افکار و نگرش به خودکشی در زنان کتک خورده Suicidal Ideation and Attitudes in Battered Women

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1 افکار و نگرش به خودکشی در زنان کتک خورده Suicidal Ideation and Attitudes in Battered Women Dr.Khodabandeh MD,MPh

2 It is said that we were all born under a star; when I watch the stars at night I ask which of them is mine, so that I can change it for another one.

3 Violence Against Women Facts everyone should know

4 اطالعات سازمان بيداشت جيانی 2017 WHO fact sheet 2017 Violence against women and girls manifests itself in physical, sexual and psychological forms.

5 آمار ارقام Facts and figures خشونت علیه زنان بخصوص از طرف همسران یک مشکل سالمت عمومی و نقض حقوق زنان است بر آوردهای جهانی انتشار داده شده از طرف WHO حاکی از آمار و ارقام زیر است : در %30 در %70 موارد خشونت از طرف فرد ی غیر از همسر خشونت از طرف همسر زنانی که تجربه خشونت از طرف همسر داشته اند هستند. 2 برابر بیشتر در معرض مبتال به افسردگی حدود 750 میلیون دختر و زن در دنیا زیر سن 18 سال ازدواج می کنند ( 1 از هر 7 نفر زیر 15 سال ) که شانس بیشتری برای خشونت دارند. حدود 120 میلیون زن و دختر در دنیا ( 1 از 10 نفر( تجربه ارتباط جنسی اجباری را داشتند که بیشتر بوسیله همسر و یا دوست پسر آنها بوده است. حداقل 200 میلیون دختر زنده تا کنون در 30 کشور جهان ختنه شده اند که بیشتر در سن زیر 5 سالگی بوده است.. از زنان بالغ و در مجموع %71 دختران و زنان بالغ قربانی قاچاق انسانی بودند %51

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7 بر اساس بار جيانی بیماریيا کش رىا را در 6 منطقو قرار داده است WHO 1.South-East Asia Region:37.7% 2. Eastern Mediterranean Region:37.0% 3. African Region :36.6% 4.Region of the Americas:29.8% 5. European Region:25.4% 6. Western Pacific Region:24.6%

8 پیامدهای سالمتی Health consequences Psycological Physical gynecological homicide or suicide headaches unintended pregnancies depression back pain abortions post-traumatic stress abdominal pain sexually transmitted infections including HIV other anxiety disorders sleep difficulties suicide attempts eating disorders Injuries gastrointestinal disorders poor overall health limited mobility

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10 Our Aim Assessment of Suicidal Ideation and Attitudes in battered women in the forensic sample.

11 Objective: The relationship between domestic-violence victimization, suicidal thoughts and attempts, examined among 621 physically abused women, came from all walks of life,demographic category and social classes ; seeking formal forensic medical certificates, to prove domestic violence, seriousness of the injury, and providing the opportunity for some further Security coverage. Collection sites included five centers (Central, North, East, West and South) of forensic medical clinic provided by the Legal Medicine Organization, in Tehran city, between

12 Method: After agreeing to participate and acknowledging informed consent, relevant questioner completed by face to face interview to provide: (a) socio- demographic profile description, (b) Spouse Abuse Questionnaire (SAQ) a 44-item self-report 4-point likert type scale, validated questionnaire in the local language for level and pattern of abuse determination in three domains: physical violence (10 items), psychological abuse (20 items) and sexual maltreatment (14 items).

13 Method: (c) Scale for Suicidal Ideation (SSI) A 19-item clinical research instrument designed to quantify and assess suicidal intention, developed by Beck, Kovacs and Weismann. assesses both the suicidal intents and their degree and intensity in the present and in the past in several dimensions: 1) attitude towards life and death, 2) suicidal thoughts or wishes, 3) a project contemplating suicide, and 4) carrying out a contemplated suicide attempt. SSI total score was assessed in the three classes of the suicidality assessment: 0-5, no suicidality; 6-19 mild to moderate suicidal ideation; and 20-38, high suicidal ideation or self-harming acts.

14 RESULTS

15 Sample Characteristics of Battered Women

16 Result: In context of measuring Suicidal Frequency data of the Suicidal Ideation (SSI) items indicate that : 32.5% at base line scored 0-5(no suicidal ideation ); 35.3% scored 6-19 (mild to moderate suicidal ideation) and 32.2% scored 20-38(sever suicidal ideation). Our results indicated that :female attending forensic clinic experienced suicidal ideation 57.3% (240) since two weeks 26.5% (111) since last 30 day, and 16.2% ( 68) since last year prior to study

17 Correlations : Suicidal ideation was correlated : positively (p <.05) with o husband, age ; Results oabuse pattern (P=.000) significantly with psychological abuse (P=.004) oabuse duration (P=.001); and oabuse frequency (P =.05). negatively (p >.05) with : oparticipant, s age ; ooccupation; oage at marriage

18 Analyses for the Relation between participants Variable and suicidal ideation subscale (SSI)

19 Discussion A WHO multi-country study data from low and middle income countries (Devries et al.,2011) suggested IPV as risk factor for suicide among battered women A systematic review (Kazan et al.,2016) drew attention to the impact of intimate partner relationships on suicidal thoughts and behaviors.

20 Discussion Study (Ko Ling Chan et al 2008) on suicidal ideation among 16,000university students 22 sites in 21 countries, explores increased rate of suicidal ideation in dating violence Kazan et al. (2016) review highlights intimate partner relationships as a significant component in a suicide risk assessment

21 Conclusion These data support a relationship between domestic-violence victimization and suicidal intent. From the perspective of assessment, inpatient clinicians need to carefully screen every patient with a history of domestic violence for a history suicidal intent, which can lead to the design of effective preventive and intervention strategies.

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