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Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America
pathology. (2) Multiple or complex victimization histories for each respondent should be collected and considered in causal models of psychopathology, as opposed to focusing on one type of crime, occurring at one point in time, committed by one type of assailant (e.g., the FBI’s UCR, in which only the most serious victimization is included in prevalence rates; assessment of abuse by family members or caretakers, but not by strangers). (3) Studied samples should be representative of the population of interest. (4) Both quantitative aspects (e.g., level of physical injury experienced, number of perpetrators, presence of weapon during assault) and qualitative aspects (e.g., perceptions of life threat during assault, fear of crime) of victimization history should be obtained and studied. (5) Other contextual factors that influence postviolence outcome, including familial and personal history of psychopathology, social and vocational adjustment, and level of social support, should be assessed.
CONCLUSIONS AND SUGGESTIONS FOR FUTURE RESEARCH
There are two very distinct groups of elderly victims: those without significant cognitive impairment living independently, with a relative or caretaker, or in a care setting, and those with cognitive impairment, typically in the last two settings. These two classes of victims very likely require different assessment methodologies for two major reasons. First and most obvious, the nature of cognitive impairment limits one’s ability to participate in survey research. Second, the type of elder mistreatment very likely varies with the level of cognitive impairment. Moreover, the location of the elder also determines, in some part, the type of mistreatment to which she or he will be exposed (e.g., familial abuse is less likely in institutionalized elders). Existing methods to identify elder abuse fall into five groups: (1) agency record review, (2) sentinel reports, (3) criminal justice statistics, (4) caretaker/family member interview, and (5) interviews of elderly respondents themselves (in person or via telephone).
In the past, research made a distinction when studying victimization of older adults in that assessment efforts were confined to investigating either elder abuse/neglect by family members (including caregivers) or nonfamilial criminal violence, but not both. This distinction may be artificial for three reasons. First, the physical and emotional effects of such events, particularly elder abuse and nonfamilial physical and sexual assault, are often very similar, or at least share a number of similarities (Acierno et al., 1997). Second, both forms of violence appear to have several risk factors in common (e.g., poverty, limited resources, previous victimization), indicating that victims of one type of assault may be more likely to experience the other type of assault than nonvictims. Third, both forms of victimization are amenable to assessment through similar methodological strategies. Stud-