Child maltreatment prevalence and mental disorders outcomes among American Indian women in primary care☆
Section snippets
General introduction: child maltreatment and mental disorders
The prevalence of child maltreatment among American Indian families and communities is not well documented, nor is the effect of that maltreatment on the mental health of individuals as they grow to adulthood. The prevalence of mental disorders has emerged as an important public health concern worldwide (Ustun, 1999). In the non-American Indian population, child maltreatment in its various manifestations is well established as a risk factor for general psychological distress (Bernet & Stein,
Study location
The study was conducted at the outpatient clinics of the IHS hospital in Albuquerque New Mexico, between June and October 1999. The outpatient clinics include general medical patients who have regular scheduled appointments and those phoning in or showing up for “urgent care”; they represent the range of women presenting for primary care services at this IHS facility (North, C., & Lyon, C., personal communication between Dr. Charles North, Sheri Lyon and Bonnie Duran on sampling from the
Demographics
Participants ranged in age from 18 to 45 years (mean=29.8). All the women were enrolled with a tribe, 90% with southwestern tribes. Approximately 61% were married or living in common law relationships, and most (88%) lived in urban areas. A majority (60%) of women had formal education beyond high school, and 55% were employed full-time. Despite relatively high education, over one-quarter of participants (29%) lived below the federal poverty level, and only 33% lived above 185% of the poverty
Discussion
We are able to highlight four main findings from this study of child maltreatment and mental disorders. Specifically, American Indian women in primary care exhibit (a) a high prevalence of childhood maltreatment; (b) a high degree of overlap between abuse types; (c) a strong relationship between severity of maltreatment and mental disorder outcomes; and (d) a non-specific relationship between child maltreatment and mental disorder outcomes except for PTSD. Since there are no other primary care
Acknowledgements
The authors would like to acknowledge the contributions of several individuals and tribes without whom this work would not have been possible. Special thanks to: each woman who agreed to be interviewed for this study; Ken Lucero and all the members of the Albuquerque Service Unit Indian Health Board and Tribal administrations, Cheri Lyon, Charles North and other IHS ASU administrators and employees for their support, feedback, and use of facilities; and Claudia Honeywell, Kathleen Earle, Arthur
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This research was made possible by Grants 1R24MH58404, K01MH02018, and R25MH60288 from the National Institute of Mental Health (NIMH).
Points of view in this article are those of the authors and do not necessarily represent the official views of the NIMH.
The Institutional Review Boards of both the University of New Mexico Health Science Center and the National Research Office of the Indian Health Service approved this study. The Albuquerque Indian Hospital, Service Unit Indian Health Board also approved this study and publication.