Qualitative study examines abuse against people with SCI
A range of research studies have shown that people with disabilities are at a greater risk of experiencing interpersonal violence. However, there has been very little research on interpersonal violence against people with spinal cord injury (SCI) — until now.
Researchers from TIRR Memorial Hermann in Houston, UT Health Houston and the University of Montana have been examining the issue of interpersonal violence, or the intentional use of force or power by one person against another, in the SCI community. With funding from the Department of Defense, they conducted a qualitative examination in 2024, and Susan Robinson-Whelen, PhD, shared preliminary results Aug. 26 during the Paralyzed Veterans of America Healthcare Summit + Expo at the Hyatt Regency in New Orleans.
Robinson-Whelen says people with disabilities can experience the same types of interpersonal violence as the general population, including physical, sexual, emotional or financial abuse. But they can also endure disability-related abuse.
“This includes things like preventing some someone from using their wheelchair or preventing someone from using some other important essential assistive device, denying or neglecting assistance with essential personal needs by someone that they normally do rely on for that help and denying access to basic human needs, transportation, medical assistance, access to medications and caregiver support,” Robinson-Whelen says. “In addition to that abuse that’s specifically related to their disability, they are apt to experience abuse at the hands of many different types of perpetrators.”
She says those perpetrators may be intimate partners, personal care assistants, family members, strangers or even health care providers. In addition, there is some evidence in the literature that people with disabilities experience abuse for a longer duration than those without disabilities, and people with disabilities experience numerous barriers to escaping interpersonal violence, including many disability-related barriers.
Robinson-Whelen and her team first published a health promotion intervention study for women with SCI in 2023, asking about 175 participants’ lifetime experience with interpersonal violence. Although the study didn’t ask if abuse was pre- or post-injury, the researchers found that over half of the women reported some lifetime abuse — 43% reported physical abuse, 32% reported sexual abuse and 23% reported disability-related abuse. In addition, 16% of the sample had experienced all three types of abuse.
This study encouraged the team to closely examine interpersonal violence against people with SCI in the 2024 study, titled the SCI Personal Safety Study. The advisory board includes people with SCI lived experience.
The qualitative study involved 21 participants who were interviewed about their post-injury experiences with interpersonal violence. Interviews were conducted via Zoom video conferencing and averaged about 45 minutes.
In total, there were 48 emotional abuse reports; 38 disability-related reports, such as being left in the shower, crutches being thrown in the snow or wheelchairs being damaged or destroyed; 13 examples of physical abuse; seven reports of financial abuse and six reports of sexual abuse or threats of sexual abuse. The vast majority (18 of 21) described experiencing more than one type of abuse. There were 15 reports of abuse at the hands of an intimate partner or spouse and 15 reports of abuse at the hands of health care providers. Ten of the 21 study participants reported having experienced abuse by multiple perpetrators and multiple types of abuse from multiple perpetrators. Twenty of the 21 respondents had disclosed the abuse to someone, with 11 of those disclosed to the police or other authorities.
Some of the barriers to reporting the abuse were a fear of reporting, fear that it would only make it worse, fear of the unknown and a sense of futility, or ‘What good would it do?’
Robinson-Whelen says there is more data to come, such as participants’ perceptions of the psychosocial impacts of interpersonal violence, coping strategies that participants shared and advice they would give to others, as well as thoughts on prevention and intervention programs.
In the meantime, the team launched a national survey study in the spring and hopes to recruit several hundred participants through December. The survey aims to data about types of interpersonal violence experienced by people with SCI, risk factors, contextual factors and the relation of post-injury interpersonal violence to psychosocial health (anxiety, depression, post-traumatic stress disorder, loneliness and social isolation). Eligible participants will receive a small payment for completing the survey.
“So, we are trying to spread the word that know even if you don’t feel you’ve experienced abuse, it’s really important to contribute to this literature by taking our survey,” Robinson-Whelen says.
For information on the national survey, email SCIPSstudy@uth.tmc.edu or call 713-797-7245.