Victimization in depressed patients (WC2015-053)

Background

Starting date: 01/02/2015

Victimization in psychiatric patients
Psychiatric patients have a considerably high risk of being victim of a crime (Hiday et al., 2001; Silver et al., 2005). Even after controlling for demographic variables, prevalence rates were found to be 11 times higher in psychiatric patients than in the general population (Teplin, 2005). Victimization is a highly stressful experience that often impacts multiple domains of life, especially in the vulnerable population of psychiatric patients. Victimization can exacerbate existing symptoms, increase the likelihood of service use, hospitalization, relapse, remission and posttraumatic stress disorder and can substantially diminish quality of life (Teplin, 2005). In a recent prevalence study, depressed patients were 3.8 times more likely to be victim of a violent crime in comparison to people in the general population (Meijwaard et al., 2015). Depressive patients seem to be particularly vulnerable to violent crimes such as assault, threat and sexual crimes. Moreover, some studies indicate that even after recovery of the depression, former patients still show higher levels of interpersonal conflict and victimization (Hammen, 2008).

Risk factors for victimization
In psychiatric patients, previous victimization, symptom severity, alcohol and drug abuse, psychotic symptoms, and comorbid disorders such as depression and personality disorders have been identified as risk factors for victimization (e.g., Teasdale, 2009). In addition, emotion regulation (ER) is assumed to be an underlying mechanism in victimization. ER refers to “the processes responsible for monitoring, evaluating and modifying emotional reactions, especially their intensive and temporal features, to accomplish one’s goals” (Thompson, 1994). Emotion dysregulation (ED) is considered to be a consequence of prior victimization and a unique predictor of future (re)victimization (e.g., Messman-Moore et al., 2013). The influence of ED on victimization seems highly relevant for patients with depression. In a recent study, ED has been identified as a risk factor and maintaining factor for depression as well (Radkovsky et al., 2014).