Gender differences in characteristics of physical and sexual victimization in patients with dual diagnosis: A cross-sectional study

Abstract

Background: Patients with substance use disorders and co-occurring mental health disorders are vulnerable to violent victimization. However, no evidence-based interventions are available to reduce patients' vulnerability. An exploration of the characteristics of physical and sexual violence can provide valuable information to support the development of interventions for these patients. This study aimed to examine gender differences in characteristics of violent victimization in patients with dual diagnosis. Methods: In this cross-sectional survey study recent incidents of physical and sexual assault were examined with the Safety Monitor in 243 patients with dual diagnosis. Chi-square tests were used to examine gender differences in the prevalence of physical and sexual victimization. Fisher's exact tests and Fisher-Freeman-Halton exact tests were used to determine whether there were significant differences between victimized men and women with regard to perpetrators, locations, reporting to the police and speaking about the assault with others. Results: There was no significant difference in the prevalence of physical violence in men (35%) and women (47%) with dual diagnosis. There was a significant association between gender of the victim and type of perpetrator (P < .001). Men were most often physically abused by a stranger or an acquaintance, whereas women were most frequently abused by an (ex)partner. Sexual violence was more prevalent in women (29%) compared to men (4%) (P < .001). Patients with dual diagnosis were unlikely to report incidents of physical abuse and sexual assault to the police and to speak about it with caregivers. Conclusions: Characteristics of physical violence are different for men and women with dual diagnosis. Women with dual diagnosis are more often victims of sexual violence compared to men. Interventions aimed at reducing patients' vulnerability for victimization should take gender differences into account.