Search Results (102)

Gender equity is one of the most complex contemporary challenges, encompassing political, economic, labor, and cultural dimensions. This study aims to analyze the impact of public policies, labor practices, and social movements in promoting gender equity across various socio-political contexts. To answer the central question of how these elements influence a reduction in gender inequalities, a Systematic Literature Review (SLR) was conducted, complemented by a Bibliometric Analysis, following PRISMA protocol guidelines. The bibliographic search, carried out in the Scopus database, covered the period from 2015 to 2025 and identified 26 relevant studies that met the predefined inclusion criteria. The results reveal that, despite progress in formulating policies aimed at combating gender-based violence and promoting equality, the implementation of these measures is hindered by a lack of inter-institutional coordination and the persistence of deeply rooted cultural norms. Likewise, structural inequalities in the labor sphere are evident, such as the gender wage gap and barriers to professional advancement. On the other hand, social movements have emerged as key actors—including governmental institutions, civil society organizations, and healthcare providers—in highlighting and transforming these disparities by driving changes in political agendas and increasing women’s representation in decision-making positions. In summary, this study underscores the need to adopt intersectional and comprehensive approaches to achieve effective and sustainable gender equity, while comparing the influence of policies across different global regions. Full article

Background/Objectives: The homeless population (HP) is a heterogeneous group characterized by the absence of stable and conventional housing, often relying on public spaces and deteriorated environments for shelter and survival, either temporarily or permanently. This group is exposed to multiple health vulnerabilities, with substance use disorder (SUD) identified as a significant risk factor for suicidal behavior. The aim of this study was to conduct a scoping review of the relationship between PAS use and suicide among homeless individuals. Methods: A comprehensive literature search was performed using five databases: PubMed, Scopus, SciELO, LILACS, and Google Scholar. Studies were selected based on their relevance to the topic, and data were extracted regarding substance use, suicide-related outcomes, and associated sociodemographic and clinical factors. Results: The findings indicated a strong association between PAS use and increased suicidal ideation and behavior among homeless individuals, particularly among youth, men, and women. Opioids and alcohol were the most frequently reported substances in this context. Additional factors such as unemployment, exposure to violence, social inequalities, and mental health disorders further exacerbated the risk of suicide in this population Conclusions: The reviewed literature underscores the urgent need for integrated, context-sensitive interventions addressing both substance use and mental health among the homeless. Tailored public health strategies focused on prevention, harm reduction, and psychosocial support are essential to reducing suicide risk and promoting overall well-being in this highly vulnerable group. Full article

The criminological approach to relapse is based, on the one hand, on the theories that explain the risk of relapse, including the risk level assessment tools, and on the other hand, on the rehabilitation theories—the Risk-Need-Responsivity (RNR) Model and The Good Live Model (GLM), which explain the mechanisms of reducing the risk of relapse in the assisted desistance paradigm. The objectives of this study focus on identifying the predictors of relapse in correlation with relapse inhibitors that combine a number of personal, psycho-emotional factors with psychopathological, socio-economic, and cultural accents. The method used is that of the case study from the perspective of clinical criminology, referring to forensic psychiatry through specific techniques and working procedures of some institutions in the correctional system—territorial structures of probation (TSP) in cooperation with the penitentiary system. The results of the study focus on the impact of standardized programs on the reduction in the risk of relapse after prison (RRR) and on personal and socio-familial factors involved in post-executional surveillance and post-criminal assistance. In conclusion, the current study highlights the need to corroborate the clinical or subjective assessment of relapse risk with the actual or objective assessment, which also includes the risk of violence in the framework of community monitoring from the perspective of community or social psychiatry. Full article

In Mexico, pervasive violence, forced disappearances, and homicides have deeply impacted certain groups, particularly journalists, activists, and human rights defenders, who are at high risk of victimization. While these groups receive state support for physical and legal safety, mental health and sleep-focused interventions remain insufficient. Collaborating with a Mexico City-based institution supporting human rights defenders and journalists, we conducted a psychometric assessment of 47 individuals affected by violence. Results showed that 80% exhibited symptoms of post-traumatic stress disorder, 25.5% showed depression, and 57.4% displayed anxiety; 95.7% reported poor sleep quality based on the Pittsburgh Sleep Quality Index. In a second phase, neuropsychological tests and polysomnographic recordings identified cognitive impairments in attention, memory, and decision-making in some participants, along with sleep disorders such as insomnia, primary snoring, obstructive sleep apnea, and bruxism. A third phase introduced Cognitive Behavioral Therapy for insomnia, nightmares, and circadian rhythm issues. Results showed improvements in sleep quality, total sleep time, and a reduction in depression, anxiety, and post-traumatic stress disorder symptoms. This approach suggests that treating sleep issues in high-risk populations can improve mental health. Full article

Understanding the mechanisms of change in batterer intervention programs (BIPs) is essential for advancing effective interventions for intimate partner violence (IPV). This study evaluates changes in psychological inflexibility and IPV behaviors among men participating in an acceptance and commitment therapy (ACT)-based BIP for men court-mandated to domestic violence classes. Participants (N = 56) were assessed across three time points using validated measures of psychological inflexibility and IPV behaviors. Findings revealed significant improvements in psychological inflexibility and corresponding reductions in IPV behaviors over the intervention period, with medium to large effect sizes. Psychological inflexibility at the final assessment predicted IPV outcomes, accounting for 15% of the variance, even after controlling for baseline IPV, age, and race. These results highlight psychological inflexibility as a potential mechanism of change in IPV interventions. Despite this study’s strengths, including its longitudinal design and rigorous analyses, limitations such as a small sample size and lack of a control group warrant further investigation. This study underscores the potential of ACT-based interventions to reduce IPV by targeting psychological inflexibility and offers insights for refining BIPs to enhance their impact. Full article

Background/Objectives: Violent behaviors are uncommon in patients with schizophrenia (Sch), but when present, exacerbate stigma and challenge treatment. The following study aimed to identify the structural abnormalities associated with violent behaviors in Sch by implementing a validated tool specifically designed to evaluate violent behaviors in psychiatric populations, as well as by performing region-of-interest neuroimaging analyses, focused on areas commonly associated with the neurobiology of violence and aggression. Methods: Eighty-three participants were divided into three groups: Sch with violent behaviors (Sch+V, n = 34), Sch without violent behaviors (Sch-V, n = 28), and healthy controls (HC, n = 21). Structural neuroimaging analyses were performed across groups to assess gray matter volume (GMV) and cortical thickness (CT) differences in regions previously implicated in aggressive behaviors. Results: The data revealed significant reductions in GMV in the right amygdala and diminished cortical thickness (CT) in the bilateral dorsolateral prefrontal cortices (dlPFC) in patients with Sch+V compared to patients with Sch-V and HCs. Right amygdalar volume also demonstrated a negative correlational trend with hostility scores in patients with Sch+V. Conclusions: These findings underscore disruptions in the structural integrity of the dlPFC—responsible for inhibitory control—and the amygdala—central to emotional processing in violent patients with Sch. Future research should aim to investigate potential functional interactions at a network level to gain a deeper understanding of the neurobiological underpinnings of violent behaviors in this population. Full article

Incarcerated women report extremely high rates of lifetime sexual violence victimization. Survivors Healing from Abuse: Recovery through Exposure (SHARE) is an exposure-based group therapy specifically designed for incarcerated women survivors of sexual violence. SHARE has been continuously delivered in a women’s prison for more than 12 years. However, like many prisons during the COVID-19 pandemic, the prison ceased all in-person programming between March 2020 and July 2021. In response, the SHARE treatment team pivoted to a hybrid telehealth delivery model (i.e., group participants gathering in a facility group room and therapists joining via video, displayed on a computer screen within the group room). Given the lack of evidence for hybrid telehealth in carceral settings, and specifically for group therapy for sexual trauma, the current study compared ratings on internalizing symptoms (Brief Symptom Inventory-18 or BSI-18), posttraumatic stress symptoms (Posttraumatic Checklist-5 or PCL-5), and group cohesion ratings (Inclusion of Self in Other scale, or IOS) for participants who received SHARE in person (n = 21) or through hybrid telehealth (n = 19). The results demonstrated that participants of in-person and hybrid telehealth SHARE groups reported similar significant reductions in BSI-18 (15.21 in person vs. 16.00 in hybrid telehealth) and PCL-5 (30.78 in person vs. 26.40 in hybrid telehealth) scores pre- to post-treatment and comparable IOS ratings (5.06 in person vs. 5.31 in hybrid telehealth). The findings suggest hybrid telehealth is an effective and feasible treatment modality for meeting the need for trauma-focused therapy in prisons. Future studies examining the effectiveness and implementation of trauma-focused hybrid telehealth groups in prisons are warranted. Full article

Screening, brief intervention, and referral to treatment (SBIRT) is a widely used public health approach for delivering early intervention for substance misuse. SBIRT adaptations that incorporate content on interpersonal violence and posttraumatic stress disorder (PTSD) symptoms may be warranted, as experiences of interpersonal violence are prevalent and associated with greater substance misuse; however, more research is needed to refine the delivery of PTSD-substance use content within the SBIRT model. This study examined clinical data collected as part of a web-based SBIRT developed for co-occurring substance misuse and PTSD symptoms after interpersonal violence to characterize the clinical symptoms and responses of adults presenting to agencies serving intimate partner and sexual violence survivors. The respondents (N = 52) completed self-report measures during the SBIRT tool to personalize the recommendations, as well as motivational enhancement exercises. Descriptive statistics were conducted. The results underscored high rates of probable PTSD, substance use, and trauma-related motives for substance use. The respondents were ready to change their substance use on average after receiving personalized feedback. Many expressed values related to trauma recovery and self-empowerment, perceived these values as useful for substance use reduction, and set goals to seek mental health services or reduce their drinking quantity. The findings point to several clinical targets for integrated PTSD-substance misuse interventions for interpersonal violence survivors. Full article

Emotion recognition through artificial intelligence and smart sensing of physical and physiological signals (affective computing) is achieving very interesting results in terms of accuracy, inference times, and user-independent models. In this sense, there are applications related to the safety and well-being of people (sexual assaults, gender-based violence, children and elderly abuse, mental health, etc.) that require even more improvements. Emotion detection should be done with fast, discrete, and non-luxurious systems working in real time and real life (wearable devices, wireless communications, battery-powered). Furthermore, emotional reactions to violence are not equal in all people. Then, large general models cannot be applied to a multi-user system for people protection, and health and social workers and law enforcement agents would welcome customized and lightweight AI models. These semi-personalized models will be applicable to clusters of subjects sharing similarities in their emotional reactions to external stimuli. This customization requires several steps: creating clusters of subjects with similar behaviors, creating AI models for every cluster, continually updating these models with new data, and enrolling new subjects in clusters when required. An initial approach for clustering labeled data compiled (physiological data, together with emotional labels) is presented in this work, as well as the method to ensure the enrollment of new users with unlabeled data once the AI models are generated. The idea is that this complete methodology can be exportable to any other expert systems where unlabeled data are added during in-field operation and different profiles exist in terms of data. Experimental results demonstrate an improvement of 5% in accuracy and 4% in F1 score with respect to our baseline general model, along with a 32% to 58% reduction in variability, respectively. Full article

Background/Objectives: Coercion in mental health is challenged, prompting reduction interventions. Among those, the Joint Crisis Plan (JCP), which aims to document individuals’ treatment preferences in case of future de-compensation, regardless of the potential loss of discernment, has been identified as a key path to study. Identified challenges related to its implementation highlight the need to adapt this intervention to the local context. Considering that in Quebec (Canada), the JCP is not widely used, but the scientific literature supports its adoption and corroborates its potential impact on reducing coercion, this study evaluates the feasibility, acceptability, and preliminary outcomes of the JCP among psychiatric and forensic inpatient settings. Methods: A pilot mixed-methods study was conducted through 16 individual interviews with inpatients and healthcare providers, combined with a pre–post analysis of seclusion and restraint use and the violence prevention climate (VPC) based on healthcare providers’ (n = 57) and inpatients’ perspectives (n = 53). Results: Although the challenging implementation of the JCP complicated the evaluation of its effects on seclusion and restraint use, a moderate change (d = 0.40) in the VPC was identified based on healthcare providers’ perspectives. Qualitative findings are also insightful to understand the acceptability and feasibility of the JCP use. A tension emerged between the perspectives of inpatients and healthcare providers: while inpatients valued the reflective process of completing the plan, providers focused more on its technical aspects. Conclusions: The results support the integration of the JCP into patient care pathways, as it provides a tool to amplify patients’ voices, promote patient empowerment, facilitate open dialog on alternatives to coercion, and foster more collaborative and humane mental health care. Full article

Background and Objectives: Post-traumatic stress disorder (PTSD) is a debilitating condition worldwide. The limited effectiveness of current psychological and pharmacological treatments has motivated studies on meditation techniques. This study is a comprehensive, multiple-treatments meta-analysis comparing the effectiveness of different categories of meditation in treating PTSD. Methods and Materials: We followed Prisma guidelines in our published protocol to search major databases and to conduct a meta-analysis of the studies. Results: We located 61 studies with 3440 subjects and divided them logically into four treatment groups: Mindfulness-Based Stress Reduction (MBSR, 13 studies); Mindfulness-Based Other techniques (MBO, 16 studies), Transcendental Meditation (TM, 18 studies), and Other Meditations that were neither mindfulness nor TM (OM, 14 studies). Trauma populations included war veterans, war refugees, earthquake and tsunami victims, female survivors of interpersonal violence, clinical nurses, male and female prison inmates, and traumatized students. Of those offered, 86% were willing to try meditation. The baseline characteristics of subjects were similar across meditation categories: mean age = 52.2 years, range 29–75; sample size = 55.4, range 5–249; % males = 65.1%, range 0–100; and maximum study duration = 13.2 weeks, range 1–48. There were no significant differences between treatment categories on strength of research design nor evidence of publication bias. The pooled mean effect sizes in Hedges’s g for the four categories were MBSR = −0.52, MBO = −0.66, OM = −0.63, and TM = −1.13. There were no appreciable differences in the study characteristics of research conducted on different meditations in terms of the types of study populations included, outcome measures, control conditions, gender, or length of time between the intervention and assessment of PTSD. TM’s effect was significantly larger than for each of the other categories, which did not differ from each other. No study reported serious side effects. Conclusions: All categories of meditation studied were helpful in mitigating symptoms of PTSD. TM produced clinically significant reductions in PTSD in all trauma groups. We recommend a multisite Phase 3 clinical trial to test TM’s efficacy compared with standard treatment. Full article

This study examined the effectiveness of the virtual delivery of the Strength at Home (SAH) intervention program for intimate partner violence in a sample of 605 military veterans across 69 Veterans Affairs (VA) Medical Centers through a national implementation of the program. Outcome measures included physical IPV, psychological IPV, coercive control behaviors, post-traumatic stress disorder (PTSD) symptoms, and alcohol misuse. Significant pre-intervention to post-intervention reductions were found for all the outcomes, with similar effect size estimates relative to a prior investigation of in-person-delivered SAH through the same national VA implementation. Study findings suggest that the virtual delivery of SAH may be as effective as in-person delivery which has important implications for program access and impact. Full article

Background: The purpose of this study was to examine how the COVID-19 pandemic influenced the patterns, distribution, and circumstances of dental trauma (DT) cases at a German cranio-maxillofacial trauma center. Materials and Methods: This retrospective analysis compared DT cases from the PreCovid (PC) period (February 2019–January 2020) with those from the IntraCovid (IC) period (February 2020–January 2021). It included an examination of baseline characteristics, types of DT, circumstances leading to DT, and the treatment approaches applied. Results: In the IC period, there was an increase in the number of DT, a significant increase in uncomplicated crown fractures, crown–root fractures, subluxations, avulsions, alveolar fractures, combined tooth fractures and dislocations, and concomitant soft tissue injuries. There were no differences regarding the location of DT. During the IC period there was a significant reduction in sports accidents, road traffic accidents, interpersonal violence, and alcohol-related DT. Simultaneously, there was a marked increase in falls, syncopal episodes, home accidents, and DT incidents occurring on weekdays. Furthermore, during the IC period, the number of cases of DT increased in the morning and decreased at nighttime. Conclusions: The COVID-19 pandemic significantly affected the types of DT, the treatment approaches, and the circumstances under which DT occurred. Investigating these impacts can help to predict the effects of a future pandemic on DT and/or maxillofacial trauma and possibly reduce these effects through establishing appropriate preventive measures. Full article

Women who receive substance use treatment have a particular classification of sensitivity to European drugs and drug use (according to the EMCDDA). The average level of women’s treatment is lower than men’s across Europe, while women’s abandonment is higher than men’s. The purpose of this study was to examine the factors associated with problems for women who use drugs, analyzing several psychological and social factors (gender, substance use, mental health, source of economic support, legal status, and abuse). Methodology: This was a quantitative study. Data on 2179 people receiving rehabilitation treatment were obtained from the EuropASI survey. The dependent variables in this study were (1) a patient’s known history of addiction and mental illness; (2) primary drug use; (3) drug use in their lifetime and the past month; (4) mood in their lifetime and the past month, physical condition, and sexual abuse history; (5) mental illness in their lifetime and the past month (including suicide attempts); (6) legal status in their lifetime and the past month; (7) and source of income in the past month and (8) and the number of patients. The factor of gender was taken as a dichotomous variable (male–female). The confidence interval used was 95%. Results: In summary, we found that women had consumed more alcohol, used more drugs, and suffered more from depression, anxiety, and suicidal ideation than men, both during their lifetimes and in the past month. In addition, women were more likely than men to be stigmatized for prostitution because their financial support came mainly from colleagues, friends, and family, as well as from prostitution. Finally, women had experienced more violence (emotional, physical, and sexual) during their lifetimes and in the last month than men. Conclusion: There appears to be a need to develop a comprehensive treatment network for addictive behaviors from a multifactorial perspective, including harm reduction, psychosocial support, and recovery programs; furthermore, targeting specific groups with special needs, such as women, especially those with mental health problems, women with alcoholism, and abused women, it also seems important to develop adaptive recovery programs within addictive behavior treatment networks. Full article

Background: Violence against health professionals is a global and growing problem, with significant impacts on the quality of care and the mental health of workers. Objectives: To analyze the level of knowledge, reporting practices and consequences of violence against health professionals in the Alentejo region (southern Portugal). Methods: This was an observational, cross-sectional study involving 440 health professionals (doctors and nurses). Data were collected using an online platform and a structured questionnaire created specifically for this study. In the statistical analysis, the data were described as counts and proportions and the X2 test was used considering a significance level of 0.05. Results: This study reveals that violence against health professionals in the southern region of Portugal is a frequent problem (40%), with a higher incidence among nurses (80%). Despite awareness of the existence and functioning of reporting channels, reporting is low (52%). The main causes are related to the health system, professionals and users. The consequences include mental health problems and a reduction in the quality of care provided. Suggested measures to combat violence include improving security, training and punishing aggressors. Conclusions: This study reveals that violence against health professionals in the southern region of Portugal is a frequent, under-reported problem with serious consequences for professionals and the quality of care. Full article