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  • 1.
    Davidsson Simmons, Johanna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Benjaminsson, Gabriella
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Association between experiencing rape, police reporting, and self-reported health among women visiting three gynecology clinics in Sweden2009In: ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, ISSN 0001-6349, Vol. 88, no 9, p. 1000-1005Article in journal (Refereed)
    Abstract [en]

    Objective. To describe the frequency of police reporting among rape victims based on two hypotheses: (1) victims of rape more often report poor health than those who have not been victims of any abuse, and (2) victims who report abuse to the police are more likely to state poor self-reported health than those who do not report any abuse. Design. Cross-sectional questionnaire study. Setting. Three Swedish departments of obstetrics and gynecology. Sample. From an original sample of 2,439 women, those who had experienced rape and those who had no history of abuse were included (n=1,319). Method. Analysis of associations between self-reported poor health, rape, and police reporting among rape victims were assessed by multivariate models adjusted for type of abuse, perpetrator, and sociodemographic factors. Main outcome measures. Odds ratios (ORs) for poor health among rape victims. Results. Rape was seldom reported to the police (23.5%, 44/187). Both hypotheses were confirmed; rape victims more often state poor health than non-abused women (adjusted OR 3.9; 95% confidence interval (CI) 2.4-6.3), and women who had reported abuse to the police stated poor health more often than those who had not reported abuse to the police (adjusted OR 3.0; 95% CI 1.1-8.1). Conclusions. Three of four rape victims had not reported any abuse to the police, and those who had were more likely to report poor health. Rape myths are prevalent in society and affect how victims of sexual abuse are treated both by formal and informal support providers, which in turn may affect the recovery and health of victims. Our results send an urgent message to the current debate on sexual abuse against women: Why do women not report rape to the police?

  • 2.
    Simmons, Johanna
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine. Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Toward an integrated approach in research on interpersonal violence: Conceptual and methodological challenges2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: There is a growing understanding that different kinds of interpersonal violence are interrelated. Many victims report experiences of cumulative violence, i.e., being subjected to more than one kind of violent behaviour (sexual, physical, emotional) and/or violence from more than one kind of perpetrator (family members, partners, acquaintances/strangers). To gain a more comprehensive understanding of what violence entails for victims, how victims can be helped and how violence can be prevented, there is a need to learn more about the co-occurrence of violence. Also, despite strong associations repeatedly being found between exposure to violence and the reporting of different kinds of ill-health, only a minority of victims have told health care professionals about their victimization. Less is known about the process of disclosing victimization to health care professionals for men than for women.

    Main aims: 1) Investigate the prevalence and co-occurrence of self-reported lifetime experiences of different kinds of interpersonal violence among male and female clinical and random population samples in Sweden (Study I-II). 2) Investigate whether cumulative violence is more strongly associated with       self-reported symptoms off psychological ill-health than with any kind of victimization alone (Study III).   3) Develop a theoretical model concerning male victims’ process of disclosing experiences of victimization to health care professionals in Sweden (Study IV).  

    Method: The self-reported prevalence of interpersonal violence as well as self-reported symptoms of psychological ill-health were estimated by means of secondary analyses of data collected with the NorVold Abuse Questionnaire (NorAQ). Both sexes were represented in clinical (women n=2439 men n=1767) and random population samples (women n=1168 men n=2924). Descriptive statistics as well as binary logistic regression and ordinal regression analyses were used (Study I-III). In study IV, constructivist grounded theory was used, and 12 men were interviewed concerning their experience of disclosing victimization to health care professionals.

    Results: A large proportion of victims (women: 47-48%, men: 29-31%) reported experiences of more than one kind of violent behaviour. Many also reported being subjected to violence by more than one kind of perpetrator (women: 33-37%, men: 22-23%). Reporting cumulative violence had a stronger association with symptoms of psychological ill-health than reporting only one kind of victimization. In study IV, the interviewed men’s own perceptions and considerations beforehand (e.g., perceived need for help and feelings of shame), as well as the dynamics during the actual health care encounter (e.g., patient-provider relationship and time constraints), were essential for understanding the process of disclosure. Also, the men’s own conformity to hegemonic constructions of masculinity and professionals’ adherence to gender norms had a strong negative influence on the men’s process of disclosure.

    Discussion: Experiences of cumulative violence were common. Prevalence rates of experiences of different kinds of interpersonal violence were compared to previous studies on interpersonal violence in Sweden. Large discrepancies were found between all studies, which is a symptom of methodological and conceptual difficulties within the research field. Violence is a gendered phenomenon. Differences were seen in the kind of violence men and women reported. In addition to this, the results in study IV indicate that gender affects how violence is perceived and how victims are treated by health care professionals.

    Conclusion: Integrated approaches in research on interpersonal violence, as well as in clinical work, are needed. If the co-occurrence of violence is ignored, it may hamper our understanding of the experiences and consequences of interpersonal violence for victims. More research is needed into what produces the differences found in prevalence rates between studies to improve the methodology.

    List of papers
    1. Men's experiences of emotional, physical, and sexual abuse and abuse in health care: A cross-sectional study of a Swedish random male population sample
    Open this publication in new window or tab >>Men's experiences of emotional, physical, and sexual abuse and abuse in health care: A cross-sectional study of a Swedish random male population sample
    2012 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, no 2, p. 191-202Article in journal (Refereed) Published
    Abstract [en]

    Aims: This article addresses the under-researched area ofmen’s experiences of abuse. The aims were to estimate prevalence ofemotional, physical, and sexual abuse and abuse in health care in a random sample of Swedish adult men, to compare these estimates with previously collected prevalence rates in a male clinical sample to see if prevalence rates were dependant on response rate and sampling method. We also wanted to contribute to a more general analysis of men’s experiences ofvictimisation.

    Methods: Cross-sectional study design. The NorVold Abuse Questionnaire that measures the prevalence of four kinds of abuse was sent to 6000 men selected at random from the population of Östergötland, Sweden.

    Results: The responserate was 50% (n=2924). Lifetime experiences of emotional abuse were reported by 16.7%, physical abuse by 48.9%, sexualabuse by 4.5%, and abuse in health care by 7.3%. The proportion ofmen who currently suffered fromabusive experiences washighest for emotional abuse and abuse in health care. No difference in prevalence was seen between the random populationsample and the clinical sample despite significant differences regarding response rate and background characteristics.

    Conclusions: Abuse against men is prevalent and men are victimised as patients in health care. Response rateand sampling method did not influence prevalence rates of abuse. Men’s victimisation from emotional abuseand abuse in health care was associated with low income and being born outside of the Nordic countries and hence needs to be analysed in the intersections of gender, class, and ethnicity.

    Keywords
    Abuse, male victimisation, masculinity, violence
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Identifiers
    urn:nbn:se:liu:diva-75588 (URN)10.1177/1403494811425711 (DOI)000301192100012 ()
    Funder
    Swedish Research Council, 2007-3011
    Note

    funding agencies|Swedish Research Council| 2007-3011 |

    Available from: 2012-03-09 Created: 2012-03-09 Last updated: 2018-11-15
    2. Associations and Experiences Observed for Family and Nonfamily Forms of Violent Behavior in Different Relational Contexts Among Swedish Men and Women
    Open this publication in new window or tab >>Associations and Experiences Observed for Family and Nonfamily Forms of Violent Behavior in Different Relational Contexts Among Swedish Men and Women
    2014 (English)In: Violence and Victims, ISSN 0886-6708, E-ISSN 1945-7073, Vol. 29, no 1, p. 152-170Article in journal (Refereed) Published
    Abstract [en]

    The aim of this study was to examine how lifetime experiences of different types of violent behavior as well as violence by different kinds of perpetrators overlap, and to investigate the co-occurrence of experiences of violent behavior by kind of perpetrator. This was done among both sexes in both a random sample from a county population (women n = 1,168, men n = 2,924) and a clinical sample (women n = 2,439, men, n = 1,767) in Sweden. More than 1 kind of perpetrator was reported by 33%-37% of female and 22%-23% of male victims of some kind of violence, whereas 47%-48% of female and 29%-31% of male victims reported more than 1 kind of violence. The reporting of 2 or 3 kinds of perpetrators was associated with the reporting of experiences of more than 1 kind of violent behavior. Health care providers must be trained to recognize the overlap of violent victimization and help prevent further victimization of those who already have such experiences.

    Place, publisher, year, edition, pages
    Springer Publishing Co, 2014
    Keywords
    revictimization; gender; cumulative violence; perpetrator; multiple victimization
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-105043 (URN)10.1891/0886-6708.VV-D-12-00084 (DOI)000330514100010 ()2-s2.0-84899457345 (Scopus ID)
    Available from: 2014-03-06 Created: 2014-03-06 Last updated: 2018-11-15
    3. Lifetime co-occurrence of violence victimisation and symptoms of psychological ill health: a cross-sectional study of Swedish male and female clinical and population samples
    Open this publication in new window or tab >>Lifetime co-occurrence of violence victimisation and symptoms of psychological ill health: a cross-sectional study of Swedish male and female clinical and population samples
    2015 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, article id 979Article in journal (Refereed) Published
    Abstract [en]

    Background

    Lifetime co-occurrence of violence victimisation is common. A large proportion of victims report being exposed to multiple forms of violence (physical, sexual, emotional violence) and/or violence by multiple kinds of perpetrators (family members, intimate partners, acquaintances/strangers). Yet much research focuses on only one kind of victimisation. The aim of this study was to investigate the association between symptoms of psychological ill health, and A) exposure to multiple forms of violence, and B) violence by multiple perpetrators.

    Method

    Secondary analysis of cross-sectional data previously collected for prevalence studies on interpersonal violence in Sweden was used. Respondents were recruited at hospital clinics (women n = 2439, men n = 1767) and at random from the general population (women n = 1168, men n  = 2924). Multinomial regression analysis was used to estimate associations between exposure to violence and symptoms of psychological ill health.

    Results

    Among both men and women and in both clinical and population samples, exposure to multiple forms of violence as well as violence by multiple perpetrators were more strongly associated with symptoms of psychological ill health than reporting one form of violence or violence by one perpetrator. For example, in the female population sample, victims reporting all three forms of violence were four times more likely to report many symptoms of psychological ill health compared to those reporting only one form of violence (adj OR: 3.8, 95 % CI 1.6–8.8). In the male clinical sample, victims reporting two or three kind of perpetrators were three times more likely to report many symptoms of psychological ill health than those reporting violence by one perpetrator (adj OR 3.3 95 % CI 1.9–5.9).

    Discussion

    The strong association found between lifetime co-occurrence of violence victimisation and symptoms of psychological ill-health is important to consider in both research and clinic work. If only the effect of one form of violence or violence by one kind of perpetrator is considered this may lead to a misinterpretation of the association between violence and psychological ill health. When the effect of unmeasured traumata is ignored, the full burden of violence experienced by victims may be underestimated.

    Conclusion

    Different kinds of victimisation can work interactively, making exposure to multiple forms of violence as well as violence by multiple perpetrators more strongly associated with symptoms of psychological ill health than any one kind of victimisation alone.

    Place, publisher, year, edition, pages
    BioMed Central, 2015
    Keywords
    Abuse, Mental health, Stress, Intimate Partner Violence, Revictimization, polyvictimization
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Identifiers
    urn:nbn:se:liu:diva-114676 (URN)10.1186/s12889-015-2311-3 (DOI)000361795600010 ()
    Note

    On the day of the defence date the status of this article was Manuscript and the original title was Cumulative violence and symptoms of psychological ill-health : importance of the interplay between exposure to different kinds of interpersonal violence in Swedish male and female clinical and population samples.Funding: Nordic Council of Ministers

    Available from: 2015-03-02 Created: 2015-03-02 Last updated: 2018-11-15Bibliographically approved
    4. Disclosing victimisation to healthcare professionals in Sweden: a constructivist grounded theory study of experiences among men exposed to interpersonal violence
    Open this publication in new window or tab >>Disclosing victimisation to healthcare professionals in Sweden: a constructivist grounded theory study of experiences among men exposed to interpersonal violence
    2016 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, no 6, article id e010847Article in journal (Refereed) Published
    Abstract [en]

    Despite associations between being subjected to violence and ill-health being well known, most victims have never told health care professionals about their victimisation. Although both experiences of victimisation and help-seeking behaviour are gendered, male victims’ encounters with the health care system are under-researched. The aim of this study was to develop a theoretical model concerning male victims’ processes of disclosing experiences of being subjected to violence to health care professionals in Sweden. Constructivist grounded theory was used. Twelve men who had reported experiences of emotional, sexual, and/or physical violence by any type of perpetrator in an earlier quantitative study were interviewed. Conflicting thoughts within the men affected their likelihood of disclosing their victimisation. For example, a sense of urgency to seek help increased their likelihood, whereas shame and fear of negative consequences decreased their likelihood. Conformity to hegemonic masculinity had a strong negative influence, and was tipping the men towards a low likelihood of disclosing victimisation. Health care professionals strongly influence the disclosing process. For example, a good patient-provider relationship would help the men disclose, whereas a strong factor hindering disclosure was professionals’ adherence to gender norms, thus neither validating men’s experiences of violence nor acknowledging their psychological suffering.

    Place, publisher, year, edition, pages
    BMJ Publishing Group Ltd, 2016
    Keywords
    Sweden; Violence; Abuse; Help-seeking; Screening; Gender; Masculinity; Constructivist Grounded Theory
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Identifiers
    urn:nbn:se:liu:diva-114678 (URN)10.1136/bmjopen-2015-010847 (DOI)000380237100066 ()
    Note

    The status of this article was previous manuscript.

    Funding agencies: Region Ostergotland, Sweden [LIO-340221, LIO-514621]

    Available from: 2015-03-02 Created: 2015-03-02 Last updated: 2018-11-15Bibliographically approved
  • 3.
    Simmons, Johanna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine and Geriatrics.
    Brüggemann, Adrianus Jelmer
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Thematic Studies, Technology and Social Change. Linköping University, Faculty of Arts and Sciences.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden .
    Disclosing victimisation to healthcare professionals in Sweden: a constructivist grounded theory study of experiences among men exposed to interpersonal violence2016In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, no 6, article id e010847Article in journal (Refereed)
    Abstract [en]

    Despite associations between being subjected to violence and ill-health being well known, most victims have never told health care professionals about their victimisation. Although both experiences of victimisation and help-seeking behaviour are gendered, male victims’ encounters with the health care system are under-researched. The aim of this study was to develop a theoretical model concerning male victims’ processes of disclosing experiences of being subjected to violence to health care professionals in Sweden. Constructivist grounded theory was used. Twelve men who had reported experiences of emotional, sexual, and/or physical violence by any type of perpetrator in an earlier quantitative study were interviewed. Conflicting thoughts within the men affected their likelihood of disclosing their victimisation. For example, a sense of urgency to seek help increased their likelihood, whereas shame and fear of negative consequences decreased their likelihood. Conformity to hegemonic masculinity had a strong negative influence, and was tipping the men towards a low likelihood of disclosing victimisation. Health care professionals strongly influence the disclosing process. For example, a good patient-provider relationship would help the men disclose, whereas a strong factor hindering disclosure was professionals’ adherence to gender norms, thus neither validating men’s experiences of violence nor acknowledging their psychological suffering.

  • 4.
    Simmons, Johanna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Associations and Experiences Observed for Family and Nonfamily Forms of Violent Behavior in Different Relational Contexts Among Swedish Men and Women2014In: Violence and Victims, ISSN 0886-6708, E-ISSN 1945-7073, Vol. 29, no 1, p. 152-170Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to examine how lifetime experiences of different types of violent behavior as well as violence by different kinds of perpetrators overlap, and to investigate the co-occurrence of experiences of violent behavior by kind of perpetrator. This was done among both sexes in both a random sample from a county population (women n = 1,168, men n = 2,924) and a clinical sample (women n = 2,439, men, n = 1,767) in Sweden. More than 1 kind of perpetrator was reported by 33%-37% of female and 22%-23% of male victims of some kind of violence, whereas 47%-48% of female and 29%-31% of male victims reported more than 1 kind of violence. The reporting of 2 or 3 kinds of perpetrators was associated with the reporting of experiences of more than 1 kind of violent behavior. Health care providers must be trained to recognize the overlap of violent victimization and help prevent further victimization of those who already have such experiences.

  • 5.
    Simmons, Johanna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Lifetime co-occurrence of violence victimisation and symptoms of psychological ill health: a cross-sectional study of Swedish male and female clinical and population samples2015In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, article id 979Article in journal (Refereed)
    Abstract [en]

    Background

    Lifetime co-occurrence of violence victimisation is common. A large proportion of victims report being exposed to multiple forms of violence (physical, sexual, emotional violence) and/or violence by multiple kinds of perpetrators (family members, intimate partners, acquaintances/strangers). Yet much research focuses on only one kind of victimisation. The aim of this study was to investigate the association between symptoms of psychological ill health, and A) exposure to multiple forms of violence, and B) violence by multiple perpetrators.

    Method

    Secondary analysis of cross-sectional data previously collected for prevalence studies on interpersonal violence in Sweden was used. Respondents were recruited at hospital clinics (women n = 2439, men n = 1767) and at random from the general population (women n = 1168, men n  = 2924). Multinomial regression analysis was used to estimate associations between exposure to violence and symptoms of psychological ill health.

    Results

    Among both men and women and in both clinical and population samples, exposure to multiple forms of violence as well as violence by multiple perpetrators were more strongly associated with symptoms of psychological ill health than reporting one form of violence or violence by one perpetrator. For example, in the female population sample, victims reporting all three forms of violence were four times more likely to report many symptoms of psychological ill health compared to those reporting only one form of violence (adj OR: 3.8, 95 % CI 1.6–8.8). In the male clinical sample, victims reporting two or three kind of perpetrators were three times more likely to report many symptoms of psychological ill health than those reporting violence by one perpetrator (adj OR 3.3 95 % CI 1.9–5.9).

    Discussion

    The strong association found between lifetime co-occurrence of violence victimisation and symptoms of psychological ill-health is important to consider in both research and clinic work. If only the effect of one form of violence or violence by one kind of perpetrator is considered this may lead to a misinterpretation of the association between violence and psychological ill health. When the effect of unmeasured traumata is ignored, the full burden of violence experienced by victims may be underestimated.

    Conclusion

    Different kinds of victimisation can work interactively, making exposure to multiple forms of violence as well as violence by multiple perpetrators more strongly associated with symptoms of psychological ill health than any one kind of victimisation alone.

  • 6.
    Swahnberg, Katarina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Davidsson-Simmons, Johanna
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Hearn, Jeff
    Linköping University, The Tema Institute, The Department of Gender Studies. Linköping University, Faculty of Arts and Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Men's experiences of emotional, physical, and sexual abuse and abuse in health care: A cross-sectional study of a Swedish random male population sample2012In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, no 2, p. 191-202Article in journal (Refereed)
    Abstract [en]

    Aims: This article addresses the under-researched area ofmen’s experiences of abuse. The aims were to estimate prevalence ofemotional, physical, and sexual abuse and abuse in health care in a random sample of Swedish adult men, to compare these estimates with previously collected prevalence rates in a male clinical sample to see if prevalence rates were dependant on response rate and sampling method. We also wanted to contribute to a more general analysis of men’s experiences ofvictimisation.

    Methods: Cross-sectional study design. The NorVold Abuse Questionnaire that measures the prevalence of four kinds of abuse was sent to 6000 men selected at random from the population of Östergötland, Sweden.

    Results: The responserate was 50% (n=2924). Lifetime experiences of emotional abuse were reported by 16.7%, physical abuse by 48.9%, sexualabuse by 4.5%, and abuse in health care by 7.3%. The proportion ofmen who currently suffered fromabusive experiences washighest for emotional abuse and abuse in health care. No difference in prevalence was seen between the random populationsample and the clinical sample despite significant differences regarding response rate and background characteristics.

    Conclusions: Abuse against men is prevalent and men are victimised as patients in health care. Response rateand sampling method did not influence prevalence rates of abuse. Men’s victimisation from emotional abuseand abuse in health care was associated with low income and being born outside of the Nordic countries and hence needs to be analysed in the intersections of gender, class, and ethnicity.

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