Effect of intimate partner violence on birth outcomes

Background

Violence by intimate partner during pregnancy has many adverse pregnancy outcomes. Thus, that's why we sought to determine association between intimate partner violence during pregnancy and adverse birth outcomes.

Methods

A facility based cross-sectional study was conducted among 183 recently delivered women from March 31–April 30, 2014 in public health facilities of Hossana Town. The data were collected through structured questionnaire and record review. Women who were not mentally and physically capable of being interviewed and those admitted for abortion were excluded. Ethical clearance was obtained from Jimma University. Logistic regression analysis was employed to determine the association between intimate partner violence and adverse birth outcomes.

Results

About 23 % of women experienced intimate partner violence during pregnancy. The result of this study indicated an association of intimate partner violence with low birth weight of the new born (AOR:14.3,95% CI: (5.03, 40.7). Intimate partner violence was not associated with still birth, pre-term birth and Apgar score less than 7 at 5 minutes.

Conclusion

The findings of this study showed that intimate partner violence during pregnancy was associated with a low birth weight of the new born. Health sectors should train health care providers on how to screen, counsel, treat and follow up abused women.

Partner abuse and its association with emotional distress: A study exploring LGBTI relationships

This study examines partner abuse in LBGTI relationships, with focus on the associations with emotional distress and protective factors. Two hundred and eighty-seven participants took part. Partner abuse (victimisation) comprised three factors; conflict orientated aggression; hostile ignorance and control of communication; and social control and possessiveness (including threats to possessions). Perpetration factors were similar. Significant differences across sexuality or gender were limited to the perpetration of abuse relating to suspicion and possessiveness, where men were more likely to report this than the other gender groups, and women were less likely to report this. Of those reporting abuse in their current relationship, over half reported experiencing abuse in a primary relationship previously, with 60% reporting exposure to abuse as a child. Partner abuse in their current relationship predicted current levels of increased emotional distress, with reduced satisfaction with the current relationship having an indirect impact on this association. Resilience traits were not a predictor or mediator. The results demonstrate the similarity in abuse across LGBTI communities despite the diversity of genders, sexualities and experiences within these groups. The results are discussed with regard to directions for future research and implications for practice.

Racial/Ethnic Differences in Women's Experiences of Reproductive Coercion, Intimate Partner Violence, and Unintended Pregnancy

OBJECTIVE

To explore racial/ethnic differences in reproductive coercion (RC), intimate partner violence (IPV), and unintended pregnancy (UIP).

MATERIALS AND METHODS

We analyzed cross-sectional, baseline data from an intervention that was conducted between August 2008 and March 2009 in five family planning clinics in the San Francisco, California area, to examine the association of race/ethnicity with RC, IPV, and UIP among female patients aged 16-29 (n = 1234).

RESULTS

RC was significantly associated with race/ethnicity, p < 0.001, [prevalence estimates: Black (37.1%), multiracial (29.2%), White (18.0%), Hispanic/Latina (24.0%), and Asian/Pacific Islander/other (API/other) (18.4%)]. Race/ethnicity was not associated with IPV. UIP was more prevalent among Black (50.3%) and multiracial (47.2%) women, with an overall range of 37.1%-50.3% among all racial/ethnic groups (p < 0.001). In adjusted analyses, factors associated with UIP were RC [adjusted odds ratio (AOR) = 1.59, 95% confidence interval (95% CI) = 1.26-2.01] and Black (AOR = 1.63, 95% CI = 1.02-2.60) and API/other (AOR = 1.41, 95% CI = 1.15-1.73) race/ethnicity, which remained significant in the presence of RC. Race-stratified models revealed that RC increased odds of UIP for White (AOR = 2.06, 95% CI = 1.45-2.93) and Black women (AOR = 1.72, 95% CI = 1.14-2.60).

CONCLUSIONS

Black and multiracial women seeking care in family planning clinics have a disproportionately high prevalence of RC and UIP. RC may partially explain differences in UIP prevalence, with the effect of race/ethnicity slightly attenuated in RC-adjusted models. However, the impact of RC on risk for UIP was similar for White and Black women. Findings from this study support the need to understand and prevent RC, particularly among women of color. Results are foundational in understanding disparities in RC and UIP that may have implications for refinement of clinical care.

An analysis of retrospective and repeat prospective reports of adverse childhood experiences from the South African Birth to Twenty Plus cohort

Most studies rely on cross-sectional retrospective reports from adult samples to collect information about adverse childhood experiences (ACEs) to examine relationships with adult outcomes. The problems associated with these reports have long been debated, with only a few studies determining their reliability and validity and fewer still reaching consensus on the matter. This paper uses repeat prospective and retrospective reports of adverse childhood experiences from two respondent sources in the South African Birth to Twenty Plus (Bt20+) cohort to explore agreement and concordance in the prospective reporting of ACEs by caregivers and respective children as adolescents and then as young adults. The findings demonstrate little overall agreement between prospective and retrospective accounts of childhood experiences, with 80% of kappa values below the moderate agreement cutoff (k = .41). The highest levels of agreement were found between prospective and retrospective reporting on parental and household death (kappas ranging from .519 to .944). Comparisons between prospective caregiver reports and retrospective young adult reports yielded high concordance rates on sexual and physical abuse and exposure to intimate partner violence (91.0%, 87.7% and 80.2%, respectively). The prevalence of reported ACEs varied with the age of the respondent, with adolescents reporting much higher rates of exposure to violence, physical and sexual abuse than are reported retrospectively or by caregivers. This variation may partly reflect actual changes in circumstances with maturation, but may be influenced by developmental stage and issues of memory, cognition and emotional state more than has been considered in previous analyses. More research, across disciplines, is needed to understand these processes and their effect on recall. Long-term prospective studies are critical for this purpose. In conclusion, methodological research that uses a range of information sources to establish the reliability and validity of both retrospective and prospective reports ‒ recognizing that the two approaches may fundamentally answer different questions ‒ should be encouraged.

"I Was Naive in Thinking, 'I Divorced This Man, He Is Out of My Life'": A Qualitative Exploration of Post-Separation Power and Control Tactics Experienced by Women

The purpose of this study was to explore women's perceptions of the power and control tactics used by their former husbands post-separation. A total of 22 in-depth interviews with divorced mothers who reported male-initiated partner abuse (psychological and/or physical) during and/or after their marriages were analyzed. The most common themes to emerge from the narratives were, in order of prevalence, as follows: Using the Children; Using Threats, Harassment, and Intimidation; Emotional Abuse; Economic Abuse; "Stuff to Try to Hurt Me"; Disrupting Her Relationships With the Children; Using the System; and Physical Violence. We also found that the violent and coercive behaviors men used during the marriage continued to influence the women's perceptions of the power and control their former husbands had over them post-separation. As a result, many of the women described how they gave up everything just to get out of their abusive marriages.

Coercive Control and Its Impact on Intimate Partner Violence Through the Lens of an EU-Wide Survey on Violence Against Women

Research on intimate partner violence has suggested that not all violence is the same. This article builds upon earlier research on coercive control-or intimate terrorism-and examines the experiences of women who can be assessed as having experienced coercive controlling violence both in terms of the types of violent incidents they experience and the impact and consequences of the most serious incident of violence by an intimate partner. The article explores differences across the 28 European Union (EU) Member States in terms of coercive control and type of violence used. The results-based on data from the first EU-wide survey on violence against women by the EU Agency for Fundamental Rights-are further considered in terms of their association with gender equality. The results show that, in the EU, violence against women perpetrated under coercive control differs from other forms of violence as it involves more serious forms of violence and has a bigger impact in terms of its varied consequences. Countries where women indicated lower levels of coercive control are shown as scoring higher on a measure of gender equality, in contrast with earlier interpretations of the survey findings concerning the relationship between survey measures of physical and/or sexual violence and gender equality. The analysis supports the need to differentiate between various types of intimate partner violence against women-including violence under coercive control-in the European context, both in terms of research to better understand violence and for interventions to prevent violence.

Sex Disparities in Adverse Childhood Experiences and HIV/STIs: Mediation of Psychopathology and Sexual Behaviors

HIV and other sexually transmitted infections (STIs) are important public health challenges in the US. Adverse childhood experiences (ACEs), including abuse (emotional, physical or sexual), witnessing violence among household members, may have an effect on sexual behaviors, which increase the risk of HIV/STIs. The aim of this study was to examine the sex differences in the role of posttraumatic stress disorder (PTSD), major depression (MD), substance use disorders (SUDs), early sexual debut, and intimate partner violence (IPV) perpetration as mediators in the association between ACEs and HIV/STIs. Data were obtained from Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Structural equation modeling was used to determine the role of PTSD, MD, SUDs, early sexual debut, and IPV perpetration as mediators in the relationships between ACEs and HIV/STIs. Differences and similarities existed in the mediational roles of psychopathology and sexual behaviors. For example, among men, MD fully mediated physical/psychological abuse (β = 0.0002; p = 0.012) and sexual abuse (β = 0.0002; p = 0.006), and HIV/STIs while among women, MD fully mediated physical/psychological abuse (β = 0.0005; p < 0.001) and parental violence (β = -0.0002; p = 0.012). Among men, IPV perpetration fully mediated sexual abuse (β = -0.0005; p = 0.012) and HIV/STIs while among women, IPV perpetration was not a statistically significant mediator. HIV/STI prevention and intervention programs should use a life course approach by addressing adverse childhood events among men and women and consider the sex differences in the roles of psychopathology and sexual behaviors.

Victim Gender, Rater Attitudes, and Rater Violence History Influence Perceptions of Intimate Partner Violence

Perceptions of intimate partner violence (IPV) have been proposed to play a role in the stigmatization and underreporting of violence by individuals who are victimized by intimate partners, especially in cases that are inconsistent with the male-to-female IPV paradigm. We examined the independent and combined influences of victim and perpetrator sex, attitudes toward gender roles, and history of IPV perpetration on perceptions of IPV among 240 college students. We employed a vignette methodology to manipulate perpetrator and victim sex in a fully crossed design. Results indicate that violence perpetrated against males is perceived as less serious and more justified, and male victims are perceived to be more blameworthy than female victims. Traditional gender role attitudes and histories of IPV perpetration are associated with greater blaming of victims and justification of perpetrators across contexts.

Risk factors associated with current intimate partner violence at individual and relationship levels: a cross-sectional study among married rural migrant women in Shanghai, China

OBJECTIVE

To identify individual and relationship risk factors associated with current intimate partner violence (IPV) against married rural migrant women in Shanghai, China.

DESIGN

Cross-sectional survey.

SETTING

Two subdistricts of one administrative district, Shanghai, China.

PARTICIPANTS

A total of 958 married rural migrant women of reproductive age were selected using a community-based two-stage cluster sampling method in April and May of 2010.

OUTCOME MEASURES

Data were collected using a modified questionnaire based on an instrument from the WHO Multi-country Study on Women's Health and Domestic Violence against Women. Adjusted odds ratio (AOR) and 95% CI from a multivariable logistic regression model were estimated to identify individual and relationship risk factors associated with different types of violence in the past 12 months.

RESULTS

Women's low financial autonomy was associated with all types of violence (AORs ranged from 1.98 to 7.89, p<0.05). Quarrelling with husband was a very strong risk factor (AORs >6, p<0.05) for both emotional violence and any violence. Experience of job change in the past year (AOR=4.03, 95% CI 1.57 to 10.35) and history of husband being abused (AOR=4.67, 95% CI 2.17 to 7.69) were strongly associated with physical or sexual violence.

CONCLUSION

Women's low financial autonomy and unstable employment status at an individual level, quarrelling with husband and history of husband beaten by family members at a relationship level were identified as the most robust risk factors for IPV among married rural migrant women. Efforts to prevent IPV among this population should be made to involve both women and their husbands, with a focus on improving financial autonomy and employment status of women, promoting problem-solving and interaction skills of the couples and changing their knowledge and attitudes towards gender norms and IPV.

Intimate Partner Violence Victimization and Romantic Relationship Distress Among White and Mexican Newlyweds

This study examined the association between intimate partner violence (IPV) victimization and romantic relationship distress in a sample of 100 heterosexual White and Mexican American couples. Data were collected during the first and during the third year of marriage. In the overall sample, wives' own IPV victimization was associated with wives' increased distress and husbands' IPV victimization was associated with wives' decreased distress. Among Mexican Americans, wives' IPV victimization was related to husbands' increased distress, whereas among White Americans, wives' IPV victimization was related to husbands' decreased distress. These results indicate that the association between IPV victimization and relationship distress may not only differ by gender but also by ethnicity.

Perceptions of Psychological Abuse Versus Physical Abuse and Their Relationship With Mental Health Outcomes

Prior research has been limited in examining at what degree aggressive actions are initially perceived negatively. The present research examined whether anxiety, depression, and posttraumatic stress disorder (PTSD) symptoms were associated with prior abuse or with being attributed to past or present relationships. Scales such as the Dating Relationship Profile (DRP) and hypothetical scenarios of abuse perpetration were used. This study hypothesized that acceptability ratings from hypothetical scenarios would predict answers on DRP items measuring whether physical or psychological abuse is considered acceptable in relationships. Specifically, gender would be a predictor variable. Convenience sampling of undergraduate psychology students from a comprehensive, metropolitan university in north Georgia was used and resulted in 291 respondents (n = 227 [78%] female, n = 64 [22%] male) whose ages ranged from 18 to 54 years (M = 20.57 years, SD = 5.12 years). The present research used a 2 × 2 between-subjects design examining gender and type of hypothetical scenario violence with perceptions of abuse as the dependent variable. A significant association between experience of abuse and attribution of anxiety, depression, and PTSD symptoms to past or present relationships and between experience of abuse and these symptoms was found. Results revealed a significant difference between acceptability ratings of psychological abuse and gender, with men perceiving psychological abuse as more acceptable.

Intimate partner violence in the post-war context: Women's experiences and community leaders' perceptions in the Eastern Province of Sri Lanka

BACKGROUND

Exposure to armed conflict and/or war have been linked to an increase in intimate partner violence (IPV) against women. A substantial body of work has focused on non-partner rape and sexual violence in war and post-war contexts, but research about IPV is limited, particularly in Asian settings. This paper presents the finding of a study conducted in the Eastern Province of Sri Lanka. The study explored women's experiences of and responses to IPV as well as how health and social service providers perceive the problem. It also explored the IPV-related services and supports available after the end of a 30-year civil war.

METHOD

We conducted in-depth, qualitative interviews with 15 women who had experienced IPV and 15 service providers who were knowledgeable about IPV in the Eastern Province of Sri Lanka. Interviews were translated into English, coded and organized using NVivo8, and analyzed using inductive thematic analysis.

RESULTS

Participants described IPV as a widespread but hidden problem. Women had experienced various forms of abusive and controlling behaviours, some of which reflect the reality of living in the post-war context. The psychological effects of IPV were common, but were often attributed to war-related trauma. Some men used violence to control women and to reinstate power when their gender roles were reversed or challenged due to war and post-war changes in livelihoods. While some service providers perceived an increase in awareness about IPV and more services to address it, this was discordant with women's fears, feelings of oppression, and perception of a lack of redress from IPV within a highly militarized and ethnically-polarized society. Most women did not consider leaving an abusive relationship to be an option, due to realistic fears about their vulnerability to community violence, the widespread social norms that would cast them as outsiders, and the limited availability of related services and supports.

IMPLICATIONS

These findings revealed the need for more research about IPV in post-war contexts. Women's experiences in such contexts are influenced and may be masked by a complex set of factors that intersect to produce IPV and entrap women in violence. A more nuanced understanding of the context-specific issues that shape women's experiences of IPV- and community responses to it-is needed to develop more comprehensive solutions that are relevant to the local context.

Between Synergy and Travesty: A Sexual Risk Syndemic Among Pregnant Latina Immigrant and Non-immigrant Adolescents

Substance use, intimate partner violence, and depression contribute to sexual risk individually, yet have not been evaluated as a syndemic for adolescents. Using data from 772 pregnant Latina adolescents, we evaluated these factors as a syndemic and tested the moderating role of immigration. Bivariate analyses showed syndemic score (OR = 1.40, p = 0.02) and severity (OR = 1.68, p = 0.006) were predictors for multiple sex partners, and syndemic score predicting STIs (OR = 1.15, p = 0.05). Syndemic severity remained significant in multivariate analyses for multiple sex partners (OR = 1.53, p = 0.04). Moderation analyses showed higher syndemic severity was associated with more condom use among immigrants (OR = 1.75, p = 0.04) and less condom use (OR = 0.07, p = 0.011) among those with separated orientation. Higher syndemic severity also predicted greater odds for multiple partners (OR = 2.40, p = 0.01) among immigrants. This evidence suggests a sexual risk syndemic exists among Latina adolescents. Research should continue exploring this phenomenon, particularly exploring the role immigration plays for sexual health.

Parenting in poverty: Attention bias and anxiety interact to predict parents' perceptions of daily parenting hassles

Research has long acknowledged the centrality of parents' subjective experiences in the caregiving role for the organization of parenting behaviors and family functioning. Recent scientific advances in cognitive process models and in the neurobiology of parenting indicate that parenting is shaped in part by conscious and nonconscious cognitive processes. This study extends a growing literature on neurocognitive models of parenting by exploring the extent to which attention processes in parents operate independently and interactively with intrapsychic processes, proximal interpersonal stressors, and the larger socioeconomic context to predict perceptions of parenting hassles in primarily low-income Latino/a parents of young children living in urban areas of concentrated disadvantage (N = 185). Analyses indicated that parent reports of anxiety, intimate partner violence, and perceptions of financial hardship each uniquely predicted parents' perceptions of daily parenting hassles. Parents' attentional bias toward threat interacted with anxiety symptoms such that parents experiencing high levels of attention bias toward threat in combination with high levels of anxiety reported significantly more daily parenting hassles. Findings from the current study provide insight into the ways in which neurocognitive processes affect one aspect of parenting, with implications for programs and policies designed to support parenting for families in poverty. (PsycINFO Database Record

Reliability and Validity of the Sexual Experiences Survey-Short Forms Victimization and Perpetration

The Sexual Experiences Survey (SES), the most widely used measure of unwanted sexual experiences, was recently updated (Koss et al., 2007). The purpose of this study was to provide psychometric data on the updated Sexual Experiences Survey-Short Form Perpetration (SES-SFP) and the Sexual Experiences Survey-Short Form Victimization (SES-SFV). Men (n = 136) and women (n = 433) were randomly assigned to in-person or Internet formats of administration for 3 measurement points. Women completed victimization surveys and trauma measures. Men completed perpetration surveys and attitude/ personality measures. Results supported the validity and reliability of both the SES-SFV with women and the SES-SFP with men. Further research is needed regarding the use of the SES-SFV with men and the SES-SFP with women.

"If I Can't Have You Nobody Will": Explicit Threats in the Context of Coercive Control

Physical assault is only one tool in partner abuse characterized by coercive control. Coercive control creates an ongoing state of fear and chronic stress. Explicit threats are an important component of coercive control yet have received limited research attention. This study examined 210 women with protective orders (POs) against abusive (ex)partners and their experiences of explicit threats including threats of harm and death, threats about harming friends and family, and actual threats to friends and family. There are 4 main findings from this study: (a) explicit threats of harm and death, threats about harming others, and actual threats to others are common both in the history of the abusive relationship as well as within 6 months prior to obtaining a PO but are only moderately correlated with each other; (b) the high-frequency threats of harm group had the highest rates of concurrent abuse, violence, distress, and fear; (c) the prevalence and frequency of threats changed over time for all 3 types of threats examined in this study; and (d) understanding the variety of threats partner abuse victims experience, especially threats of third-party harm, may be important in understanding the larger context and consequences of partner abuse. This study is an interim step toward a better understanding of the role of explicit threats in abusive relationships. Future research is needed to examine the prevalence, frequency, trajectory, features, context, and types of explicit threats that victims of partner abuse experience. This information may be especially key to understanding more about future risk of harm, risk of harm to others, victim distress and fear, and safety planning.

Impact of Intimate Partner Forced Sex on HIV Risk Factors in Physically Abused African American and African Caribbean Women

We examined associations between intimate partner forced sex (IPFS) and HIV sexual risk behaviors among physically abused Black women. Women aged 18-55 in intimate relationships were interviewed in health clinics in Baltimore, MD and St. Thomas and St. Croix, US Virgin Islands (USVI). Of 426 physically abused women, 38% experienced IPFS; (Baltimore = 44 and USVI = 116). USVI women experiencing IPFS were more likely to have 3+ past-year sex partners (AOR 2.06, 95% CI 1.03-4.14), casual sex partners (AOR 2.71, 95% CI 1.42-5.17), and concurrent sex partners (AOR 1.94, 95% CI 1.01-3.73) compared to their counterparts. Baltimore women reporting IPFS were more likely to have exchanged sex (AOR 3.57, 95% CI 1.19-10.75). Women experiencing IPFS were more likely to report their abuser having other sexual partners in Baltimore (AOR 3.30, 95% CI 1.22-8.88) and USVI (AOR 2.03, 95% CI 1.20-3.44). Clinicians should consider the influence of IPFS on individual and partnership HIV sexual risk behaviors.

Prevalence of intimate partner violence and its associated risk factors among Saudi female patients attending the primary healthcare centers in Western Saudi Arabia

Objectives:

To estimate the prevalence of intimate partner violence (IPV) among female patients, age 18-60 years, attending primary health care centers (PHCCs) and to measure its determinants, and reporting behavior.

Methods:

A cross-sectional study design using validated, translated, and self-administered questionnaire among 497 Saudi female patients attending PHCCs in Taif, Kingdom of Saudi Arabia (KSA) from January to February 2015 was employed. A 2-stage probability sampling was adopted for selection of PHCCs in the first stage, and then participants in the second stage.

Results:

The estimated prevalence of IPV during the last year was 11.9%. Predictors of IPV related to abused women included divorced status and divorced parents; while those related to abusers (husbands) included widowed parents, exposure to violence in childhood, and alcohol or drugs addiction. Most of the abused wives (56%) talked regarding their IPV to their families, their husbands’ families (15.2%), or their friends (11.8%); while only a minority (3.3%) complained to the police or to a judge, and no one reported this to a family physician, or to women protection agency.

Conclusion:

One out of 10 women is a victim of IPV in Taif, KSA. Intimate partner violence is significantly associated with a number of victim and abuser-related psychosocial factors, the detection of which might help screening for individuals at risk.

NETWORK MAP OF ADVERSE HEALTH EFFECTS AMONG VICTIMS OF INTIMATE PARTNER VIOLENCE

Intimate partner violence (IPV) is a serious problem with devastating health consequences. Screening procedures may overlook relationships between IPV and negative health effects. To identify IPV-associated women's health issues, we mined national, aggregated de-identified electronic health record data and compared female health issues of domestic abuse (DA) versus non-DA records, identifying terms significantly more frequent for the DA group. After coding these terms into 28 broad categories, we developed a network map to determine strength of relationships between categories in the context of DA, finding that acute conditions are strongly connected to cardiovascular, gastrointestinal, gynecological, and neurological conditions among victims.

Experiencing Lifetime Domestic Violence: Associations with Mental Health and Stress among Pregnant Women in Rural Bangladesh: The MINIMat Randomized Trial

Background

Experience of domestic violence has negative mental health consequences for women. The association of cumulative and specific forms of domestic violence, particularly emotional violence and controlling behavior, with common mental disorders and stress has rarely been studied in pregnant women. The aim of this study is to evaluate associations of specific and multiple forms of lifetime domestic violence and controlling behavior with distress and cortisol level during pregnancy in rural Bangladeshi women.

Methods and findings

In this observational sub-study of larger MINIMat trial, 3504 pregnant women were interviewed using a shortened Conflict Tactic Scale about their lifetime experience of domestic violence including physical, sexual, emotional domestic violence and controlling behavior. Women’s levels of emotional distress were assessed using the self-reported questionnaire (SRQ-20) developed by WHO, and levels of morning salivary cortisol were measured in a subsample (n = 1300) of women during week 28–32 of pregnancy. Regression analyses were used to estimate the associations of lifetime physical, sexual, emotional domestic violence and controlling behavior with levels of distress and cortisol during pregnancy. The prevalence of lifetime domestic violence was 57% and emotional distress was 35% in these pregnant women. All forms of domestic violence were associated with higher levels of emotional distress. Women who experienced either emotional violence or controlling behavior had the highest levels of emotional distress. There was a dose-response relationship between cumulative number of the different forms of domestic violence and women’s levels of emotional distress. There was no association between women’s experience of domestic violence and level of morning salivary cortisol.

Conclusion

Including emotional violence and controlling behavior as major types of violence in future research and health interventions is warranted. Furthermore, the extent of the negative impacts of domestic violence on pregnant women, multiple forms of violence and their cumulative effects need to be investigated.

A Scoping Review of Intimate Partner Violence Screening Programs for Health Care Professionals

INTRODUCTION

Between 38 and 59 percent of women presenting to health care professionals have experienced intimate partner violence. Consequently, multiple intimate partner violence identification or screening programs within health care settings have been developed; however, substantial variations in program content and interpretation of program effectiveness has resulted in conflicting practice guidelines. The purpose of our scoping review is to broadly identify and synthesize the available literature evaluating intimate partner violence identification programs within health care settings to identify key areas for potential evidence-based recommendations and to focus research priorities in the field.

MATERIALS AND METHODS

We conducted a search of MEDLINE, Embase, Cumulative Index of Nursing and Allied Health Literature, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and psycINFO. We used broad eligibility criteria to identify studies that evaluated intimate partner violence identification programs in health care settings. We completed all screening and data extraction independently and in duplicate. We used descriptive statistics to summarize all data.

RESULTS

We identified 59 eligible studies evaluating intimate partner violence identification programs within health care settings. The most commonly reported outcome themes were IPV disclosure (69%, n = 35), number of patients screened (39%, n = 20), HCP opinions towards screening (37%, n = 19), and patient opinions towards screening (29%, n = 15). The majority of studies (36 studies (70.6%)) reported positive program evaluation results.

DISCUSSION

The majority of studies reported positive program evaluation results. This may suggest that many different intimate partner violence identification programs are beneficial for identifying victims of abuse, however, it remains unknown as to whether identification programs prevent future episodes of abuse. Additionally, the substantial heterogeneity of the intervention characteristics, study methodology, and outcome measures assessed limits the ability to make clear recommendations as to the optimal method(s) of screening.

Intimate partner violence against married rural-to-urban migrant workers in eastern China: prevalence, patterns, and associated factors

BACKGROUND

Intimate partner violence (IPV) is a significant public health issue among married rural-to-urban migrant workers, the largest group of internal migrants in China. This study aims to explore the prevalence, patterns and associated factors of intimate partner violence against married rural-to-urban migrant workers in eastern China.

METHODS

A cross-sectional study was conducted in Zhejiang province in China between July 2015 and April 2016, and a total of 1,744 married rural-to-urban migrant workers ultimately took part in the study. Conflict Tactics Scales and several short demographic questions were applied. Data were principally analyzed with logistic regression.

RESULTS

The majority of married rural-to-urban migrant workers were middle-aged couples with a low education level and a relatively long-term duration of migration in fixed migrant cities. Nearly 45% of married rural-to-urban migrant workers were experienced at least one incident of intimate partner violence during the past 12 months. The joint occurrence of multiple forms of violence is the most commonly reported features of intimate partner violence, especially three overlapping patterns of intimate partner violence. Some individual (education and age), relationship (marital satisfaction, premarital sex and extramarital affairs) and social (duration of migration and number of migratory cities) factors of the respondents, were negatively or positively associated with intimate partner violence against married rural-to-urban migrant workers.

CONCLUSION

The results indicated that one out of two married rural-to-urban migrant workers experienced at least one incident of intimate partner violence during the past 12 months in China. Accordingly, there is an obvious demand of intervention and treatment activities to prevent and reduce the occurrence of intimate partner violence among the millions of migrant workers in China.

Spirituality and Resilience Among Mexican American IPV Survivors

Women with abusive partners use a variety of coping strategies. This study examined the correlation between spirituality, resilience, and intimate partner violence using a cross-sectional survey of 54 Mexican American women living along the U.S.-Mexico border. The meaning-making coping model provides the conceptual framework to explore how spirituality is used as a copying strategy. Multiple ordinary least squares (OLS) regression results indicate women who score higher on spirituality also report greater resilient characteristics. Poisson regression analyses revealed that an increase in level of spirituality is associated with lower number of types of abuse experienced. Clinical, programmatic, and research implications are discussed.

Child Marriage and Intimate Partner Violence in Rural Bangladesh: A Longitudinal Multilevel Analysis

Child marriage (before age 18) is a risk factor for intimate partner violence (IPV) against women. Worldwide, Bangladesh has the highest prevalence of IPV and very early child marriage (before age 15). How the community prevalence of very early child marriage influences a woman's risk of IPV is unknown. Using panel data (2013-2014) from 3,355 women first married 4-12 years prior in 77 Bangladeshi villages, we tested the protective effect of a woman's later first marriage (at age 18 or older), the adverse effect of a higher village prevalence of very early child marriage, and whether any protective effect of a woman's later first marriage was diminished or reversed in villages where very early child marriage was more prevalent. Almost one-half (44.5 %) of women reported incident physical IPV, and 78.9 % had married before age 18. The village-level incidence of physical IPV ranged from 11.4 % to 75.0 %; the mean age at first marriage ranged from 14.8 to 18.0 years. The mean village-level prevalence of very early child marriage ranged from 3.9 % to 51.9 %. In main-effects models, marrying at 18 or later protected against physical IPV, and more prevalent very early child marriage before age 15 was a risk factor. The interaction of individual later marriage and the village prevalence of very early child marriage was positive; thus, the likely protective effect of marrying later was negated in villages where very early child marriage was prevalent. Collectively reducing very early child marriage may be needed to protect women from IPV.

Economic Coercion and Partner Violence Against Wives in Vietnam: A Unified Framework?

Economic coercion refers to behaviors that control an intimate partner's ability to acquire, use, and maintain economic resources. Little is known about economic coercion in Vietnam. Using survey responses from 533 married women ages 18 to 50 years, we estimated multinomial logistic regression models to compare the determinants of exposure to economic coercion only, co-occurring economic coercion, and any psychological, physical, or sexual intimate partner violence (IPV), and any IPV only, relative to no exposure. Women who, in their childhood, witnessed physical IPV against their mother had higher odds of exposure to co-occurring economic coercion and any IPV as an adult (adjusted Odds Ratio = 3.54, 95% confidence interval [CI] = [1.84, 6.83]) and any IPV only (adjust Odds Ratio = 1.75, 95% CI = [1.00, 3.06]), but not economic coercion only. Women who experienced violence as a child had higher odds of exposure to any IPV only (adjusted Odds Ratio = 1.63, 95% CI = [1.04, 2.56]) but not economic coercion only. Women with more schooling had higher odds of exposure to economic coercion only (adjusted Odds Ratio = 1.17, 95% CI = [1.03, 1.33]) but not other forms of violence. Overall, the estimates from the three models differed significantly. Thus, the determinants of economic coercion and common forms of IPV may differ. More research should focus on men's perpetration of economic coercion.

Intimate Partner Violence

Intimate partner violence (IPV) is a prevalent worldwide health problem, affecting women more commonly than men. IPV is underreported and underrecognized by health care professionals. Even when IPV is recognized, it remains an underaddressed issue. In addition to physical injury and death, IPV causes significant physical and psychiatric health problems commonly treated by family physicians. The U.S. Preventive Services Task Force recommends screening all female patients of childbearing age for IPV. There are several brief screening tools that have been proven effective at detecting IPV and that can be used in the office setting. Identification of IPV allows the physician to provide better care and improves health outcomes for the survivor. Family physician offices should provide patients with local and national resources. Thorough documentation of injuries sustained from abuse is critical. Although caring for patients unready to leave an abusive relationship may be challenging for the physician, continuous, supportive care improves patient outcomes.

Risk factors for dating violence versus cohabiting violence: Results from the third generation of the Cambridge Study in Delinquent Development

BACKGROUND

Dating violence is an important problem. Evidence suggests that women are more likely to perpetrate dating violence.

AIMS

The present study investigates the prevalence of dating violence compared with cohabiting violence in a community sample of men and women and assesses to what extent child and adolescent explanatory factors predict this behaviour. A secondary aim is to construct a risk score for dating violence based on the strongest risk factors.

METHODS

The Cambridge Study in Delinquent Development is a prospective longitudinal survey of 411 men (generation 2) born in the 1950s in an inner London area. Most recently, their sons and daughters [generation 3 (G3)] have been interviewed regarding their perpetration of dating and cohabiting violence, utilising the Conflict Tactics Scale. Risk factors were measured in four domains (family, parental, socio-economic and individual).

RESULTS

A larger proportion of women than men perpetrated at least one act of violence towards their dating partner (36.4 vs 21.7%). There was a similar pattern for cohabiting violence (39.6 vs 21.4%). A number of risk factors were significantly associated with the perpetration of dating violence. For G3 women, these included a convicted father, parental conflict, large family size and poor housing. For G3 men, these included having a young father or mother, separation from the father before age 16, early school leaving, frequent truancy and having a criminal conviction. A risk score for both men and women, based on 10 risk factors, significantly predicted dating violence.

CONCLUSION

Risk factors from four domains were important in predicting dating violence, but they were different for G3 men and women. It may be important to consider different risk factors and different risk assessments for male compared with female perpetration of dating violence. Early identification and interventions are recommended. Copyright © 2016 John Wiley & Sons, Ltd.

Childhood abuse and suicidal ideation in a cohort of pregnant Peruvian women

BACKGROUND

Childhood abuse is a major global and public health problem associated with a myriad of adverse outcomes across the life course. Suicide is one of the leading causes of mortality during the perinatal period. However, few studies have assessed the relationship between experiences of childhood abuse and suicidal ideation in pregnancy.

OBJECTIVE

We sought to examine the association between exposure to childhood abuse and suicidal ideation among pregnant women.

STUDY DESIGN

A cross-sectional study was conducted among 2964 pregnant women attending prenatal clinics in Lima, Peru. Childhood abuse was assessed using the Childhood Physical and Sexual Abuse Questionnaire. Depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 scale. Logistic regression procedures were performed to estimate adjusted odds ratios and 95% confidence intervals adjusted for potential confounders.

RESULTS

Overall, the prevalence of childhood abuse in this cohort was 71.8% and antepartum suicidal ideation was 15.8%. The prevalence of antepartum suicidal ideation was higher among women who reported experiencing any childhood abuse compared to those reporting none (89.3% vs 10.7%, P < .0001). After adjusting for potential confounders, including antepartum depression and lifetime intimate partner violence, those with history of any childhood abuse had a 2.9-fold (2.90, adjusted odds ratio; 95% confidence interval, 2.12-3.97) increased odds of reporting suicidal ideation. Women who experienced both physical and sexual childhood abuse had much higher odds of suicidal ideation (adjusted odds ratio, 4.04; 95% confidence interval, 2.88-5.68). Women who experienced any childhood abuse and reported depression had 3.44-fold (3.44, adjusted odds ratio; 95% confidence interval, 1.84-6.43) increased odds of suicidal ideation compared with depressed women with no history of childhood abuse. Finally, the odds of suicidal ideation increased with increased number of childhood abuse events experienced (P value for linear trend < .001).

CONCLUSION

Maternal history of childhood abuse was associated with increased odds of antepartum suicidal ideation. It is important for clinicians to be aware of the potential increased risk of suicidal behaviors among pregnant women with a history of childhood physical and sexual abuse.

Rurality and Self-Reported Health in Women with a History of Intimate Partner Violence

OBJECTIVE

To investigate differences in self-reported health among Australian women with a history of intimate partner violence (IPV) in relation to rurality of residence.

METHODS

Data were drawn from six survey waves of the Australian Longitudinal Study on Women's Health 1973-78 birth cohort. Self-reported general and mental health scores derived from the SF-36 scale were compared for women with a history of IPV living in metropolitan, regional and rural areas. Multivariable generalised estimating equations were constructed adjusting for income hardship, number of children, education, social support, age and marital status.

RESULTS

Women with a history of IPV living in regional and rural areas had no significant differences in self-reported general health scores compared to their metropolitan counterparts. Rural women affected by IPV had slightly better self-reported mental health than equivalent women living in metropolitan or regional areas. The socio-demographic factors with the strongest association with self-reported health were income, education, social support, and number of children.

CONCLUSIONS

Women in regional and rural areas were no more disadvantaged, in terms of self-reported general health or mental health, than IPV affected women living in major cities in Australia.

Exposure to Spousal Violence in the Family, Attitudes and Dating Violence Perpetration Among High School Students in Port-au-Prince

This study examined the associations of exposure to spousal violence in the family and personal and peer attitudes with dating violence (DV) perpetration among high school students in Port-au-Prince, Haiti. Participants were 342 high school students in Grades 10 to 12 who stated that they had ever been on a date. Multiple linear regression methods were used to examine correlates of the scale of DV perpetration. Findings showed that personal acceptance of DV mediated the association between exposure to wife-perpetrated and husband-perpetrated spousal violence in the family and DV perpetration for girls. Boys who were exposed to husband-perpetrated spousal violence in the family had significantly higher levels of psychological DV perpetration than those who were not. Contrary to expectations, exposure to wife-perpetrated spousal violence in the family was negatively associated with psychological and physical/sexual DV perpetration by boys, after controlling for other factors. Overall, perceived peer tolerance of DV was more strongly associated with DV perpetration than personal tolerance of DV, and was the only significant correlate of psychological DV perpetration for girls. Perceived peer attitudes also moderated the association between boys' exposure to spousal violence in the family and DV perpetration. Implications for future research and policy are discussed.

Childhood maltreatment as a risk factor for diabetes: findings from a population-based survey of Canadian adults

BACKGROUND

It is well established that childhood maltreatment (CM) is a risk factor for various mental and substance use disorders. To date, however, little research has focused on the possible long-term physical consequences of CM. Diabetes is a chronic disease, for which an association with CM has been postulated.

METHODS

Based on data from a sample of 21,878 men and women from the 2012 Canadian Community Health Survey - Mental Health (CCHS - MH), this study examines associations between three types of CM (childhood physical abuse (CPA), childhood sexual abuse (CSA), and childhood exposure to intimate partner violence (CEIPV)) and diabetes in adulthood. Multiple logistic regression models were used to examine associations between CM and diabetes controlling for the effects of socio-demographic characteristics and risk factors for type 2 diabetes.

RESULTS

When controlling socio-demographic characteristics, diabetes was significantly associated with reports of severe and frequent CPA (OR = 1.8) and severe and frequent CSA (OR = 2.2). A dose-response relationship was observed when co-occurrence of CSA and CPA was considered with the strongest association with diabetes being observed when both severe and frequent CSA and CPA were reported (OR = 2.6). Controlling for type 2 diabetes risk factors attenuated associations particularly for CPA. CEIPV was not significantly associated with having diabetes in adulthood.

CONCLUSION

CPA and CSA are risk factors for diabetes. For the most part, associations between CPA and diabetes are mediated via risk factors for type 2 diabetes. Failure to consider severity and frequency of abuse may limit our understanding of the importance of CM as a risk factor for diabetes.

A Study of Violence Among Hong Kong Young Adults and Associated Substance Use, Risky Sexual Behaviors, and Pregnancy

This study aimed to estimate the self-reported prevalence of violence perpetration and victimization among Hong Kong youths and the associated health risk behaviors using a representative sample of 1,126 young adults aged 18-27 years. Perpetrating physical and emotional violence was common in Hong Kong, with prevalences ranging from 20.8% to 38.3% in males and from 6.4% to 21.3% in females. Victimization of physical and emotional violence was also common for both sexes, with prevalences ranging from 16.4% to 36.3% in males and from 6.6% to 19.2% in females. Perpetration of sexual harassment and sexual violence was less prevalent, whereas victimization of sexual harassment and sexual violence ranged from 0.6% to 3.6% in males and from 2.3% to 13.2% in females. Both violence perpetration and victimization among youths were significantly associated with substance use, risky sexual behaviors, and pregnancy. The implications of this study for violence prevention programs are discussed.

Military/Civilian Risk Markers for Physical Intimate Partner Violence: A Meta-Analysis

This meta-analysis compared risk markers for perpetration of physical intimate partner violence (IPV) among military and civilian males. We also examined strength of risk markers among male and female service members. In total, 36 military studies and 334 civilian studies, which reported 883 effect sizes, were included in the analyses. Results revealed more similarities than differences in risk markers for IPV among military and civilian males and among military males and females. Of the risk markers examined, relationship satisfaction and alcohol problems were significantly stronger risk markers for IPV among civilian males compared to military males. Perpetrating emotional abuse was a significantly stronger risk marker for IPV perpetration among military females compared to military males. Recommendations for IPV prevention and intervention are discussed.

Identifying patients with complex PTSD

While the common perception of post-traumatic stress disorder (PTSD) is of an individual suffering from a single traumatic event, clinicians need to be aware of those people who have been exposed to multiple potentially traumatic events. Type 2 or complex trauma results from multiple or repeated traumatic events occurring over extended periods. Complex trauma is often associated with other adversity and stressors such as neglect, loss or deprivation. For many individuals these traumas occur at a developmentally vulnerable time with the perpetrator often in a caregiving role; thus the trauma incorporates a betrayal of trust. Disclosure can be a problem particularly with complex trauma such as sexual abuse or domestic violence, and is often incremental as trust with the clinician is formed. Patients who have experienced complex trauma should be assessed for the core symptoms of PTSD. In addition, patients should be assessed for disturbances in the three domains of emotional dysregulation, negative self-concept and interpersonal disturbances.

The Effects of Expressive Writing on Pain, Depression and Posttraumatic Stress Disorder Symptoms in Survivors of Intimate Partner Violence

This study examined the effects of expressive writing on depression, posttraumatic stress disorder (PTSD) and pain symptoms among women who have survived intimate partner violence (IPV). Forty-seven women completed baseline and four-month follow-up assessments and were randomly assigned to four writing sessions of either expressive writing focused on traumatic life events or writing about a neutral topic. Main effects were not significant for changes in depression, pain or PTSD symptoms. However, among depressed women, those assigned to expressive writing showed a significantly greater drop in depression. For depressed women with IPV histories, expressive writing may lead to reduced depression.

Association of Domestic Violence From Husband and Women Empowerment in Slum Community, Mumbai

Prevalence of violence by husband against wife is an indicator of women's status at household level. The objective of the study is to understand the relationship between domestic violence and women's empowerment in a slum community in Mumbai, India. Data were collected from a sample of 1,136 married women aged 18 to 39 years having at least one child and reporting of unmet need for family planning. Domestic violence by husband against wife was measured in terms of either physical, sexual, or emotional violence. Three logit regression analyses were carried out using decision-making power, freedom of movement, and justified wife beating as dependent variables separately and socio-demographic and economic variables as independent variables. Furthermore, the relationship between domestic violence and women's decision-making power, freedom of movement, and justified wife-beating index has been explored. About 21% of women had ever experienced violence, and 38% of women had decision-making power with respect to own health care, household purchase, or visiting family and relatives. A little more than one fifth of the women reported freedom of movement to market, health facilities, or places outside the community. Women who justified wife beating were 2.29 (95% CI [1.59, 3.29]) times at risk of experiencing violence than women who disagreed with the wife-beating statements. Women not empowered in decision making were 1.15 (95% CI [0.91, 1.46]) times at risk of experiencing domestic violence than women who were empowered in decision making. Women who are empowered are less likely to be at risk of domestic violence. Programs aimed at empowering women must address socio-cultural norms relating to justification of violence in marriage.

Correlates of Female-Perpetrated Intimate Partner Violence in Kano, Northern Nigeria

Women are by no means the exclusive victims of intimate partner violence (IPV). This study assessed the lifetime prevalence and predictors of female-perpetrated IPV among public servants in Kano, Nigeria. Using a descriptive cross-sectional design and systematic sampling, pre-tested structured self-administered questionnaires were used to assess prevalence, types, and predictors of IPV among 302 married men. The lifetime prevalence of IPV was 66.8% (n = 177; 95% confidence interval [CI] = [60.7, 72.4]). Of surveyed men who have ever experienced violence, 78.0% (n = 138), 81.4% (n = 144), and 16.4% (n = 29) encountered physical assault, psychological aggression, and sexual coercion, respectively. After controlling for confounders, having ≥5 children, adjusted odds ratio (aOR) [95% CI] = 3.93 [1.16, 13.29], p = .027, and childhood experience of violence, aOR [95% CI] = 0.14 [0.05, 0.39], p = .0001, remained significant predictors of female-perpetrated IPV. In conclusion, female-perpetrated IPV is prevalent in northern Nigeria. Addressing IPV will require comprehensive violence prevention measures, including counseling and support for victims and exposed children.

Individual, Family, and Community Risk Markers for Domestic Violence in Peru

This study draws on an ecological framework in testing relationships between individual, family, and community characteristics and the likelihood of women experiencing domestic violence in Peru. The sample of 15,991 women was taken from the 2000 Peru Demographic and Health Survey. Logistic regression models revealed that at the individual level, low educational attainment, early union formation, and a violent family background increase a woman’s likelihood of abuse. Family-level risk markers include cohabitation, large family size, partner alcohol consumption, employment, and a woman’s having higher status than her husband. At the community level, living in a noncoastal area and having an urban residence increase the likelihood of abuse.

Intimate Partner Violence, Technology, and Stalking

This research note describes the use of a broad range of technologies in intimate partner stalking, including cordless and cellular telephones, fax machines, e-mail, Internet-based harassment, global positioning systems, spy ware, video cameras, and online databases. The concept of “stalking with technology” is reviewed, and the need for an expanded definition of cyberstalking is presented. Legal issues and advocacy-centered responses, including training, legal remedies, public policy issues, and technology industry practices, are discussed.

Children in the Crossfire

Although most states mandate considerations of intimate partner violence (IPV) in child custody proceedings, little is known about how often a preexisting history of IPV is effectively presented to the courts in dissolution cases and, when it is, what effect it has on child custody and visitation outcomes. This retrospective cohort study examined the effects of a history of IPV, further categorized by whether substantiation of that history existed and whether the court handling the custody proceedings knew of that history, on child custody and visitation outcomes. The findings from this study highlight several issues of concern regarding the reality of child custody among families with a history of IPV. These include two primary concerns: a lack of identification of IPV even among cases with a documented, substantiated history, and a lack of strong protections being ordered even among cases in which a history of substantiated IPV is known to exist.

Women’s Experience of Violence During Stalking by Former Romantic Partners

This study investigated female experiences of physical violence during stalking by a former romantic partner. It aimed to identify factors that were predictive of such stalking violence. Two hundred and twenty female undergraduates who defined themselves as victims of stalking following the dissolution of a romantic relationship completed a short questionnaire. From their responses, 11 predictor variables were considered. These were self-reported relationship experiences of physical and sexual violence, intentional damage to participant’s property, partner jealousy, isolation, monitoring, criticism and insults by the former partner, former partner’s drug and alcohol abuse, and specific threats of violence while being stalked. The dependent variable in the study was whether stalking violence occurred; 35.9% (79/220) of participants experienced stalking violence. Logistic regression analysis revealed that there were statistically significant independent associations between threats, partner jealousy, and former partner drug abuse and stalking violence.

Women’s Resources and Use of Strategies as Risk and Protective Factors for Reabuse Over Time

Using a longitudinal and ecological approach, we investigated the relationships between women’s material and emotional resources and strategies and their ability to stay safe over time in a sample of 406 help-seeking African American women. The multivariate analysis demonstrated that social support served as a protective factor and resistance strategies as risk factors for reabuse during a 1-year period. It also showed an interaction between social support and history of violence such that for participants who had experienced the most severe violence, social support did not serve as a protective factor; however, for the other participants, those with the least amount of social support had a 65% predicted probability of reabuse during the next year, compared to a 20% predicted probability for women reporting the highest level of social support. Policy and programmatic implications of these findings are discussed.

Knowledge and Attitudes About Intimate Partner Violence Among Immigrant Latinos in Rural North Carolina

To create appropriate intimate partner violence (IPV) services for Latino immigrants, practitioners must be aware of their needs. We conducted interviews with 100 recent Latino immigrants in a rural North Carolina county. Overall, IPV was not perceived to be a problem; however, men and women differed in their perceptions. Men were more likely to agree with IPV myths, and both men and women felt that IPV had a detrimental impact on children. Many did not know about the local domestic violence agency, and knowledge about protective orders was limited. Outreach should emphasize the seriousness of IPV, adapt content for gender-specific audiences, and increase awareness about local resources.

Exploring the Perceptions of Domestic Violence Service Providers in Rural Localities

This exploratory study uses a nonprobability purposive sample to investigate the perceptions of domestic violence service providers in rural regions of North Carolina and Virginia. Investigators gathered data incorporating both quantitative and qualitative methods. Quantitative data were retrieved through the development and distribution of a self-administered survey targeting service provider perceptions about the general public, consumers of services, self-perceptions, and perceptions related to inter- and intra-agency issues. Qualitative data were collected to provide further elaboration on the topic through the use of a focus group composed of rural service providers. The focus group was facilitated by the investigators. Findings identified deficits in public knowledge, agency resources, and community resources, and professional development as being the most problematic issues. Victims were perceived as having to face multiple issues and barriers when seeking services. Implications of these findings are discussed as well as the need for continued research efforts.

Restraining Orders in California

The authors tabulated statewide administrative data for all types of restraining orders. On June 6, 2003, there were 227,941 active restraining orders against adults in California; most were for domestic violence. Rates of restraining orders (i.e., restrained persons) were highest for men, African Americans, and 25- to 34-year-olds. In 72.2% of the orders, a woman was to be protected and a man was to be restrained; in 19.3%, the restrained and protected persons were of the same sex. Although state law prohibits the purchase or possession of a firearm by persons against whom a restraining order is issued, 9.2% of the orders documented no firearm restrictions.

Risk Factors for Abusive Relationships

This study identifies risk factors for Vietnamese American women's abuse. Intensive interviews with 129 Vietnamese women immigrants in a northeastern metropolitan area provided data to examine risk factors for sexual, physical, and verbal abuse. Patriarchal gender arrangements in the family, arguments about fulfilling gender and family roles, and partner's threat that divorce would compromise the participant's immigration status put women at risk for each type of abuse. “Picture brides” were at heightened risk for sexual abuse. For women with limited resources, education and interventions within the ethnic immigrant community are critical to addressing wife abuse.

A Specification of the Types of Intimate Partner Violence Experienced by Women in the General Population

This study analyzes data from a national, general population sample of respondents (National Violence Against Women Survey) to estimate the prevalence of the different forms of intimate partner violence (IPV) that women experience in the United States. The study's purpose, to differentiate types of IPV, follows the Johnson and Ferraro tradition that distinguishes occasional and random acts of abuse from chronic and controlling forms of violence. When examining the specific types of IPV that the survey respondents disclosed, the author finds that the distribution closely resembles Gordon's epidemiological findings. This study analyzed the variance in the number of types of IPV as a function of the childhood abuse the women experienced and their partner's controlling and threatening behaviors. It concludes with a discussion of the multiple responses to IPV that are necessary in contemporary U.S. society.

Patterns of Injuries

This study uses two types of independent variables, age and the location of the physical wound, to develop a model of injury patterning that identifies violent behavior without direct observation of the assault. In this research, domestic violence injuries are compared to accidental injuries. The results indicate that there are specific and predictable injury patterns that separate abuse from other kinds of wounds. A logistic regression model was developed to identify the regions of the body most susceptible to injury from domestic assault. Using the age of the victim and the injury regions, probabilities were calculated to determine which wounds were caused by abuse.

Outcomes of Custody and Visitation Petitions When Fathers Are Restrained by Protection Orders

A random sample of custody and visitation petitions filed in New York City Family Courts in 1995 was used to examine outcomes of mothers’ Order of Protection (OP) Petitions in relation to parents’ custody and visitation petitions. Fathers restrained by OPs were more likely to secure visitation orders (64%) than not. In contrast, 80.8% of fathers’ custody petitions were dismissed when they were restrained by OPs. Fathers’ custody petitions were most likely to be ordered when mothers’ OP petitions were withdrawn. Mothers were most likely to secure custody when their OP petitions were ordered or withdrawn. Courts rarely denied petitions. Those that did not result in court orders were either withdrawn by the petitioner or dismissed by the court (most likely because of failure of the petitioner to appear in court). This pattern has negative implications for battered women who may be vulnerable to pressure or threats from abusive expartners.

Do Structural Inequalities Contribute to Marital Violence? Ethnographic Evidence From Rural South India

Ethnographic research was conducted in rural communities in Karnataka State, South India, to explore the contexts in which marital violence occurs and the relationships between structural inequalities (gender, caste, and class inequalities) and marital violence. Research highlighted that (a) marital violence is intimately linked to experiences of gender, caste, and class inequalities; (b) women’s ability to resist violence hinges on access to economic and social resources; and (c) health care providers need to be actively involved in responding to violence. This study demonstrates the urgent need for violence prevention initiatives, particularly those that address the contribution of structural inequalities.