Journal of Interpersonal Violence Case Study Assignment

Journal of Interpersonal Violence Case Study Assignment

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Journal of Interpersonal Violence Case Study Assignment

Journal of Interpersonal Violence 35(21-22)

example, approximately 0.4% of older adults had experienced two or more types of abuse in the past year (Comijs, Pot, Smit, Bouter, & Jonker, 1998). Researchers in Spain noted higher rates of polyvictimization in their sample of 676 community-dwelling Spanish older adults, with 3.6% of the sample reporting two or more types of abuse in the past year and 0.1% of the sample endorsing three or more types of abuse in the past year (Garre-Olmo et al., 2009).

Results from a national prevalence study in Portugal revealed a simi- lar polyvictimization rate of 3.4% among Portuguese older adults (Gil et al., 2015). Further illustrating the considerable variability in international preva- lence estimates, an examination of elder abuse prevalence among older adults in rural communities in Hubei, China, revealed that approximately 10.5% of these older adults had experienced two or more types of mistreatment in the past year (Wu et al., 2012).

Thus, it seems clear that elder polyvictimization may be more prevalent in the community than previously thought, underscoring the need to identify key risk factors for polyvictimization. Some known risk factors for elder abuse identified by prior research include (but are not limited to) gender, socioeconomic status, race/ethnicity, prior trauma exposure, and low social support (Acierno et al., 2010; Biggs, Manthorpe, Tinker, Doyle, & Erens, 2009;

Hernandez-Tejada, Amstadter, Muzzy, & Acierno, 2013; Laumann, Leitsch, & Waite, 2008). No studies, however, have explored whether these characteristics can distinguish polyvictims from older adults who experience single types of victimization in isolation. Thus, the two primary aims of this study are to (a) evaluate the prevalence and correlates of elder polyvictimiza- tion using data from the National Elder Mistreatment Study—a nationally representative survey of elder abuse and neglect among community-residing U.S. adults aged 60 years and older, and (b) identify demographic risk factors for polyvictimization among this sample of older adults.

Method

Participants

Participants for this study were 5,776 adults (weighted sample; 5,777 older adults in unweighted sample) aged 60 years or older, recruited as part of the National Elder Mistreatment Study (Acierno et al., 2010). The sample was selected using stratified random-digit dialing in an area probability sample derived from Census-defined size-of-place parameters (e.g., rural, urban) in the continental United States. Interviews were conducted in either English or Spanish depending on participant preference using standardized computer assisted telephone interviewing procedures. The cooperation rate was 69%.

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Study procedures are described in full detail in a prior publication from this data set (see Acierno et al., 2010), and the research protocol was reviewed and approved by the Medical University of South Carolina’s institutional review board.

The final sample consisted of 2,300 (39.8%) males and 3,477 (60.2%) females with a mean age of 71.46 years (SD = 8.08). In terms of racial/ethnic identity, 4,876 (84.4%) adults identified as Caucasian, 386 (6.7%) African American, 245 (4.3%) Hispanic, 132 (2.3%) American Indian or Alaskan Native, 49 (0.9%) Asian, and 13 (0.2%) Pacific Islanders. The majority of participants were retired or unemployed (5,174; 80.9%), and just over half of the sample reported that they were married or cohabitating (3,281; 56.8%). Approximately, one third of participants (2,176; 37.8%) reported needing some assistance with activities of daily living (ADL).

Measures

Demographics. Demographic variables, including age, gender, education level, ethnicity, and race, were assessed as part of the interview. Ethnicity was assessed via a single question: “Are you of Hispanic origin or descent?” Race was assessed via the following question: “In which of the following categories do you feel you belong:

White, Black, Pacific Islander, American Indian or Alaskan Native, Asian, or something else?” Participants were also asked about household income, and, for purposes of this study, low income was defined as cases where the combined household income was less than US$35,000 per year. Marital and relationship status was assessed with the question, “What is your marital status?”

Elder abuse. A series of behaviorally specific questions regarding emotional, physical, and sexual abuse, neglect, and financial mistreatment were used to assess past-year elder abuse in survey form as validated by Acierno, Resnick, Kilpatrick, and Stark-Riemer (2003).

These questions were worded so as to elicit a “yes” or “no” response rather than a description of specific mistreat- ment events to increase participant privacy and protection. After querying about the specific abuse type, respondents were asked how long ago the abuse happened (i.e., “How old were you when this happened most recently?”) to establish past-year prevalence. Here, emotional abuse was defined as an affirmative response to any one of the following four questions: (a) “Has anyone ever verbally attacked, scolded, or yelled at you so that you felt afraid for your safety, threatened, or intimidated?” (b) “Has anyone ever made you feel humiliated or embarrassed by calling you names such as stupid, or telling you that you or your opinion was worthless?” (c) “Has anyone ever forcefully

4522 Journal of Interpersonal Violence 35(21-22)

or repeatedly asked you to do something so much that you felt harassed or coerced into doing something against your will?” (d) “Has anyone close to you ever completely refused to talk to you or ignored you for days at a time, even when you wanted to talk to them?”

Physical abuse was defined as an affirmative response to any one of the following three questions: (a) “Has anyone ever hit you with his or her hand or object, slapped you, or threatened you with a weapon?” (b) “Has anyone ever tried to restrain you by holding you down, tying you up, or locking you in your room or house?” (c) “Has anyone ever physically hurt you so that you suffered some degree of injury, including cuts, bruises, or other marks?”

Sexual abuse was defined as an affirmative response to any one of the fol- lowing three questions: (1) “Regardless of how long ago it happened or who made the advances, has anyone ever made you have sex or oral sex by using force or threatening to harm you or someone close to you?” (2a) For females: “Has anyone ever touched your breasts or pubic area or made you touch his penis by using force or threat of force?” (2b) For males: “Has anyone ever touched your pubic area or made you touch their pubic area by using force or threat of force?” (3a) For females: “Has anyone ever forced you to undress or expose your breasts or pubic area when you didn’t want to?” (3b) For males: “Has anyone ever forced you to undress or expose your pubic area when you didn’t want to?”

Potential neglect was defined as an affirmative response to one of the fol- lowing six questions regarding personal need, along with a response indicat- ing that there was no one available to fulfill that need: (a) “Do you need someone to help you get to the places you need to go, for example, do you need someone to drive you to the grocery store, a place of worship, the doc- tor?” (b) “Do you need someone to make sure you have enough food, medi- cines, or any other things you need in your house?”(c) “Do you need someone to help you with household things, like cooking meals, helping you eat, or making sure you take the correct medicines each day?”(d) “Do you need someone to help you with house cleaning or yard work?” (e) “Do you need someone to help you get out of bed, get showered, or get dressed?” (f) “Do you need someone to make sure your bills get paid?”

If the older adult acknowledged that someone helps him or her manage his or her finances, or someone other than the elder makes decisions about his or her money and property, financial exploitation was defined as an affirmative response to one of the following questions with reference to that individual: (a) “Does that person ask for your PERMISSION before deciding to spend your money or sell your property?” (b) “Do you feel like that person makes good decisions about your finances?” (c) “Do you have the copies of paperwork for the financial decisions they make or can you get copies if you wanted them?”

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(d) “Has that person ever forged your signature without your permission to sell your property or to get money from your accounts?” (e) “Has that person ever forced or tricked you into signing a document so that he or she would be able to get some of your money or possessions?” (f) “Has that person, or anyone else you are close to, ever stolen your money or taken your things for them- selves, their friends, or to sell?” (g) “Has a stranger ever spent your money or sold your property without your permission?” (h) “Has a stranger ever forged your signature to get some of your money or sell your property?” (i) “Has a stranger ever forced or tricked you into signing a document so that he or she would be able to get some of your money or possessions?”

For purposes of this study, we only assessed financial exploitation perpetrated by a family member, and, thus, financial exploitation by a stranger was not included in our definition of financial exploitation. Perpetrator characteristics by type of abuse are pro- vided in prior publications from this data set (Amstadter et al., 2011).

Health status. Health status over the prior month was assessed using the gen- eral health Question 1 from the World Health Organization Short-Form 36 Health Questionnaire (Ware & Gandek, 1998). Participants were asked to rate the following question: “In general, would you say your health is excel- lent, very good, good, fair, or poor?”

Prior traumatic events. Participants were asked to report if they had been exposed to the following events and indicated fear that they would be killed or seriously injured during this exposure: natural disasters such as earth- quake, hurricane, flood, or tornado; serious accident at work, in a car, or somewhere else; or being in any other situation where you thought you would be killed.

Social support. Perceived social support during the past month was assessed via a modified five-item version of the Medical Outcomes Study module for social support (Sherbourne & Stewart, 1991). Participants were asked about emo- tional (e.g., “someone available to love you and make you feel wanted”), instrumental (e.g., “someone available to help you if you were confined to bed”), and appraisal (e.g., “someone available to give you good advice in a crisis”) social support and responded to items using a 4-point scale from none of the time to all of the time. Low social support was operationalized as a score in the lower quartile of the sample ratings, and the comparison high social sup- port was operationalized as a score in the upper quartile of sample ratings.

Social service utilization. Participants were asked if they had used any of the following programs or services: senior centers or day programs; physical

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rehabilitation; Meals on Wheels or any other meal service, social services or health services provided to the home; hospice; formal senior friends services, church group home visits, or any other program or service. Participants responded to these questions using dichotomous “yes” or “no” responses.

ADL assistance. Participants were asked if they needed help from time to time with the following ADLs: shopping for groceries or medicines; going to the doctor; transportation to friends, church, or temple; paying bills or doing related paperwork; taking medicines, getting dressed, bathing, and eating. Participants responded to these questions using dichotomous “yes” or “no” responses.

Data Analysis Plan

Frequency distributions were computed to assess the prevalence of polyvic- timization, here defined as having experienced two or more categories of mistreatment (emotional, physical, sexual, and financial abuse and neglect) in the past year. Bivariate analyses comparing older adults with no past-year abuse, older adults reporting one form of victimization, and elder polyvictims on various demographic factors were conducted using a series of χ2 analyses. Analyses were also conducted just comparing older adults reporting one form of victimization and elder polyvictims.

For comparisons, racial groups were collapsed into a dichotomous variable (White and non-White) given the small number of individuals in several racial categories screening positive for poly- victimization, and, in looking at marital/relationship status, participants were categorized as married or cohabitating or not in a long-term relationship (e.g., separated, divorced, widowed, single).

Consistent with prior publications from this data set (e.g., Acierno et al., 2010), we also collapsed age into a dichotomous variable representing young-old (aged 60-69 years) and old-old (aged ≥ 70 years). A significance level of p < .05 was chosen a priori. A logis- tic regression analysis was conducted to explore the unique contribution of demographic risk factors to endorsement of polyvictimization. For all of the following analyses, data were weighted based on age and sex to match 2000 Census estimates, and, thus, all ns and proportions reported in the results are based on weighted data unless otherwise specified. Analyses were conducted using SPSS Version 23 software.

We examined each abuse and mistreatment variable for missing data, and rates of missingness were generally low, ranging from 0.3% to 7.1% for the emotional abuse, physical abuse, sexual abuse, and neglect variables. Only one abuse variable, financial exploitation, had a missing data rate >10% (13.1%). Missing data were handled such that rates of victimization,

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including polyvictimization, were computed based on the number of abuse variables with valid data. For our primary analyses, cases were excluded analysis by analysis with tests using all cases with valid data for each tested variable. Listwise deletion was used for logistic regression analyses.

RUBRIC
Excellent Quality 95-100%	Introduction 45-41 points The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned.		Literature Support 91-84  points The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned.			Methodology 58-53 points Content is well-organized with headings for each slide and bulleted lists to group related material as needed. Use of font, color, graphics, effects, etc. to enhance readability and presentation content is excellent. Length requirements of 10 slides/pages or less is met.
Average Score 50-85%	40-38 points More depth/detail for the background and significance is needed, or the research detail is not clear. No search history information is provided.		83-76  points Review of relevant theoretical literature is evident, but there is little integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are included. Summary of information presented is included. Conclusion may not contain a biblical integration.			52-49  points Content is somewhat organized, but no structure is apparent. The use of font, color, graphics, effects, etc. is occasionally detracting to the presentation content. Length requirements may not be met.
Poor Quality 0-45%	37-1 points The background and/or significance are missing. No search history information is provided.		75-1 points Review of relevant theoretical literature is evident, but there is no integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are not included in the summary of information presented. Conclusion does not contain a biblical integration.			48-1 points There is no clear or logical organizational structure. No logical sequence is apparent. The use of font, color, graphics, effects etc. is often detracting to the presentation content. Length requirements may not be met
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