Background: Transgender and gender diverse (TGD) individuals face substantial physical and mental health care barriers. Community pharmacies are one of the most accessible health care settings; however, concern for discrimination at the pharmacy has been reported. It is important to gain a better understanding of TGD individual's perspectives and experiences at the pharmacy to ensure optimal and inclusive care. Objective: To identify TGD individual experiences and barriers at the pharmacy. Methods: This institutional review board-approved qualitative study recruited TGD young adults in the United States between ages 18 and 29 years for semi-structured focus group discussions. Questions focused on barriers to obtaining medications at the pharmacy and negative or positive experiences with pharmacists. Interviews were recorded, transcribed, and transcripts were analyzed for common themes amongst participants. Results: Nine 1.5- to 2-hour focus groups were conducted and included 30 participants (2-6 participants in each group). All participants reported having been prescribed medications by a physician or mental health provider. Participants self-reported issues at pharmacies and with pharmacy personnel. Major themes included issues accessing medications and supplies (needles, syringes), questioning of prescription validity and patient identity, and lack of education or understanding of TGD individuals by pharmacy staff. Conclusion: TGD individuals experience barriers at the pharmacy and concerning issues with pharmacy staff. Education, structural competency, and improvements in gender-related data management are necessary for pharmacists and pharmacy staff to provide equitable and inclusive care for TGD individuals. (c) 2024 American Pharmacists Association (R). (R) . Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

Exposure to potentially traumatic events (PTE), higher rates of Posttraumatic Stress Disorder (PTSD) and higher distress intolerance have been associated separately with opioid misuse in clinical samples. Adult women who reported past year misuse of a prescription drug were recruited on Prolific Academic (ProA) to participate in an online survey ( n = 154). Measures included the Trauma History Questionnaire (THQ) for lifetime trauma histories, PTSD Checklist for DSM-5 (PCL-5), Distress Intolerance (DI), NIDA-Modified ASSIST, and the Drug Abuse Screening Test (DAST-10). In a multinomial logistic regression model, experiencing a potentially traumatic event involving interpersonal victimization, having higher distress intolerance, and having greater PTSD symptoms, were significantly associated with drug use class. In particular, higher distress intolerance was associated with problem opioid use relative to problem use of other drugs. Distress intolerance is a potentially salient and modifiable target for mental health and substance use interventions.

Many women survivors of intimate partner violence (IPV) experience repetitive head injuries in their lifetime, but limited research has examined the cumulative effects of multiple head injuries on post-concussion symptom severity in this population. This study examined how number of lifetime head injuries and episodes of loss of consciousness (LOC) due to head injuries were related to current cognitive, physical, and emotional symptoms among women survivors of IPV. Cisgender women from Kentucky were recruited following a protective order against an intimate partner, including 268 women with no reported lifetime head injuries and 250 women with one or more IPV-related head injuries (mean [M] = 17.2 head injuries, standard deviation [SD] = 50.5, median [Mdn] = 4, range = 1-515; M = 1.8 LOC episodes, SD = 4.3, Mdn = 1, range = 0-35, respectively). Participants underwent in-person interviews about lifetime physical and sexual IPV history, head injury history, and current cognitive, physical, and emotional symptoms. Sociodemographic characteristics, physical and sexual IPV severity, and current symptom severity were examined in relation to number of head injuries and LOC episodes. A higher number of head injuries was associated with greater age, White race, less than high school education, unemployment, and rural residence. No sociodemographic variables differed based on number of LOC episodes. Greater number of lifetime head injuries and LOC episodes correlated significantly with physical IPV severity (rho = 0.35, p < 0.001; rho = 0.33, p < 0.001, respectively) and sexual IPV severity (rho = 0.22, p < 0.001; rho = 0.19, p = 0.003). Greater number of head injuries and LOC episodes correlated significantly with greater cognitive (rho = 0.33, p < 0.001; rho = 0.23, p < 0.001, respectively), physical (rho = 0.36, p < 0.001; rho = 0.31, p < 0.001), emotional (rho = 0.36, p < 0.001; rho = 0.18, p = 0.004), and total symptom severity (rho = 0.39, p < 0.001; rho = 0.26, p < 0.001). In group comparisons, participant groups stratified by number of head injuries (i.e., 0, 1-3, 4+) differed in total symptom severity (p < 0.001, η2 = 0.15), with greater symptom burden associated with more head injuries. Participants with and without LOC differed in symptom severity: cognitive (p < 0.001, d = 0.45), physical (p < 0.001, d = 0.60), emotional (p = 0.004, d = 0.37), and total symptom severity (p < 0.001, d = 0.53). Group differences between participants with and without LOC remained significant after controlling for sociodemographic variables and IPV severity. There was no cumulative effect of LOC, in that participants with 1 LOC episode did not differ from participants with 2 + LOC episodes (p > 0.05). Based on hierarchical regression analyses, only physical symptoms were independently related to number of head injuries (p = 0.008, ΔR2 = 0.011) and number of LOC episodes (p = 0.014, ΔR2 = 0.021) after controlling for sociodemographic characteristics and IPV severity. Among women survivors of IPV, cumulative head injuries appear related to greater symptom severity. Greater head injury history was independently related to worse physical symptoms (e.g., headaches, dizziness, sleep problems), whereas cognitive and emotional symptoms were, in part, attributable to cumulative physical and emotional trauma due to IPV. Women survivors of IPV with repetitive head injuries have unmet neurobehavioral health needs that may benefit from targeted interventions.

Women survivors of intimate partner violence (IPV) have increased risk of repetitive neurotrauma in their lifetime but have received less research focus compared with populations of athletes, veterans, and emergency department patients. The current study examined the importance of IPV as a contextual mechanism of injury, by comparing women survivors of IPV based on whether they experienced a head injury due to IPV or a head injury not due to IPV. The analyses involved archival data from in-person interviews conducted with women who received a protective order against an intimate partner in Kentucky from 2001 to 2004 (n = 641). Women were excluded if they reported no head injury history (n = 268), resulting in two groups compared based on a retrospective cohort design: 255 women with at least one self-reported IPV-related head injury (M = 33.8 +/- 9.0 years old, range: 19-65; 87.5% White) and 118 women with self-reported head injuries due to reasons other than IPV (M = 32.2 +/- 9.1 years old, range: 18-62; 89.0% White). Participants were compared on injury characteristics, lifetime physical and sexual IPV severity, subacute symptoms of head injury, and receipt of care for head injury. Compared with women with head injuries unrelated to IPV, women with IPV-related head injuries reported a higher number of lifetime head injuries (Mdn[range]: IPV-related = 3[1-515] vs. non-IPV-related = 1[1-13], p < 0.001, r = 0.51) and a higher number of head injuries involving loss of consciousness (Mdn[range]: IPV-related = 1[1-35] vs. non-IPV-related = 1[1-4], p < 0.001, r = 0.27), but lower rates of hospitalization (IPV-related = 56.1% vs. non-IPV-related = 73.7%, p = 0.001, odds ratio [OR] = 2.20 [95% confidence interval (CI): 1.36, 3.55]) and formal rehabilitation (IPV-related = 3.2% vs. non-IPV-related = 9.4%, p = 0.011, OR = 3.18 [1.24, 8.13]) following head injury. Women with IPV-related head injuries had greater lifetime severity of physical IPV (p < 0.001, d = 0.64 [0.41, 0.86]) and sexual IPV (p < 0.001, d = 0.38 [0.16, 0.60]). Women with IPV-related head injuries endorsed all symptoms at greater rates than women with non-IPV-related head injuries (ps < 0.001), including physical (e.g., headaches: OR = 3.15 [1.81, 5.47]; dizziness: OR = 2.65 [1.68, 4.16]), cognitive (e.g., trouble problem solving: OR = 2.66 [1.53, 4.64]; inattention: OR = 2.39 [1.52, 3.78]), and emotional symptoms (e.g., depression: OR = 7.39 [4.48, 12.20]; anxiety: OR = 4.60 [2.82, 7.51]). The total count of symptoms endorsed was higher for women with IPV-related head injury than women with head injuries unrelated to IPV (p < 0.001, d = 0.71 [0.49, 0.94]). When controlling for lifetime physical and sexual IPV, IPV-related head injury was independently associated with symptom count (beta = 0.261, p < 0.001) and accounted for additional variance in symptom count (Delta R-2 = 0.06, p < 0.001). Among women survivors of IPV, those reporting IPV-related head injuries reported greater subacute symptoms, but a lower likelihood of being hospitalized or receiving rehabilitative care. Women with self-reported IPV-related head injuries represent an underserved population that is often unevaluated following injury and may have many unmet care needs. Future studies should examine persistent symptoms following IPV-related head injuries and interventions that would be most beneficial for this population.

Stalking victimization, regardless of victim–stalker relationship, has been associated with negative consequences including high fear levels, mental health problems, and resource losses. Much of the research on stalking has focused on (ex)partner stalking victim experiences and consequences; however, many women are stalked by acquaintances. This is one of the first studies to examine acquaintance stalking victims who did ( n = 140) and who did not ( n = 222) experience negative work consequences from stalking victimization. Results found that just over half of the acquaintance stalking victims indicated the stalker was someone from work or school. Overall, many acquaintance stalking victims regardless of work losses experienced work interference, although those with work losses experienced increased work interference and job performance problems. Additionally, stalking victims with negative work consequences experienced more stalking threats, life interference, more non-work-related resource losses, and had higher stalking-related fear levels than victims without work losses. Regardless of group, stalking victims lost an average of nine different resources other than work losses, and resource losses were associated with current negative mental health symptoms and help-seeking. Help-seeking, outside of friends or family, even though they endured stalking for an average of almost 2 years, was low for all of the victims. However, acquaintance stalking victims with work losses sought help from more sources on average. Implications from this study suggest that safety at work should be a primary concern for all types of stalking victims, and workplace policies should consider stalking as a separate category of victimization.

Purpose/Objective: The current study examined the psychometric properties of common mental health questionnaires among women survivors of intimate partner violence (IPV) with and without brain injuries due to IPV and evaluated whether women with and without IPV-related brain injuries differed in depression, anxiety, and posttraumatic stress disorder (PTSD) symptom severity. Research Method/Design: Women survivors of IPV with and without IPV-related brain injuries were recruited online through Prolific (N = 205, M = 39.8 +/- 11.9 years old, 83.9% non-Hispanic White, 42.4% college-educated). They completed the eight-item Patient Health Questionnaire (PHQ-8), seven-item Generalized Anxiety Disorder scale (GAD-7), and PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders (fifth edition) (PCL-5). Model fit and internal consistency were estimated for each scale. Groups were compared on mental health symptom severity, with and without controlling for age, education, and IPV severity. Results: Both one-factor and multifactor models showed excellent fit for all scales. PHQ-8 (omega = .91), GAD-7 (omega = .94), and PCL-5 total scores (omega = .95) had strong reliability, and all subscale scores had acceptable-to-strong reliability (omega range = .79-.94). Women with IPV-related brain injuries reported greater physical IPV severity, higher rates of depression, and higher somatic anxiety and PTSD symptom severity. No group differences in mental health symptoms were significant after controlling for IPV severity. Conclusions/Implications: The PHQ-8, GAD-7, and PCL-5 showed evidence for reliability and validity among women survivors of IPV. Women with IPV-related brain injuries had higher PTSD symptom severity, attributable to greater physical violence exposure in general. Brain injury screening among survivors appears warranted for women with extensive physical IPV experiences. Interventions addressing PTSD, violence prevention, and brain injury recovery may best serve this population.

This study psychometrically evaluated the Neurobehavioral Symptom Inventory (NSI) among women survivors of intimate partner violence (IPV) and compared symptoms between women with no brain injury history ( n = 93) and women with IPV-related brain injury history ( n = 112). Women completed the NSI and questionnaires on traumatic brain injury (TBI), hypoxic-ischemic brain injury (HI-BI), and lifetime IPV history. A four-factor NSI model, including affective, somatosensory, cognitive, and vestibular factors, had the best fit (comparative fit index = 0.970, root mean square error of approximation = 0.064), with strong reliability for the total score ( ω = .93) and subscale scores ( ω range = .72–.89). In group comparisons, women with IPV-related brain injuries reported greater total, affective, and cognitive symptom severity after adjusting for age and education; however, no group differences were observed after adjusting for IPV severity. When examining lifetime number of brain injuries, HI-BI count was independently predictive of total, cognitive, and vestibular symptom severity after adjusting for age, education, and IPV severity; whereas TBI count did not independently predict any NSI scores after adjusting for these covariates. The NSI had acceptable psychometric properties for measuring neurobehavioral symptoms among women survivors of IPV. The association between HI-BI count and cognitive and vestibular symptoms may indicate the importance of studying repetitive nonfatal strangulation as an injury mechanism in this population.

This study examines male (n = 2,612) and female (n = 2,644) clients entering SUD treatment who rated their quality-of-life (QofL) lower or higher and then examined thier recovery needs at program entry and at follow-up as well as return to substance use at follow-up. Results found that lower QofL ratings at program entry were associated with many recovery needs at both program entry and at follow-up. In the multivariate analysis, QofL ratings at program entry were significantly and uniquely associated with the average number of recovery needs at follow-up as well as return to use after controlling for recovery needs at program entry. Individuals who continued to rate their QofL lower at follow-up had lower SUD program satisfaction and engagement ratings and had more recovery needs, on average, at follow-up. Focusing on recovery needs and quality-of-life, which vary by person and context, may enhance recovery from substance use.

This study examined mental health and recovery needs at substance use disorder (SUD) program entry and at follow-up (n = 2064) among: (1) women with no stalking victimization; (2) women with lifetime stalking victimization experiences; and (3) women with recent stalking victimization experiences (within 12 months of program entry). Stalking can be defined as a repeated pattern of behavior that creates fear or concern for safety or extreme emotional distress in the target. Women who experienced any stalking victimization, and particularly recent stalking victimization at program entry, had more recovery needs and increased mental health symptoms. At follow-up, women with any stalking victimization experiences continued to have more recovery needs with few differences between the lifetime and recent stalking victimization groups. Stalking victimization experiences were significantly associated with depression and anxiety symptoms in the multivariate analysis. Addressing stalking victimization during SUD treatment may be important to facilitate recovery.

Women survivors of intimate partner violence (IPV) experience increased risk for traumatic brain injury (TBI) due to partner abuse, but few studies have examined cognition and mental and behavioral health outcomes among women with IPV-related TBIs. This pilot study examined differences in cognition, neurobehavioral symptoms, mental health symptoms, chronic pain, alcohol use, and social functioning between women survivors with and without repetitive IPV-related TBIs. Women with 2 or more IPV-related TBIs (n = 33; M = 36.5 years old, SD = 9.4; 63.6% White) were compared to women survivors without IPV-related TBI history (n = 22; M = 34.4 years old, SD = 10.3; 77.3% White) on the Rey Auditory Verbal Learning Test, NIH Toolbox Cognition Battery, and mental and behavioral health questionnaires. Women with repetitive IPV-related TBIs had greater cognitive concerns (one-tailed p = .006, d = 0.71), lower verbal learning (p = .045, d = 0.47) and delayed memory test scores (p = .034, d = 0.51), and reduced fluid cognition compared to estimated premorbid functioning (p = .035, d = -0.51), particularly executive functions (p < .001, d = -1.01). Women with IPV-related TBIs also had greater neurobehavioral (p = .003, d = -0.78), post-traumatic (p = .003, d = -0.75), depressive (p = .038, d = -0.50), and anxiety-related symptom severity (p = .047, d = -0.44). Women with IPV-related TBIs had worse pain intensity (p = .003, d = -0.79) and interference (p = .001, d = -0.87), greater social isolation (p = .002, d = -0.84), and less emotional support (p = .002, d = 0.80). Per adjusted analyses, group differences in delayed memory (p = .025, eta(2)(p) = 0.08) and reduced fluid cognition (p = .012, eta(2)(p) = 0.10) remained significant after controlling for comorbid mental and behavioral health conditions. Repetitive IPV-related TBIs were associated with worse objective cognitive performances and worse mental, behavioral, and social health. These pilot results require replication but indicate that women with IPV-related TBIs experience multidimensional health needs. In practice, women with IPV-related TBIs may benefit from psychological or neuropsychological assessments evaluating cognition, mental health, pain, substance use, and social support to characterize the health needs of survivors and inform treatment planning.

Safety planning is often recommended for stalking victims, yet there has been limited research on personal safety planning in general and specifically for stalking victims. This study has two overall objectives: (1) to examine whether frequency of safety scenario planning (thinking through various strategies in responding to threatening situations) among ex-partner stalking victims is associated with increased personal safety worry, safety efficacy, and other safety behaviors (e.g., seeking safety advice, carrying a safety device); and (2) to explore associations of frequency of safety scenario planning with partner abuse and stalking experiences, help-seeking, and mental health symptoms. Women stalking victims were recruited from Prolific. Three groups were developed for comparisons including stalking victims who: (a) did not engage in safety scenario planning in the past year (n = 121); (b) engaged in one safety scenario planning activity in the past year (n = 256); and (c) engaged in 2 or more safety scenario planning activities in the past year (n = 184). Bivariate results found that frequency of safety scenario planning was associated with increased personal safety worry, increased seeking and giving safety advice, and increased defensive safety behaviors. Additionally, the multivariate analysis found more frequent safety scenario planning was uniquely and significantly associated with increased personal safety worry, safety efficacy, work interference, the number of different help-seeking sources, PTSD symptoms, and sexual discomfort. More research is needed to provide information about best practices in safety planning to better help victims manage the short- and long-term consequences of violence exposure in their recovery journey.

Increases in methamphetamine use among individuals seeking treatment for opioid use disorder (OUD) have implications for substance use disorder (SUD) treatment. Secondary data from 28,358 adults (18+) in a multi-year evaluation of publicly funded SUD treatment was analyzed. A significant linear trend showed an increase in opioid and methamphetamine co-use over time. In the multinomial logistic regression, recent co-use of opioids and methamphetamine was significantly associated with being female, younger age, being White, living in a metropolitan community, greater economic hardship, using more substances (other than opioids and methamphetamine) relative to the other drug use patterns. Past-12-month interpersonal victimization was associated with co-use of opioids and methamphetamine relative to individuals who did not use opioids-methamphetamine and individuals who used opioids, no methamphetamine.

Limited research has examined the symptom sequelae of head injuries in women survivors of intimate partner violence (IPV), despite this community being at increased risk for neurotrauma due to partner abuse. The current study compared post-concussion symptom severity between women with and without IPV-related head injuries. Women were recruited from court jurisdictions in Kentucky, USA, after receiving a protective order for partner abuse. The sample included 268 women with no prior head injuries (age: M[standard deviation (SD)] = 31.8[9.8], 77.2% White) and 251 women with lifetime IPV-related head injuries (age: M[SD] = 31.8[9.8], 88.0% White). Women with IPV-related head injuries were slightly older (t = 2.46, p = 0.014) with lower education (chi(2) = 5.81, p = 0.016), were more frequently unemployed (chi(2) = 9.23, p = 0.002), and had a higher likelihood of residing in a rural setting (chi(2) = 30.16, p < 0.001). Women with IPV-related head injuries were also more often White (chi(2) = 10.47, p = 0.001), but this group difference was almost entirely related to rural versus urban residence. Women with IPV-related head injuries reported a higher severity of lifetime physical IPV (t = 7.27, p < 0.001, d = 0.64, 95% confidence interval [CI]: [.46, .82]) and sexual IPV (t = 4.65, p < 0.001, d = 0.41 [0.24, 0.59]). A three-factor model of post-concussion symptoms, inclusive of cognitive, physical, and emotional symptoms, fit well (chi(2) = 368.99, p < 0.0001, comparative fit index [CFI] = 0.974, Tucker-Lewis index [TLI] = 0.968, root mean square error of approximation [RMSEA] = 0.079 [0.071, 0.087]), and showed evidence for strong measurement invariance across women with and without IPV-related head injuries. The subscale and total scores each had acceptable reliability: cognitive (omega = 0.88 [0.86, 0.90]), physical (omega = 0.74 [0.70, 0.77]), and emotional (omega = 0.88 [0.86, 0.89]), and total score (omega = 0.93 [0.92, 0.95]). Women with IPV-related head injuries reported all individual post-concussion symptoms at a significantly higher frequency, with medium group differences in cognitive (t = 7.57, p < 0.001, d = 0.67 [0.50, 0.85]) and physical symptoms (t = 7.73, p < 0.001, d = 0.68 [0.51, 0.86]) and large group differences in emotional (t = 8.51, p < 0.001, d = 0.75 [0.57, 0.93]) and total symptoms (t = 9.07, p < 0.001, d = 0.80 [0.62, 0.98]). All sociodemographic characteristics were independently associated with post-concussion symptoms, as were physical IPV (total score: r = 0.28 [0.19, 0.35], p < 0.001) and sexual IPV severity (total score: r = 0.22 [0.13, 0.30], p < 0.001). In hierarchical regression analyses, controlling for sociodemographic characteristics (i.e., age, race/ethnicity, education, unemployment, and rural/urban residence) and physical and sexual IPV severity, IPV-related head injury was independently significant and accounted for significant additional variance when predicting cognitive (Delta R-2 = 0.05, p < 0.001), physical (Delta R-2 = 0.03, p < 0.001), emotional (Delta R-2 = 0.07, p < 0.001), and total symptoms (Delta R-2 = 0.06, p < 0.001). Negative-binomial regression resulted in similar findings. This study demonstrates that multiple sociodemographic and IPV history variables are related to post-concussion symptom severity, but IPV-related head injury was independently associated with greater symptom severity. Women with IPV-related head injuries may be at increased risk for unaddressed health problems spanning cognitive, physical, and emotional domains. Future research is needed to psychometrically evaluate assessment instruments for this population and to assess efficacy of interventions to address their unique health care needs.

There has been a surge of research interest in online stalking, often called cyberstalking, in recent years. The overall goal of this study was to better understand whether more invasive online stalking strategies were associated with stalking course-of-conduct, victim harms, and help-seeking. Specifically, the current study examined three groups of female acquaintance stalking victims who: (1) did not experience online stalking (n = 93, 23.8%); (2) experienced online harassment but not monitoring strategies (n = 144, 36.8%); and (3) experienced online harassment and monitoring strategies (n = 154, 39.4%). Results found that more women who experienced online monitoring endured threats, life interference, sexual harassment, stalker jealousy, and control, and more of them believed the stalker wanted revenge than the other two groups. Additionally, more women who experienced online monitoring had higher fear levels, reported more problems during the stalking, and had increased resource losses compared to the other two groups. In the multivariate analysis, online harassment and online monitoring strategies were not significantly associated with fear level, help-seeking, or ongoing problems. However, online stalking strategies co-occur with stalking intensity and frequency as well as with victim harms and should be taken seriously.

Women survivors of IPV with repetitive mTBI history had greater subjective cognitive concerns and lower cognitive test performances compared to national norms, indicating cognitive health needs in this population. These findings may be attributable to repetitive mTBI or other neurobehavioral variables that may affect this population, including concurrent physical conditions (e.g., headache), mental illness, chronic pain, substance use, or a combination thereof.

Prior research suggests that economic abuse and work sabotage are common tactics for abusers and (ex)partner stalkers. This study examines the context and timing (i.e., during the relationship or during separation) of work harassment among women stalked by abusive (ex)partners among victims who did (n=271) and who did not (n=302) experience work losses (significant problems at work or loss of work due to the abuse/stalking) and whether work losses and non-work related resource losses were associated with current mental health symptoms. Results showed that almost half of the women in the study reported they experienced work losses because of their abusive (ex)partner. Women with work losses experienced more work harassment particularly during periods of separation. Women who experienced work losses also experienced more work harassment, separation attempts, economic control, coercive control, physical and sexual abuse, higher fear levels, and a higher number of non-work related resource losses compared to women who did not report experiencing work losses. Women with work losses experienced more symptoms of current depression, anxiety, and Post-Traumatic Stress Disorder. Further, in the multivariate analysis, non-work related resource losses were significantly and uniquely associated with current mental health symptoms. In conclusion, women being stalked by abusive (ex)partners are at significant risk of resource losses, and those losses have long term impacts on mental health suggesting that safety planning for stalking victims should include plans to protect resources as well as physical safety.

Intimate partner violence in the United States is significantly associated with employment instability. Using a latent growth curve model, the current study investigates the impact of intimate partner violence on mothers' (N=4897) employment outcomes trajectories in the Fragile Families and Child Wellbeing study which include four waves of data collection starting when a child was born and ending about eight years later. Outcomes included annual weeks worked and employment status (employed vs. unemployed). There was a significant effect of intimate partner violence on weeks worked and employment status at the second wave of data collection, indicating that mothers were most likely to experience employment instability when they had a three-year-old child. Results also showed that intimate partner violence survivors were still experiencing unemployment six years after abuse occurred. Workplaces and policymakers should protect mothers with young children experiencing intimate partner violence by extending time off from work and connection to community resources.

Women with IPV-related HIs reported the highest pain severity and interference, although this difference became non-significant after controlling for lifetime IPV severity. Pain interference among women with IPV-related HIs may be related to more severe physical violence, coercive control, and emotional trauma.

Firearm-related risks have often been overlooked in the sequela of substance use and substance use disorders. This study compares adult substance abuse disorder treatment (SADT) clients who experienced recent ( n = 274) and lifetime ( n = 889) firearm threats to adults who were not threatened with a firearm ( n = 2029) before and 12 months after program entry. More men experienced firearm threats (38.8%) than women (34.2%). However, among those with any firearm threats, more women (27.2%) experienced firearm threats in the year before program entry than men (20.2%). Being threatened with a firearm was associated with increased economic vulnerability, criminal justice system involvement, mental health problems, and victimization both before and after SADT program entry. A higher number of adverse childhood experiences were associated with firearm threats and particularly recent firearm threats. Results of this study underscore the importance of screening for firearm-related risks in substance abuse disorder treatment programs.

Given the heightened risk for fatality and known non-fatal harm firearms pose in abusive situations, it is critical to consider the impact of the COVID-19 pandemic on firearm-related abuse and safety planning—particularly considering the surge in firearm sales in 2020. This study documented the impact of the pandemic on firearm access and violence, advice and safety planning surrounding firearms, and firearm-related abuse tactics through the perspective of victim service providers across the US participants included victim service professionals from both rural ( n = 93) and urban/suburban (i.e., non-rural; n = 78) areas who worked with victims of gender-based violence (i.e., intimate partner abuse and dating violence, child abuse, elder abuse, sexual assault, stalking, or human trafficking victims). Results revealed that nearly half of participants reported that abusers threatening to shoot victims or others became more frequent since the start of the pandemic, while nearly 30% reported that homicide involving firearms became more frequent during the pandemic. Further, nearly 40% of participants indicated an increase in firearm sales during pandemic—with higher sales in non-rural versus rural areas. Common themes related to safety planning with firearms included advising the victim to contact the system for help, assessing the location of firearms and/or remove the firearms, and leaving the abuser. The results stress the importance for safety planning around firearms when victims are isolated with an abuser at home and potential impact of abuser firearm access on public safety.