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Abused Women: Health, Somatization, and Posttraumatic Stress
Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine . Linköping University, Faculty of Health Sciences.
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aims of this thesis were to estimate the lifetime prevalence of physical, sexual, and psychological abuse in a random population-based sample of women aged 18-60 years; to estimate current suffering thereof; and to investigate associations between abuse and health problems, more specifically to study abuse related variables associated with somatization and PTSD, respectively.

The studies had a cross-sectional design. Studies I and II comprised 4150 women 18-60 years. Study III included 547 women, and study IV consisted of 213 women, randomly selected from the population-based sample of the first two studies.

The first study found lifetime prevalence rates of 19.4% for physical abuse, 9.2% for sexual abuse, and 18.2% for psychological abuse. Abused women reported more ill-health and a less advantageous social situation than non-abused women. There was an association between magnitude of abuse and health problems. Even a low magnitude of abuse was substantially associated with ill-health. In the second study we found that of the 27.5% of women who had reported any kind of abuse in the first study, 69.5 % reported current suffering thereof. Abused suffering women reported more health problems than abused non-suffering women and non-abused women, and abused non-suffering women reported more health problems than non-abused women. In study three, psychological abuse and sexual abuse without penetration were found to be associated with somatization. Physical abuse and sexual abuse with penetration were not associated with somatization, when adjustments for other kinds of abuse were made. In study four, PTSD and somatization were found to be separately reported phenomena in abused women, although PTSD was positively associated with having somatic symptoms. Women with PTSD reported higher total magnitude of abuse and a higher number of perpetrators than women with somatization. Sexually abused women with PTSD more often described their experience as an act of abuse compared with sexually abused women with somatization.

The present thesis demonstrates that even a low magnitude of abuse is associated with health problems. It also shows that a majority of the abused women, when investigating lifetime history of abuse, reported current suffering thereof, which warrants considering abuse an important societal problem. The relationship between somatization and posttraumatic stress in abused women is discussed in relation to abuse variables. Other factors than severity of abuse, such as whether the abused woman herself perceives her experience as abuse, seem to be more decisive for development of somatization in abused women. The findings suggest that PTSD is not a necessary mediator between abuse and somatization.

Place, publisher, year, edition, pages
Institutionen för molekylär och klinisk medicin , 2007.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1007
Keyword [en]
Abuse, Prevalence, Psychological health, Somatization, Posttraumatic stress
National Category
Psychology
Identifiers
URN: urn:nbn:se:liu:diva-8942ISBN: 978-91-85831-90-6 (print)OAI: oai:DiVA.org:liu-8942DiVA: diva2:23661
Public defence
2007-06-08, Aulan, Hälsans Hus, Campus US, Linköpings Universitet, Linköping, 13:00 (English)
Opponent
Supervisors
Available from: 2007-05-23 Created: 2007-05-23 Last updated: 2013-09-03
List of papers
1. The association between ill-health and abuse: a cross-sectional population-based study
Open this publication in new window or tab >>The association between ill-health and abuse: a cross-sectional population-based study
2007 (English)In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 48, no 6, 567-575 p.Article in journal (Refereed) Published
Abstract [en]

The lifetime prevalence of physical, sexual and psychological abuse was studied cross-sectionally in a representative sample of Swedish women. The association between the three kinds of abuse and ill-health, and the relation between magnitude of abuse and various health problems were also investigated. The Abuse Screening Inventory (ASI), measuring experiences of physical, sexual and psychological abuse and including questions on health and social situation, was sent by mail to 6,000 women, randomly selected from the population register. The questionnaire was completed and returned by 4,150 (70%) of 5,896 eligible women. Various kinds of abuse were reported by 1,142 women (27.5%). The prevalence rates were 19.4% for physical abuse, 9.2% for sexual abuse and 18.2% for psychological abuse. Abused women reported more ill-health and a less advantageous social situation than non-abused women. There was an association between magnitude of abuse and health problems. Also a low magnitude of abuse was substantially associated with ill-health.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2007
Keyword
Abuse, anxiety, depression, somatization, health
National Category
Basic Medicine
Identifiers
urn:nbn:se:liu:diva-14530 (URN)10.1111/j.1467-9450.2007.00553.x (DOI)000251206800014 ()
Available from: 2007-05-23 Created: 2007-05-23 Last updated: 2017-12-13Bibliographically approved
2. Lifetime history of abuse, suffering, and psychological health
Open this publication in new window or tab >>Lifetime history of abuse, suffering, and psychological health
2010 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 64, no 4, 227-232 p.Article in journal (Refereed) Published
Abstract [en]

Background: In a representative Swedish sample, we investigated lifetime prevalence of physical, sexual and psychological abuse of women and their current suffering. The relationship between current suffering from abuse and psychological health problems was also studied. Method: The study was cross-sectional and population-based. The Abuse Screening Inventory (ASI), measuring experiences of physical, sexual and psychological abuse and including questions on health and social situation, was sent by mail to 6000 women, randomly selected from the population register. The questionnaire was completed and returned by 4150 (70%) of 5896 eligible women. Results: 27.5% of the women reported abuse of any kind. Of those, 69.5% reported current suffering from abuse. Abused suffering women reported more anxiety, depression and sleep disturbances, and a less advantageous social situation than both non-abused and abused non-suffering women. Also, abused non-suffering women reported more depression than non-abused women. Somatization was reported more often by both abused suffering and non-suffering women than by non-abused women, with no difference between suffering and non-suffering women when adjusted for possible confounders. Conclusion: A majority of abused women, when investigating lifetime history of abuse, report current suffering thereof, which warrants considering abuse an important societal problem. Suffering could be a valuable construct, possibly useful to assess psychological health problems normally not captured by existing diagnostic instruments, although further investigations of the concept are needed.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14531 (URN)10.3109/08039480903478680 (DOI)20085432 (PubMedID)
Available from: 2007-05-23 Created: 2007-05-23 Last updated: 2017-12-13
3. Somatization in abused women
Open this publication in new window or tab >>Somatization in abused women
2007 (English)In: Journal of Women's Health, ISSN 1059-7115, E-ISSN 2168-7668, Vol. 16, no 6, 909-918 p.Article in journal (Refereed) Published
Abstract [en]

Background: The association between abuse and somatization has been less systematically investigated than other abuse-related outcomes. Moreover, such studies have given inconsistent results. Therefore, the aim of the present study was to investigate the relation between somatization and lifetime exposure to physical, sexual, and psychological abuse.

Methods: A total of 800 women, 400 reporting abuse and 400 reporting no abuse in a previous randomized, population-based study, were sent two questionnaires: SOMAT, a questionnaire on somatization, and the Abuse Inventory (AI). Of 781 eligible women, 547 participated (70% response rate).

Results: Psychological abuse of both limited (6 months–2 years) and prolonged duration (>2 years) was associated with somatization (OR = 2.45, 95% CI 1.37-4.40 and OR = 3.09, 95% CI 1.52-6.30, respectively). Sexual abuse without penetration was associated with somatization (OR = 2.47, 95% CI 1.17-5.20), but sexual abuse with penetration was not. Physical abuse was not associated with somatization when adjustments for other kinds of abuse were made. Being abused in adulthood and in both adulthood and childhood was associated with somatization (OR = 4.20, 95% CI 2.45-7.20 and OR = 2.90, 95% CI 1.69-4.90, respectively), whereas being abused in childhood only was not.

Conclusions: Abuse of women is associated with somatization. Other factors than severity of abuse, such as whether the abused woman herself perceives her experience as abuse, seem to be more decisive for developing somatization in abused women. Abuse should be taken into account when meeting women with somatization symptoms as patients.

National Category
Psychology
Identifiers
urn:nbn:se:liu:diva-14532 (URN)10.1089/jwh.2006.0103 (DOI)
Available from: 2007-05-23 Created: 2007-05-23 Last updated: 2017-12-13
4. Post-traumatic stress and somatization in abused women
Open this publication in new window or tab >>Post-traumatic stress and somatization in abused women
2009 (English)In: Traumatology, ISSN 1534-7656, E-ISSN 1085-9373, Vol. 15, no 1, 103-112 p.Article in journal (Refereed) Published
Abstract [en]

This study examines the relationship between posttraumatic stressdisorder (PTSD) and somatization in abused women; 213 abusedwomen were assessed for PTSD, somatization, health care contacts,and abuse-related variables. The main analyses in this exploratorystudy are based on the 91 respondents reporting either PTSDor somatization. We found no association between the occurrenceof PTSD and somatization in abused women. Women with PTSD reportedhigher total magnitude of abuse and a larger number of perpetratorsthan women with somatization. Sexually abused women with PTSDmore often described their experience as an act of abuse comparedwith sexually abused women with somatization. Results suggestthat PTSD might not be a necessary mediator between abuse andsomatization and that variables other than abuse magnitude aredecisive for the development of somatization in abused women.

Place, publisher, year, edition, pages
Sage Publications, 2009
Keyword
abused women • somatization • posttraumatic stress
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14533 (URN)10.1177/1534765608326177 (DOI)
Available from: 2007-05-23 Created: 2007-05-23 Last updated: 2017-12-13

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