtuous citizenry would protect against abuses of power in a democracy. But their experience during the period of the Articles of Confederation revealed the limits of republican virtue as a check on abuses of power and underscored the challenge of limiting the opportunities for minority and majority factions to impose their will on their fellow citizens.
With the combined experience of an abuse of power by the British monarch and an absence of executive authority under the Articles of Confederation, the Framers faced the challenge of establishing an executive authority of effective, yet limited, powers. It was generally agreed that the role of the executive was limited to the execution of the laws enacted by Congress, but the number of executives, the manner of selection, and length of tenure in office were considered important to restraining factions.
The role of the judiciary as a check on the legislative and executive branches was believed necessary to the effectiveness of the horizontal separation of powers as a check on political factions. The nature of the judicial power was generally agreed to include the power of judicial review, but selection and tenure in office were thought to be important to limiting abuses of power.
A fundamental dilemma in both the radiology reading room as well as the courtroom is whether a potential abusive head or spinal injury may be mistaken for other entities – both pathological processes and also normal anatomical or physiological variants.
A number of differential diagnoses, or mimics, for abusive head trauma may be apparent radiologically, but many may not be. Striving to achieve a medical “diagnosis” of an abusive injury requires the interplay between the radiologist and numerous other clinical specialties. The wide differentials which we discuss include accidental trauma, coagulopathies – both congenital and acquired, metabolic disorders, sepsis and vascular malformations, with all needing to be excluded before reaching a conclusion of nonaccidental trauma.
The experienced radiologist and clinician working in the challenging field of child protection also recognises that it is not always possible to reach a clear-cut decision and learning to communicate levels of uncertainty is essential. Part of this process is to always be alert to diagnostic mimics that may mislead the inexperienced and unwary.
Edited by
Liz McDonald, East London NHS Foundation Trust,Roch Cantwell, Perinatal Mental Health Service and West of Scotland Mother & Baby Unit,Ian Jones, Cardiff University
Millions of women and girls worldwide experience violence. Violence against women and girls takes many forms, including physical, emotional and sexual violence and abuse, which is associated with a range of adverse impacts on women, their families and society as a whole. Health professionals supporting women during the perinatal period should assess the risks posed by exposure to previous or current violence and how this may affect them during pregnancy. As an important risk factor in a woman’s mental health presentation, psychiatrists working with pregnant and postpartum women should consider the presence of violence in their formulation; it can increase the risk of anxiety, depression and post-traumatic stress disorder (PTSD). Domestic violence and abuse increase the risk of domestic homicide and may play a role in many perinatal suicides. Sensitive assessment and effective management of women exposed to violence can improve engagement with mental health services and response to treatment.
This chapter moves from the semi-privacy of homes to the more public arena of urban courts. It looks at the surprising role of the pox in two different kinds of legal cases involving unlawful sex: suits for separation and rape cases. In both types of case, the disease served as a proxy for sex, material evidence of otherwise unprovable acts. Yet its role in court was much more complex than this. Marks of the disease were visible and long-enduring, an early form of medical forensics, and women could talk about the disease more freely than they could talk about sexual matters. Mothers of rape victims could bear witness to the horrifying effects of disease and disgruntled wives could frame their husbands’ abuse as contagion stemming from illicit sex. The disease allowed women to speak the unspeakable. What is more, cases did not rest wholly on women’s words, which were accorded little value in courts. Confirming the existence and transmission of disease called for the allegedly more trustworthy testimony of medical men. The disease centered legal cases about sex on to the words and bodily inspections that the court deemed reliable.
Severe mental disorders (SMDs) impose profound suffering on patients and heavy burdens on family caregivers, often resulting in abusive behaviors. This study aimed to examine the association between psychiatric symptom severity and caregiver abuse, and to assess whether caregiver tobacco dependence moderates this relationship.
Methods
A cross-sectional study included 763 patient–caregiver dyads in rural Shandong, China. Psychiatric symptom severity was measured using the 18-item Brief Psychiatric Rating Scale. Caregiver tobacco dependence was assessed using the Fagerström Test for Nicotine Dependence. Patients reported caregivers’ verbal/physical abuse in the past year. Ordered logistic regression and interaction terms tested associations and moderation.
Results
Overall, 25.7% of caregivers engaged in verbal abuse and 14.9% in physical abuse. Psychiatric symptom severity was significantly associated with both verbal (OR = 1.018, 95% CI: 1.010–1.026) and physical abuse (OR = 1.015, 95% CI: 1.005–1.025). Caregivers with moderate to severe tobacco dependence were more likely to commit verbal (OR = 1.851, 95% CI: 1.136–3.016) and physical abuse (OR = 2.292, 95% CI: 1.287–4.079) than non-smokers. Moderate to severe tobacco dependence significantly amplified the association between psychiatric symptom severity and verbal abuse (interaction OR = 1.024, 95% CI: 1.002–1.046), but not physical abuse.
Conclusion
In rural China, greater psychiatric symptom severity among patients with SMDs is associated with increased frequency of both verbal and physical abuse by caregivers, particularly verbal abuse among those with moderate to severe tobacco dependence, underscoring the need for caregiver-targeted psychological support and tobacco cessation interventions.
This Element analyses issues of abuse in new religious movements (NRMs). It argues that abuse in NRMs is not unique but that certain factors can be intensified in NRM contexts – propensities for separation from wider society, teachings on unique legitimacy and exclusivity, and charismatic authority. First, a historical overview addresses how abuse in NRMs has been approached and understood, linking this to the development of NRM and cultic studies and their preferred terminology. Second, a theoretical framework allows consideration of the ways in which the interlinked structural and cultural factors of religious movements can contribute to the perpetration, legitimisation or concealment of abuse. Finally, the Element presents an applied case study analysing the interplay of these factors in the Jesus Fellowship Church, a UK-based NRM which closed in 2019, partly in recognition of abuses that had occurred. This title is also available as Open Access on Cambridge Core.
This chapter explores safeguarding as a duty on tennis sport governing bodies (SGBs) and tennis academies in respect of their athletes, whether junior or senior. The chapter considers safeguarding as a duty of care, the violation of which gives rise to tort-based liability. It looks at the various instruments and codes adopted by tennis SGBs, as well as by national tennis federations, including also their monitoring processes. The chapter explores how these processes are enforced with a view to limiting exposure to risks present or future. The chapter also considers health and safety as part of the duty of safeguarding and goes on to point out legal consequences for failure to meet safeguarding obligations.
Eileen Carey’s books are rarely read; her acting career was forgotten during her lifetime; and her presence in literary culture has always remained in the shadow of her husband. But she provided important support for Sean O’Casey throughout the second half of his life, and there is also great prescience in her own writing. This chapter presents a new assessment of Eileen Carey’s professional career in the wake of the #MeToo (2006–) and #WakingTheFeminists (2015–16) movements, showing how she experienced and wrote about male abuse in the entertainment industry, and how she inspired her husband to write about some of those themes in his own writing.
Adverse childhood experiences (ACEs) are associated with poor mental health outcomes, which are increasingly conceptualized from a transdiagnostic perspective. We examined the impact of ACEs on transdiagnostic mental health outcomes in young adulthood and explored potential effect modification. We included participants from the Avon Longitudinal Study of Parents and Children with prospectively measured data on ACEs from infancy till age 16 as well as mental health outcomes at ages 18 and 24. Exposures included emotional neglect, bullying, and physical, sexual or emotional abuse. The outcome was a pooled transdiagnostic Stage of 1b (subthreshold but clinically significant symptoms) or greater level (Stage 1b+) of depression, anxiety, or psychosis – a clinical stage typically associated with first need for mental health care. We conducted multivariable logistic regressions, with multiple imputation for missing data. We explored effect modification by sex at birth, first-degree family history of mental disorder, childhood neurocognition, and adolescent personality traits. Stage 1b + outcome was associated with any ACE (OR = 2.66, 95% CI = 1.68–4.22), any abuse (OR = 2.08, 95% CI = 1.38–3.14), bullying (OR = 2.15, 95% CI = 1.43–3.24), and emotional neglect (OR = 1.68, 95% CI = 1.06–2.67). Emotional neglect had a weaker association with the outcome among females (OR = 1.14, 95% CI = 0.61–2.14) than males (OR = 3.49, 95% CI = 1.64–7.42) and among those with higher extraversion (OR = 0.91, 95% CI = 0.85–0.97), in unweighted (n = 2,126) and weighted analyses (n = 7,815), with an openness–neglect interaction observed in the unweighted sample. Sex at birth, openness, and extraversion could modify the effects of adverse experiences, particularly emotional neglect, on the development of poorer transdiagnostic mental health outcomes.
Edited by
James Ip, Great Ormond Street Hospital for Children, London,Grant Stuart, Great Ormond Street Hospital for Children, London,Isabeau Walker, Great Ormond Street Hospital for Children, London,Ian James, Great Ormond Street Hospital for Children, London
This chapter explains principles of safeguarding, the relevant law and statutory framework, the role of the anaesthetist in safeguarding, specific forms of abuse, the safeguarding process for children when concerns arise and the investigation process when a child dies.
This chapter explores what we know about violence against young people with cognitive disability. It looks at what can make it more likely that young people with cognitive disability are abused. It’s hard to really know how many young people with cognitive disability have experienced violence. Young people with cognitive disability can be harmed by workers, family, or friends who are meant to help them. Abuse can happen in many places. Services and society need to learn how to keep young people with cognitive disability safe. We need to make sure young people can make decisions for themselves.
Young people with cognitive disability, families, and practitioners reported many acts of violence against young people. The violence included physical abuse, sexual assault/abuse, neglect, exploitation, emotional and psychological abuse, and domestic and family violence. Young people were abused by other young people with disability, family members, partners, practitioners, and services. Young people in this book found the strength to speak up and tell their stories of violence.
This chapter tells Amethyst’s story. Amethyst is an Aboriginal and South Sea Islander young woman with cognitive disability. Amethyst is not her real name. Amethyst was abused many times as a child and a young adult. Her story can tell us a lot about what needs to change for young people with cognitive disability. We need to understand that abuse affects a person’s whole life, their family, and their world.
Becoming an adult involved lots of changes and challenges for young people with cognitive disability. Many services, and sometimes families, judged young people badly because they had a cognitive disability. Young people needed help to be independent, but this wasn’t always given to them. Some young people were lonely and found so-called friends who abused them. Aboriginal and/or Torres Strait Islander young people and young people from culturally and linguistically diverse backgrounds needed others to understand and respect their culture. LQBTIQA+ young people wanted love and acceptance as they became adults.