Uvelli Allison, Pugliese Erica, Masti Alessandra, Salvo Giulia, Duranti Cristina, Gualtieri Giacomo, Ferretti Fabio
Department of Medical Science, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy.
Department of Clinical Psychology, University of Amsterdam, 1012 Amsterdam, The Netherlands.
Brain Sci. 2024 Sep 24;14(10):953. doi: 10.3390/brainsci14100953.
Violence against women impacts a minimum of 35% of the global female population, encompassing sexual, physical, and psychological forms. Perpetrators of this violence include partners, family members, or strangers. Its ramifications are substantial, evident in the prevalence of chronic pain reported by between 48% and 84% of women who have experienced abuse, with an odds ratio of 2.08. Notably associated diagnoses include pelvic/vaginal pain, fibromyalgia, irritable bowel syndrome/bowel symptoms, abdominal pain, migraine/headache, and back and neck pain. These diagnoses significantly limit a woman's ability to participate in daily activities, such as exercising or working, leading to genuine disability. Despite substantial evidence, the precise cause and etiology of these conditions remain unclear. Adhering to the bio-psycho-social model, it is conceivable that chronic pain in victims of violence cannot be attributed to a single factor alone, but rather to a combination of all three: biological, psychological, and social factors. Uncovering these factors could have significant clinical and legal implications. On one hand, it would be possible to conduct screenings to avoid developing chronic pain. and guide individuals toward the correct treatment. On the other hand, victims could seek compensation for chronic pain resulting from violence. Considering the limited knowledge about the causes of chronic pain and the absence of tools to identify risk factors or a set of tests for evaluating victims of violence, the goal of the research described in this project protocol is to pinpoint the specific contributing factors for chronic pain due to violence victimization. Additionally, it aims to devise a comprehensive protocol for assessing these factors in forensic science.
针对妇女的暴力行为至少影响了全球35%的女性人口，包括性暴力、身体暴力和心理暴力。这种暴力行为的实施者包括伴侣、家庭成员或陌生人。其后果相当严重，48%至84%遭受过虐待的女性报告称患有慢性疼痛，优势比为2.08。显著相关的诊断包括盆腔/阴道疼痛、纤维肌痛、肠易激综合征/肠道症状、腹痛、偏头痛/头痛以及背部和颈部疼痛。这些诊断严重限制了女性参与日常活动的能力，如锻炼或工作，导致真正的残疾。尽管有大量证据，但这些病症的确切病因仍不清楚。根据生物 - 心理 - 社会模型，可以想象暴力受害者的慢性疼痛不能仅归因于单一因素，而是生物、心理和社会这三个因素的综合作用。揭示这些因素可能具有重大的临床和法律意义。一方面，可以进行筛查以避免慢性疼痛的发生，并指导个体接受正确的治疗。另一方面，受害者可以就暴力导致的慢性疼痛寻求赔偿。鉴于对慢性疼痛病因的了解有限，且缺乏识别风险因素的工具或一套评估暴力受害者的测试方法，本项目方案中所述研究的目标是确定暴力受害导致慢性疼痛的具体促成因素。此外，它旨在设计一套在法医学中评估这些因素的综合方案。
