Adulthood stressors, history of childhood adversity, and risk of perpetration of intimate partner violence

Identifying and Addressing Confounding Bias in Violence Prevention Research

Purpose of review

Violence prevention research has enhanced our understanding of individual and community risk and protective factors for aggression and violence. However, our knowledge of risk and protective factors for violence is highly dependent on observational studies, since there are few randomized trials of risk and protective factors for violence. Observational studies are susceptible to systematic errors, specifically confounding, and may lack internal validity.

Recent findings

Many violence prevention studies utilize methods that do not correctly identify the set of covariates needed for statistical adjustment. This results in unwarranted matching and restriction leading to further confounding or selection bias. Covariate adjustment based on purely statistical criteria generates inconsistent results and uncertain conclusions.

Summary

Conventional methods used to identify confounding in violence prevention research are often inadequate. Causal diagrams have potential to improve the understanding and identification of potential confounding biases in observational violence prevention studies, and methods like sensitivity analysis using quantitative bias analysis can help to address unmeasured confounding. Violence research studies should make more use of these methods.

Early-life neighborhood context, perceived stress, and preterm birth in African American Women

Stressors from multiple sources, across the life-course, may have independent and joint associations with preterm birth (PTB) risk in African American women. Using data from the Life-course Influences on Fetal Environments Study (LIFE; 2009-2011) of post-partum African American women from Metropolitan Detroit, Michigan (n=1365), we examined the association between perceived stress and PTB, and effect modification by perceptions of early-life neighborhood social control and disorder. We defined PTB as birth before 37 completed weeks of gestation. We used Cohen's Perceived Stress scale, and valid and reliable scales of early-life (age 10) neighborhood social control and social disorder to quantify exposures. We estimated prevalence ratios (PR) and 95% confidence intervals (CI) with log binomial regression models- with separate interaction terms for perceived stress and each early-life neighborhood scale. We considered p < 0.10 significant for interaction terms. PTB occurred in 16.4% (n=224) of the study participants. In the total sample, perceived stress was not associated with PTB rates. However, there was suggestive evidence of a joint association between perceived stress and early-life neighborhood social disorder (p for interaction = 0.06), such that among women who reported high early-life neighborhood social disorder (n=660), perceived stress was positively associated with PTB (adjusted PR: 1.31; 95% CI: 1.05, 1.63). There was no association between perceived stress and PTB for women in the low early-life neighborhood social disorder strata (n=651) (adjusted PR: 0.95, 95% CI: 0.75, 1.21). There was no evidence that early-life neighborhood social control modified the association between perceived stress and PTB. Our results suggest that early-life neighborhood stressors may magnify the association between current perceived stress and PTB rates, in African American women. More research to confirm and explicate the biologic and/or psychosocial mechanisms of the reported association is warranted.

Youth and young adult dating relationship dynamics and subsequent abusive outcomes

INTRODUCTION

In order to prevent youth and young adult partner abuse, it is necessary to have a better understanding of dating relationship dynamics as the context for potential abusive interactions.

METHODS

Youth and young adults (ages 10-18 at baseline) were surveyed along with a matched parent/caregiver. Data, including parent and youth responses (n = 437 youth/parent dyads), are drawn from the nationally representative Survey on Teen Relationships and Intimate Violence (STRiV).

RESULTS

Applying latent class analytic techniques with seven different positive and problematic descriptors of dating relationships, this study found four classes of relationship dynamics representing healthy, unhealthy, intense, and disengaged relationships. The intense relationship dynamic class exhibits the strongest associations with reports of any youth and young adult partner abuse, as well as distinctly with the subtypes of psychological, physical, and sexual victimization and perpetration.

CONCLUSIONS

Results demonstrate the importance of clinicians, parents and other responsible adults attending to an array of youth and young adult dating relationship dynamics rather than single indicators, to assess youth and young adult risk for involvement in abusive relationships.

Intimate partner violence and incidence of depression in married women: A longitudinal study of a nationally representative sample

BACKGROUND

Intimate partner violence (IPV) has a serious detrimental effect on mental health outcomes. We aimed to investigate the association of verbal or physical IPV with incidence of depressive symptoms in both married women and men according to the victim-perpetrator role. The potential mediating role of verbal or physical IPV in the association between satisfaction level with family relationships or childhood adversity and the incidence of depressive symptoms in married adults was also explored.

METHODS

The Korea Welfare Panel Study (KOWEPS) in 2006 and 2007 dataset was analyzed for 9217 married respondents aged 19 years or older. Physical and verbal IPV was assessed according to victim-perpetrator role in 2006. Depressive symptoms were evaluated by the Center for Epidemiologic Studies Depression Scale, 11-item version in 2006 and 2007. Association of IPV with incidental depressive symptoms was investigated with logistic regression analysis fully-adjusted for all potential confounding factors.

RESULTS

The bidirectional role of verbal IPV and victimization by physical IPV led to incidence of depressive symptoms in married women. Verbal IPV significantly mediated the association between satisfaction level with the family relationship and incidental depressive symptoms in women.

LIMITATIONS

We did not investigate the influence of premorbid depressive symptoms on new-onset IPV.

CONCLUSIONS

This study is the first to demonstrate that gender and the victim-perpetrator role are critical moderating factors in the association between IPV and depressive symptom incidence using a nationally representative sample.

The social anatomy of adverse childhood experiences and aggression in a representative sample of young adults in the U.S

Objective The current study assesses the effect of adverse childhood experiences on later aggression and violence across young adult relationships contexts, including intimate partners, friends, or strangers. Method Surveys were conducted with a nationally representative sample of young adults ages 18-32, drawn from the AmeriSpeak panel, a probability-based panel with coverage of 97% of U.S. households. The weighted study sample is 2284 young adult respondents, of whom 1561 reported being in an intimate partnership. Results Rates of verbal aggression perpetrated by young adults declined with the intimacy of the relationship, such that aggression against a partner (72%) exceeded aggression directed at friends (43%) and strangers (34%). Similar rates of physical violence (about 9%) were reportedly perpetrated against partners, friends, and strangers. Adjusting for a range of personal characteristics, both adverse childhood experiences and recent stressors in these young adult lives exhibited direct associations with verbal and physically aggressive outcomes. Conclusions In models of verbal and physical aggression across relationship contexts, childhood adversity exhibits lasting effects unaccounted for by important proximal life circumstances, including recent life stressors, mental health, and substance use behaviors. These results provide empirical insights for clinical treatment of young adults prone to aggressive conflicts as well as input to positive youth development programming to foster healthy approaches to conflict.

Intimate Partner Violence in Male Survivors of Child Maltreatment: A Meta-Analysis

Intimate partner violence (IPV) is a major public health concern. Yet, despite an increasingly extensive literature on interpersonal violence, research on male victims of IPV remains sparse and the associations between different forms of child maltreatment (CM) and IPV victimization and perpetration in men remains unclear. The present meta-analysis evaluated five different forms of CM (sexual, physical, and psychological abuses, neglect, and witnessing IPV) as they predicted sexual, psychological, and physical IPV perpetration and victimization in men. Overall, most available studies examined men as perpetrators of IPV, whereas studies of victimization in men were relatively scarce. Results reveal an overall significant association ( r = .19) between CM and IPV. The magnitude of this effect did not vary as a function of type (perpetration vs. victimization) or form (sexual, psychological, or physical) of IPV. Although all forms of CM were related to IPV, with effect sizes ranging from .05 (neglect and IPV victimization) to .26 (psychological abuse and IPV victimization), these associations varied in magnitude according to the type of CM. Findings suggest the importance of expanding research on CM and IPV to include a range of different kinds of abuse and neglect and to raise concerns about the experience of men as both victims and perpetrators of IPV.

Economic Policies and Intimate Partner Violence Prevention: Emerging Complexities in the Literature

Although the question of whether economic policies serve to reduce rates of intimate partner violence (IPV) has long been raised, rigorous tests of this question have only begun to take place recently. Given the mixed evidence to date, much remains unknown about the circumstances in which a positive or negative relationship holds between changes in financial well-being and IPV. We describe an empirically based theoretical model that may link economic empowerment to IPV and that highlights research questions for further testing. This model reflects two theoretical pathways through which economic policies may reduce IPV: A program may activate social and psychological empowerment as protective factors and a program may deactivate cognitive and behavioral risk factors such as stress and substance abuse. We then consider the relevance of each of a range of economic policies and review existing experimental evidence regarding the effect of such programs on IPV. We discuss unconditional and conditional cash transfers, savings programs, microfinance and income generation programs, and economic programs combined with relationship-related training. Gaps in research on this topic and emerging complexities in the literature suggest the following three key areas that would benefit from greater research and evaluation: comparison across programs based on size and design, assessment of the returns to economic empowerment of young adults, and more evaluations in high-income countries.

Adverse Childhood Experiences and Mental and Behavioral Health Conditions During Pregnancy: The Role of Resilience

INTRODUCTION

Little is known about how exposure to adverse childhood experiences (ACEs) and protective factors, such as resilience, influence prenatal mental and behavioral health. This study examined associations between exposure to ACEs and mental and behavioral health during pregnancy overall and among women with high versus low levels of resilience.

MATERIALS AND METHODS

Women in two Kaiser Permanente Northern California medical centers were screened for ACEs and resilience during prenatal care (∼14-23 weeks of gestation; N = 355). Multivariable logistic regression analyses examined associations between ACEs and prenatal mental and behavioral health conditions overall and for women with low (≤32) versus high (>32) resilience on the 10-item Connor-Davidson Resilience Scale.

RESULTS

Overall, 54% of women reported 0 ACEs, 28% 1-2 ACEs, and 18% 3+ ACEs. Relative to women with 0 ACEs, those with 1-2 ACEs had higher odds of an anxiety or depressive disorder and intimate partner violence (IPV) (odds ratios [ORs] 2.42-3.12, p < 0.05), and those with 3+ ACEs had higher odds of an anxiety or depressive disorder, depression symptoms, and IPV (ORs 3.08-4.71, p < 0.05). In stratified analyses by high (56%) and low (44%) resilience, having one or more ACEs (vs. 0 ACEs) was only associated with worse mental and behavioral health in women with low resilience.

CONCLUSIONS

ACEs predicted mental and behavioral health conditions among pregnant women, and associations were the strongest among women with low levels of current resilience. Longitudinal research is needed to understand the causal mechanisms underlying these associations.

Clinical and Personality Disorders in a Danish Treatment-Seeking Sample of Intimate Partner Violence Perpetrators

Intimate partner violence (IPV) is a global public health concern with profound psychological consequences. Perpetrators often have a history of childhood trauma and a range of co-occurring psychiatric problems, which may have implications for treatment. This study examines the prevalence of psychiatric and personality disorders (PD) among perpetrators and the association between a range of demographic, childhood trauma, and adult criminality variables for the most prominent disorders. Data were collected from IPV perpetrators ( n = 529) engaging in a treatment program, ' Dialogue Against Violence'. High rates of childhood trauma were observed. There was significant variation in the prevalence of clinical disorders and PDs, with Antisocial PD and Anxiety Disorder being the most common. A clinical disorder was the strongest predictor of PDs, likewise a PD was the strongest predictor of clinical disorders. Findings demonstrated that IPV perpetrators have a number of personality and clinical disorders and traumatic histories that need to be considered within a treatment perspective.

Domestic and intimate partner violence among pregnant women in a low resource setting in South Africa: a facility-based, mixed methods study

BACKGROUND

Rates of violence against women are reported to be highest in Africa compared to other continents. We aimed to determine associations between mental illness, demographic, psychosocial and economic factors with experience of intimate partner violence (IPV) among pregnant women in a low resource setting in Cape Town and to explore the contextual elements pertaining to domestic violence.

METHODS

We recruited adult women attending antenatal services at a primary-level maternity facility. Demographic, socioeconomic and psychosocial data were collected by questionnaire. The Expanded Mini- International Neuropsychiatric Interview (MINI) Version 5.0.0 was used to assess mental health status and the Revised Conflict Tactic Scale (CTS2) used to assess IPV in the six months prior to the study. Non-parametric tests, Wilcoxon sum of rank test, Fisher Exact and two sample T test and multicollinearity tests were performed. Descriptive, bivariate and logistic regression analyses were conducted to identify associations between the outcome of interest and key predictors. A probability value of p ≤ 0.05 was selected. From counselling case notes, a thematic content analysis was conducted to describe contextual factors pertaining to forms of domestic violence (DV).

RESULTS

The prevalence of IPV was 15% of a sample of 376 women. Women who were food insecure, unemployed, in stable but unmarried relationships, had experienced any form of past abuse and were not pleased about the current pregnancy were more likely to experience IPV. MINI-defined mental health problems and a history of mental illness were significantly associated with IPV. Qualitative analysis of 95 counselling case notes revealed that DV within the household was not limited to intimate partners and, DV in this context was often perceived as 'normal' behaviour by the participants.

CONCLUSIONS

This study contributes towards a greater understanding of the risk profile for IPV amongst pregnant women in low-income settings. Adversity, including food insecurity and mental ill-health are closely associated with IPV during the antenatal period. Advocates against violence against pregnant women are advised to consider that violence in the home may be perpetrated by non-intimate partners and may by enabled by a pervasive belief in the acceptability of the violence.

Men of Mexican Origin Who Abuse Women: A Qualitative Study

BACKGROUND

Current literature indicates that intimate partner violence is a complex phenomenon that exists worldwide.

PURPOSE

However, little is known about why some men of Mexican origin abuse women. This descriptive study was conducted to understand the experiences of men of Mexican origin who abuse their intimate partners.

METHOD

A qualitative research design was used to conduct this study in a south Texas border community adjacent to the United States-Mexico border.

RESULTS

This study builds on existing research and furthers the knowledge related to the factors contributing to intimate partner violence, including cultural factors. The results also reinforce the negative impacts of intimate partner violence on children and the family structure.

DISCUSSION

Further research is needed to support the development of a culturally appropriate prevention and intervention program for men of Mexican origin who abuse women and their families.

High Stress and Negative Health Behaviors: A Five-Year Wellness Center Member Cohort Study

OBJECTIVE

The aim of this study was to examine the association between having a high stress level and health behaviors in employees of an academic medical center.

METHODS

Beginning January 1, 2009, through December 31, 2013, an annual survey was completed by 676 worksite wellness members.

RESULTS

Each year, about one-sixth of members had a high stress level, high stress individuals visited the wellness center less often, and most years there was a significant relationship (P < 0.05) between stress level and poor physical health behaviors (physical activity level and confidence, strength, climbing stairs), low mental health (quality of life, support, spiritual well-being and fatigue), poor nutritional habits (habits and confidence), and lower perceived overall health.

CONCLUSIONS

High stress is associated with negative health behavior, and future studies, therefore, should explore strategies to effectively engage high stress employees into comprehensive wellness programs.

Childhood Corporal Punishment and Future Perpetration of Physical Dating Violence

OBJECTIVE

To test whether experiencing childhood corporal punishment is linked to later perpetration of dating violence.

STUDY DESIGN

Young adults (n = 758; 61% female; mean age of 20 years), originally recruited for a longitudinal study as 9th- and 10th-grade Texas high school students, were asked about their childhood experiences with corporal punishment and physical abuse, as well as current experiences with dating violence. A path model was used to determine whether childhood corporal punishment was related to recent perpetration of physical dating violence, while controlling for childhood physical abuse, age, sex, ethnicity, and socioeconomic status.

RESULTS

In all, 19% of participants (n = 134) reported physical dating violence perpetration and 68% reported experiencing corporal punishment as children (n = 498). Analysis showed a significant positive association between corporal punishment and physical perpetration of dating violence (OR 1.30, 95% CI 1.07-1.59). Even after controlling for sex, ethnicity, age, parental education, and child physical abuse, childhood corporal punishment was associated significantly with physical dating violence perpetration (aOR 1.29, 95% CI 1.02-1.62).

CONCLUSIONS

The finding that childhood corporal punishment was associated with perpetration of young adult physical dating violence, even after controlling for several demographic variables and childhood physical abuse, adds to the growing literature demonstrating deleterious outcomes associated with corporal punishment.

Child abuse and work stress in adulthood: Evidence from a population-based study

The objective of this study was to examine the association between child abuse and work stress in adulthood. We used data from the 2012 Canadian Community Health Survey (CCHS) Mental Health, a nationally representative cross-sectional survey of Canadians. This study included all participants aged 20years or older who reported being employed the past 12months (N=14,581). Child physical abuse, sexual abuse, and exposure to intimate partner violence were assessed in relation to several work stress-related indicators. Multiple linear and Poisson regression models adjusted for age, sex, education, household income, marital status, occupation group, and any lifetime mental disorder. Child abuse was significantly associated with greater odds of high work stress (IRR: 1.29; 95% CI: 1.16-1.43) in adulthood. More specifically, child abuse was associated with greater odds of job dissatisfaction (IRR: 1.69; 95% CI: 1.31-2.18), job insecurity (IRR: 1.56; 95% CI: 1.27-1.91), and self-perceived low support (IRR: 1.33; 95% CI: 1.22-1.46). It was also associated with high levels of psychological demand (b=0.348; 95% CI: 0.229-0.467) and job strain (b=0.031; 95% CI: 0.019-0.043). Examination of the Karasek's Demand-Control Model using multinomial logistic regression analyses indicated that child abuse was significantly associated with high strain (RRR:1.39; 95% CI: 1.14-1.72) and active (RRR: 1.56; 95% CI: 1.28-1.90) jobs. These findings suggest the negative influence of child abuse on work experience. Success in preventing child abuse may help reduce work-related stress in adulthood.

The association between child exposure to intimate partner violence (IPV) and perpetration of IPV in adulthood-A systematic review

Increasingly recognized as a distinct form of childhood maltreatment, children's exposure to intimate partner violence (IPV) has been shown to be associated with an array of negative psychosocial outcomes, including elevated risk for additional violence over the life course. Although studies have identified child exposure to IPV as a predictor of IPV perpetration in adulthood, no review has critically evaluated the methodology of this quantitative work. The present study examines the association between childhood exposure to IPV and the perpetration of IPV in adulthood based on a systematic review of the literature from inception to January 4, 2016. Databases searched included Medline, Embase, PsycINFO, CINAHL, Cochrane Database of Systematic Reviews, Sociological Abstracts and ERIC. Database searches were complemented with backward and forward citation chaining. Studies were critically appraised using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Of 5601 articles identified by the search, 19 studies were included for data extraction. Sixteen of these studies found that child exposure to IPV was significantly and positively associated with adult IPV perpetration; three studies reported null findings. The methodological quality of the studies was low. Work thus far has tended to focus on child exposure to physical IPV and the perpetration of physical IPV within heterosexual contexts. In addition, measures of child exposure to IPV vary in their classification of what exposure entails. We critically discuss the strengths and limitations of the existing evidence and the theoretical frameworks informing this work.

Alcohol Intoxication Moderates the Association between a Polygenic Risk Score and Unprovoked Intimate Partner Aggression

Despite evidence that genetic variation contributes to aggression, few studies have examined how genetic variation contributes to IPA specifically. In the current study, 69 couples from a Midwestern university completed self-report measures of IPA, childhood trauma exposure, and hazardous alcohol use, and were randomly assigned to consume either a placebo or alcohol beverage before participating in an analogue aggression task against their partner. Genetic risk (i.e., association with lower transcriptional efficiency) for aggression was measured with a polygenic risk score (PRS) created from four polymorphisms (HTR1B rs13212041, HTR2B rs6437000, 5-HTTLPR, and MAOA uVNTR). Among individuals with a low PRS, individuals who consumed alcohol (BrAC = 0.07%) showed greater unprovoked IPA than individuals who consumed a placebo. Findings contribute to our limited understanding regarding the etiology of IPA and suggest that individuals who have increased transcriptional activity in certain serotonin system genes may be at higher risk of IPA when intoxicated.

Childhood adversities and post-traumatic stress disorder: evidence for stress sensitisation in the World Mental Health Surveys

BackgroundAlthough childhood adversities are known to predict increased risk of post-traumatic stress disorder (PTSD) after traumatic experiences, it is unclear whether this association varies by childhood adversity or traumatic experience types or by age.AimsTo examine variation in associations of childhood adversities with PTSD according to childhood adversity types, traumatic experience types and life-course stage.MethodEpidemiological data were analysed from the World Mental Health Surveys (n = 27 017).ResultsFour childhood adversities (physical and sexual abuse, neglect, parent psychopathology) were associated with similarly increased odds of PTSD following traumatic experiences (odds ratio (OR) = 1.8), whereas the other eight childhood adversities assessed did not predict PTSD. Childhood adversity-PTSD associations did not vary across traumatic experience types, but were stronger in childhood-adolescence and early-middle adulthood than later adulthood.ConclusionsChildhood adversities are differentially associated with PTSD, with the strongest associations in childhood-adolescence and early-middle adulthood. Consistency of associations across traumatic experience types suggests that childhood adversities are associated with generalised vulnerability to PTSD following traumatic experiences.

Childhood adversity, adult stress, and the risk of major depression or generalized anxiety disorder in US soldiers: a test of the stress sensitization hypothesis

BACKGROUND

The stress sensitization theory hypothesizes that individuals exposed to childhood adversity will be more vulnerable to mental disorders from proximal stressors. We aimed to test this theory with respect to risk of 30-day major depressive episode (MDE) and generalized anxiety disorder (GAD) among new US Army soldiers.

METHODS

The sample consisted of 30 436 new soldier recruits in the Army Study to Assess Risk and Resilience (Army STARRS). Generalized linear models were constructed, and additive interactions between childhood maltreatment profiles and level of 12-month stressful experiences on the risk of 30-day MDE and GAD were analyzed.

RESULTS

Stress sensitization was observed in models of past 30-day MDE (χ2 8 = 17.6, p = 0.025) and GAD (χ2 8 = 26.8, p = 0.001). This sensitization only occurred at high (3+) levels of reported 12-month stressful experiences. In pairwise comparisons for the risk of 30-day MDE, the risk difference between 3+ stressful experiences and no stressful experiences was significantly greater for all maltreatment profiles relative to No Maltreatment. Similar results were found with the risk for 30-day GAD with the exception of the risk difference for Episodic Emotional and Sexual Abuse, which did not differ statistically from No Maltreatment.

CONCLUSIONS

New soldiers are at an increased risk of 30-day MDE or GAD following recent stressful experiences if they were exposed to childhood maltreatment. Particularly in the military with an abundance of unique stressors, attempts to identify this population and improve stress management may be useful in the effort to reduce the risk of mental disorders.

A Mixed Method Study of Intimate Partner Violence: How Sex and Severity Impact Perpetrator Prior Involvement, Abnormality, and Responsibility

This study employed a mixed method approach to examine the effects of participant sex, perpetrator sex, and severity of violence on perceptions of intimate partner violence (IPV) perpetrators. Quantitative participants (n = 449) completed a survey and qualitative participants (n = 31) participated in a focus group or an interview. Participants believed that it was more likely male perpetrators had prior involvement in IPV. Participants rated stories of female perpetrators as more abnormal than stories of male perpetrators. Participants in the weak severity of violence condition had lower evaluations of responsibility than the strong or fatal severity of violence conditions and only women were discerning about perpetrator sex in their ratings of responsibility. Theoretical implications extend intimate terrorism and defensive attribution theory.

The legacy of early childhood violence exposure to adulthood intimate partner violence: Variable- and person-oriented evidence

This study examined prospective pathways from exposure to interparental violence (EIPV) during infancy (ages 0-24 months) and toddlerhood/preschool (ages 25-64 months) to intimate partner violence (IPV) perpetration and victimization in adulthood (ages 23, 26, and 32 years) using 2 complementary approaches. Building on past findings, a variable-oriented approach was used to examine the effects of developmental timing of EIPV in infancy versus toddlerhood/preschool to IPV involvement in early adulthood, at age 23 years. A person-oriented approach next examined whether continuity and change in IPV (persisting, increasing, and decreasing vs. nonviolent patterns) across the transition from early adulthood to adulthood (ages 26 to 32 years) were predicted by developmental timing of EIPV within early childhood and/or contemporaneous adulthood factors (life stress and behavior problems). In this fully prospective longitudinal study beginning at birth, mothers reported on EIPV in infancy and toddlerhood/preschool, and participants (N = 179) reported on IPV and contemporaneous stress and behavior in early adulthood and adulthood. Results indicated that according to the variable-oriented approach, EIPV in toddlerhood/preschool but not in infancy predicted both IPV perpetration and victimization at age 23. The person-oriented approach revealed that, along with life stress and externalizing behavior, EIPV in toddlerhood/preschool, but not in infancy, also differentiated patterns of IPV from ages 26 to 32. Findings converge on toddlerhood/preschool as a particular promising developmental period to intervene and deter long-term effects of EIPV on IPV across the transition from early adulthood to adulthood. (PsycINFO Database Record

Individual- and contextual-level factors associated with client-initiated HIV testing

ABSTRACT: Background: Knowing the reasons for seeking HIV testing is central for HIV prevention. Despite the availability of free HIV counseling and testing in Brazil, coverage remains lacking. Methods: Survey of 4,760 respondents from urban areas was analyzed. Individual-level variables included sociodemographic characteristics; sexual and reproductive health; HIV/AIDS treatment knowledge and beliefs; being personally acquainted with a person with HIV/AIDS; and holding discriminatory ideas about people living with HIV. Contextual-level variables included the Human Development Index (HDI) of the municipality; prevalence of HIV/AIDS; and availability of local HIV counseling and testing (CT) services. The dependent variable was client-initiated testing. Multilevel Poisson regression models with random intercepts were used to assess associated factors. Results: Common individual-level variables among men and women included being personally acquainted with a person with HIV/AIDS and age; whereas discordant variables included those related to sexual and reproductive health and experiencing sexual violence. Among contextual-level factors, availability of CT services was variable associated with client-initiated testing among women only. The contextual-level variable “HDI of the municipality” was associated with client-initiated testing among women. Conclusion: Thus, marked gender differences in HIV testing were found, with a lack of HIV testing among married women and heterosexual men, groups that do not spontaneously seek testing.

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.

Social–ecological predictors of externalizing behavior trajectories in at-risk youth

Extant research consistently links youth externalizing problems and later maladaptive outcomes, and these behaviors are particularly detrimental given their relative stability across development. Although an array of risk and protective factors for externalizing problems have been identified, few studies have examined factors reflecting the multiple social–ecological levels that influence child development and used them to predict longitudinal trajectories of externalizing problems. The current study examined externalizing behavior trajectories in a sample of 1,094 at-risk youth (539 boys, 555 girls) from the Longitudinal Studies in Child Abuse and Neglect multisite longitudinal study of child maltreatment. Normed Child Behavior Checklist externalizing scores were used to estimate group trajectories via growth-based trajectory modeling at ages 10, 12, 14, and 16 using the SAS PROC TRAJ procedure. Model fit was assessed using the Bayes information criterion and the Akaike information criterion statistics. Analyses revealed optimal fit for five distinct behavioral trajectories: low stable, mid-increasing, mid-decreasing, medium high, and high stable. Multinomial logistic regressions revealed that a combination of risk and protective factors at individual, family, school, and neighborhood levels contribute to distinct trajectories of externalizing problems over time. Predictors of low and decreasing trajectories can inform interventions aimed at addressing externalizing problems among high-risk adolescents.

Intimate partner violence and the overlap of perpetration and victimization: Considering the influence of physical, sexual, and emotional abuse in childhood

Using data from Wave 4 of the National Longitudinal Study of Adolescent to Adult Health, this study examined the independent relationship of childhood maltreatment type (emotional, sexual, physical) on IPV victimization and perpetration; then mutually exclusive categories of IPV involvement (victimization, perpetration, and victimization/perpetration) were investigated. IPV victimization and perpetration were assessed using items from the revised Conflict Tactics Scales. A series of binary regression models and multinomial regression models were estimated. Models were stratified across gender. Results uncovered significant relationships between child physical abuse and IPV victimization as well as IPV perpetration for males and females, but this effect was reduced when emotional maltreatment was added to the model. When IPV victimization/perpetration was considered, maltreatment effects changed. For males, physical maltreatment remained significantly related to victimization only and physical, sexual, and emotional maltreatment were related to victimization/perpetration. For females, physical maltreatment remained significantly related to IPV victimization only and emotional maltreatment was related to perpetration only and to victimization/perpetration. Screening and intervention for maltreatment, including emotional maltreatment, among children as well as adults with IPV histories may be important to preventing first IPV experiences and stemming current involvement.

Childhood Sexual Abuse and Sociodemographic Factors Prospectively Associated with Intimate Partner Violence Perpetration Among South African Heterosexual Men

BACKGROUND

Intimate partner violence directed at women by men continues to be a global concern. However, little is known about the factors associated with perpetrating intimate partner violence among heterosexual men.

PURPOSE

History of childhood sexual abuse and other sociodemographic variables were examined as potential factors associated with severe intimate partner violence perpetration toward women in a sample of heterosexual men in South Africa.

METHODS

Longitudinal logistic generalized estimating equations examined associations of childhood sexual abuse and sociodemographic variables at baseline with intimate partner violence perpetration at subsequent time points.

RESULTS

Among participants with a steady female partner, 21.81 % (190/ 871) reported perpetrating intimate partner violence in the past year at baseline. Having a history of childhood sexual abuse (p < .001), binge drinking (p = .002), being employed (p = .050), and more difficulty controlling sexual impulses in order to use a condom (p = .006) at baseline were associated with self-reported intimate partner violence perpetration in the past year at subsequent time points.

CONCLUSIONS

With high levels of recent severe physical and/or sexual intimate partner violence perpetration in South Africa, comprehensive interventions are urgently needed. To more fully address gender-based violence, it is important to address associated factors, including exposure to childhood sexual abuse that could impact behavior later in life and that have long-lasting and deleterious effects on men and their female partners.

Examining Perpetration of Physical Violence by Women: The Influence of Childhood Adversity, Victimization, Mental Illness, Substance Abuse, and Anger

Research on women's perpetration of physical violence has focused primarily on partners, often neglecting perpetration against nonpartners. This study proposes a conceptual model with direct and indirect relationships between childhood adversity and different targets of violence (partners and nonpartners), mediated by victimization experiences (by partner and nonpartners), mental illness, substance abuse, and anger. Using survey data from a random sample of incarcerated women (N = 574), structural equation modeling resulted in significant, albeit different, indirect paths from childhood adversity, through victimization, to perpetration of violence against partners (β = .20) and nonpartners (β = .19). The results indicate that prevention of women's violence requires attention to specific forms of victimization, anger expression, and targets of her aggression.

Controlling behaviours and technology-facilitated abuse perpetrated by men receiving substance use treatment in England and Brazil: Prevalence and risk factors

INTRODUCTION AND AIMS

Controlling behaviours are highly prevalent forms of non-physical intimate partner violence (IPV). The prevalence of perpetrating controlling behaviours and technology-facilitated abuse (TFA) was compared by men receiving substance use treatment in England (n = 223) and Brazil (n = 280). Factors associated with perpetrating these behaviours towards their current/most recent partner and their association with other types of IPV were explored.

DESIGN AND METHODS

Secondary analysis from two cross-sectional studies was performed. Data on socio-demographic characteristics, infidelity, IPV perpetration and victimisation, adverse childhood experiences (ACE), attitudes towards gender relations and roles, substance use, depressive symptoms and anger expression were collected.

RESULTS

Sixty-four percent (143/223) and 33% (73/223) of participants in England and 65% (184/280) and 20% (57/280) in Brazil reported controlling behaviours and TFA, respectively, during their current/most recent relationship. Excluding IPV victimisation from the multivariate models; perpetrating controlling behaviours was associated with a higher number of ACE, higher anger expression (England) and severe physical IPV perpetration (Brazil), and perpetrating TFA was associated with younger age. Including both IPV victimisation and perpetration in the multivariate models; perpetrating controlling behaviour was associated with experiencing a higher number of ACE, higher anger expression (England), emotional IPV victimisation (England) and experiencing controlling behaviour from a partner (England). The perpetration of TFA was associated with younger age and experiencing TFA from a partner.

CONCLUSIONS

Technological progress provides opportunities for perpetrators to control and abuse their partners. Controlling behaviours and TFA should be addressed to reduce IPV perpetration by males in substance use treatment. [Gilchrist G, Canfield M,Radcliffe P, d'Oliveira AFPL. Controlling behaviours and technology-facilitated abuse perpetrated by men receiving substance use treatment in England and Brazil: Prevalence and risk factors. Drug Alcohol Rev 2017;36:52-63].

Stress and Intimate Partner Aggression

Evidence suggests that stressed couples also tend to be aggressive couples. Chronic external stresses interact with individuals' dispositional and regulatory deficiencies, resulting in a spillover of these stresses into the relationship. High individual stress in combination with problematic interaction styles and problem-solving abilities increases the likelihood of IPA. We applied the I³ Model to better organize the instigating, impelling, and inhibiting factors and processes that moderate the stress-IPA association. Evidence suggests that certain forms of stress, such as IPA victimization, reliably instigate IPA perpetration, with weak inhibitory processes and impaired problem solving moderating the stress-IPA association. More research is needed that specifies the 'perfect storm' of factors that increase our understanding of how, and for whom, stress increases IPA risk.

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.

Effective Practices in the Treatment of Trauma in Children and Adolescents: From Guidelines to Organizational Practices

Exposure to traumatic events happens at an alarming rate for children and adolescents in the United States. If left unaddressed, these youth have a high risk of growing up with additional health and mental health problems. In this article the authors review three key aspects of helping youth heal from the symptoms of experiencing a traumatic event; (1) recommended guidelines, (2) specific treatments, and (3) the Trauma-Informed Care Framework. Eleven recommendations from the American Academy of Child and Adolescent Psychiatry are discussed as they relate to effective practices in the treatment of trauma in children and adolescents. Trauma-focused cognitive behavioral therapy and child-parent psychotherapy are also explored as the two specific interventions that have the most empirical support for treatment in children and adolescents. Finally, the tenets of a Trauma-Informed Care Framework are presented along with a review of how well these have been applied in youth serving organizations.

Adolescent Risk for Intimate Partner Violence Perpetration

The prevention of intimate partner violence is a desirable individual and public health goal for society. The purpose of this study is to provide a comprehensive assessment of adolescent risk factors for partner violence in order to inform the development of evidence-based prevention strategies. We utilize data from the Rochester Youth Development Study, a two decade long prospective study of a representative community sample of 1000 participants that has extensive measures of adolescent characteristics, contexts, and behaviors that are potential precursors of partner violence. Using a developmental psychopathology framework, we assess self-reported partner violence perpetration in emerging adulthood (ages 20-22) and in adulthood (ages 29-30) utilizing the Conflict Tactics Scale. Our results indicate that risk factors for intimate partner violence span several developmental domains and are substantially similar for both genders. Internalizing and externalizing problem behaviors as well as early intimate relationships are especially salient for both genders. Additionally, cumulative risk across a number of developmental domains places adolescents at particularly high risk of perpetrating partner violence. Implications for prevention include extending existing prevention programs that focus on high risk groups with multiple risks for developmental disruption, as well as focusing on preventing or mitigating identified risk factors across both genders.

Associations of financial stressors and physical intimate partner violence perpetration

Background

Contextual factors, such as exposure to stressors, may be antecedents to IPV perpetration. These contextual factors may be amenable to modification through intervention and prevention. However, few studies have examined specific contextual factors. To begin to address this gap, we examined the associations between financial stressors and three types of physical IPV perpetration.

Methods

This analysis used data from Wave IV of The National Longitudinal Study of Adolescent to Adult Health. We used logistic regression to examine the associations of financial stressors and each type of IPV (minor, severe, causing injury), and multinomial logit regression to examine the associations of financial stressors and patterns of co-occurring types of IPV perpetration (only minor; only severe; minor and severe; minor, severe, and causing injury; compared with no perpetration).

Results

Fewer men perpetrated threats/minor physical IPV (6.7 %) or severe physical IPV (3.4 %) compared with women (11.4 % and 8.8 %, respectively). However, among physical IPV perpetrators, a higher percentage of men (32.0 %) than women (21.0 %) reported their partner was injured as a result of the IPV. In logistic regression models of each type of IPV perpetration, both the number of stressors experienced and several types of financial stressors were associated with perpetrating each type of IPV. Utilities nonpayment, housing nonpayment, food insecurity, and no phone service were associated with increased odds of perpetrating each form of IPV in adjusted analysis. Eviction was associated with perpetrating severe physical IPV but not threats/minor IPV or IPV causing injury. In multinomial logit regression comparing patterns of IPV perpetration to perpetrating no physical IPV, the relationships of financial stressors were less consistent. Food insecurity was associated with perpetrating only minor physical IPV. Comparatively, overall number of financial stressors and four types of financial stressors (utilities nonpayment, housing nonpayment, food insecurity, and disconnected phone service) were associated with perpetrating all three forms of physical IPV.

Conclusions

Combined with prior research, our results suggested interventions to improve financial well-being may be a novel way to reduce physical IPV perpetration.

The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Waves 1 and 2: review and summary of findings

PURPOSE

The NESARC, a "third-generation" psychiatric epidemiologic survey that integrated detailed measures of alcohol and drug use and problems has been the data source for over >850 publications. A comprehensive review of NESARC findings and their implications is lacking.

METHOD

NESARC was a survey of 43,093 participants that covered alcohol, drug and psychiatric disorders, risk factors, and consequences. Wave 1 of the NESARC was conducted in 2001-2002. Three years later, Wave 2 follow-up re-interviews were conducted with 34,653 of the original participants. Scopus and Pubmed were used to search for NESARC papers, which were sorted into topic areas and summarized.

RESULT

The most common disorders were alcohol and posttraumatic stress disorders, and major depression. Females had more internalizing disorders and males had more externalizing disorders, although the preponderance of males with alcohol disorders (the "gender gap") was less pronounced than it was in previous decades. A race/ethnic "paradox" (lower risk among disadvantaged minorities than whites) remains unexplained. Younger participants had higher risk for substance and personality disorders, but not unipolar depressive or anxiety disorders. Psychiatric comorbidity was extensive and often formed latent trans-diagnostic domains. Since 1991-1992, risk for marijuana and prescription drug disorders increased, while smoking decreased, although smoking decreases were less pronounced among those with comorbidity. A nexus of comorbidity, social support, and stress predicted transitions in diagnostic status between Waves 1 and 2. Childhood maltreatment predicted psychopathology. Alcohol and drug use disorders were seldom treated; attitudinal barriers (little perceived need, perceived alcoholism stigma, pessimism about efficacy) were more important in predicting non-treatment than financial barriers.

CONCLUSIONS

Understanding comorbidity and the effects of early stressors will require research incorporating biologic components, e.g., genetic variants and brain imaging. The lack of treatment for alcohol and drug disorders, predicted by attitudinal rather than financial variables, suggests an urgent need for public and professional education to reduce the stigma associated with these disorders and increase knowledge of treatment options.

Childhood maltreatment and risk of intimate partner violence: A national study

OBJECTIVE

Prior research indicates that different types of childhood maltreatment frequently co-occur and confer risk for adulthood intimate partner violence (IPV). However, it is unknown whether the risk of IPV is due to specific type(s) of maltreatment or to their shared association or both. Although these competing explanations have different implications for intervention, they have never been evaluated empirically.

METHOD

Data were drawn from a nationally representative survey of 34,653 US adults, the 2004-2005 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Structural equation modeling was used to simultaneously examine the shared and specific effects of five types of childhood maltreatment (i.e., sexual abuse, physical and emotional abuse and neglect) on the risk of different IPV behaviors (i.e., perpetration, victimization and reciprocal violence). Analyses were stratified by sex and adjusted for sociodemographic characteristics (i.e., age, personal income, educational background and race/ethnicity).

RESULTS

Most types of childhood maltreatment increased the risk of victimization, perpetration and reciprocal violence. Effects of maltreatment types on each IPV behavior were exerted mostly through a latent factor representing the shared effect across all different types of maltreatment in both sexes (CFI = 0.990, TLI = 0.990, RMSEA = 0.023), although sexual abuse had an additional effect on victimization.

CONCLUSIONS

Because childhood maltreatment types increase the risk of each intimate partner violence behavior mainly through a general maltreatment dimension, underlying biological and developmental-ecological mechanisms should be considered important targets of prevention for both victimization and perpetration of abuse in adult relationships.

Test of the stress sensitization model in adolescents following the pipeline explosion

PURPOSE

The stress sensitization model states that early traumatic experiences increase vulnerability to the adverse effects of subsequent stressful life events. This study examined the effect of stress sensitization on development of posttraumatic stress disorder (PTSD) symptoms in Chinese adolescents who experienced the pipeline explosion.

METHODS

A total of 670 participants completed self-administered questionnaires on demographic characteristics and degree of explosion exposure, the Childhood Trauma Questionnaire (CTQ), and the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C). Associations among the variables were explored using MANOVA, and main effects and interactions were analyzed.

RESULTS

Overall MANOVA tests with the PCL-C indicated significant differences for gender (F=6.86, p=.000), emotional abuse (F=6.79, p=.000), and explosion exposure (F=22.40, p=.000). There were significant interactions between emotional abuse and explosion exposure (F=3.98, p=.008) and gender and explosion exposure (F=2.93, p=.033).

CONCLUSIONS

Being female, childhood emotional abuse, and a high explosion exposure were associated with high PTSD symptom levels. Childhood emotional abuse moderated the effect of explosion exposure on PTSD symptoms. Thus, stress sensitization influenced the development of PTSD symptoms in Chinese adolescents who experienced the pipeline explosion as predicted by the model.

Life Course Associations between Victimization and Aggression: Distinct and Cumulative Contributions

The connections between early maltreatment and later aggression are well established in the literature, however gaps remain in our understanding of developmental processes. This study investigates the cascading lifecourse linkages between victimization experiences from childhood through early adulthood andlater aggressive behavior. The diverse, at-risk sample is of particular importance to child and adolescent specialists, as it represents highly vulnerable youth accessible through conventional school settings. In addition to direct pathways from proximal life periods, path analysis revealed significant indirect mediated pathways through which earlier life victimizationcontributes to aggressive behaviors in later life periods as well as revictimization. Multivariateregressions support theorized cumulative effects of multi-form victimization as well as distinct contributions of victimization domains (emotional, witnessing, physical, property, and sexual) in explaining aggressive behavior.Consistent with theorizing about the developmental impact of early maltreatment, results bolster the importance of interrupting pathways from victimization to revictimization and later aggression. Findings are evaluated in light of implications for early identification and prevention programming.

Life Course Associations between Victimization and Aggression: Distinctive and Cumulative Contributions

The connections between early maltreatment and later aggression are well established in the literature, however gaps remain in our understanding of developmental processes. This study investigates the cascading life course linkages between victimization experiences from childhood through early adulthood and later aggressive behavior. The diverse, at-risk sample is of particular importance to child and adolescent specialists, as it represents highly vulnerable youth accessible through conventional school settings. In addition to direct pathways from proximal life periods, path analysis revealed significant indirect mediated pathways through which earlier life victimization contributes to aggressive behaviors in later life periods as well as revictimization. Multivariate regressions support theorized cumulative effects of multi-form victimization as well as distinct contributions of victimization domains (emotional, witnessing, physical, property, and sexual) in explaining aggressive behavior. Consistent with theorizing about the developmental impact of early maltreatment, results bolster the importance of interrupting pathways from victimization to revictimization and later aggression. Findings are evaluated in light of implications for early identification and prevention programming.

Intimate partner violence among women in Spain: the impact of regional-level male unemployment and income inequality

BACKGROUND

Intimate partner violence (IPV) against women is a complex worldwide public health problem. There is scarce research on the independent effect on IPV exerted by structural factors such as labour and economic policies, economic inequalities and gender inequality.

OBJECTIVE

To analyse the association, in Spain, between contextual variables of regional unemployment and income inequality and individual women's likelihood of IPV, independently of the women's characteristics.

METHOD

We conducted multilevel logistic regression to analyse cross-sectional data from the 2011 Spanish Macrosurvey of Gender-based Violence which included 7898 adult women. The first level of analyses was the individual women' characteristics and the second level was the region of residence.

RESULTS

Of the survey participants, 12.2% reported lifetime IPV. The region of residence accounted for 3.5% of the total variability in IPV prevalence. We determined a direct association between regional male long-term unemployment and IPV likelihood (P = 0.007) and between the Gini Index for the regional income inequality and IPV likelihood (P < 0.001). Women residing in a region with higher gender-based income discrimination are at a lower likelihood of IPV than those residing in a region with low gender-based income discrimination (odds ratio = 0.64, 95% confidence intervals: 0.55-0.75).

CONCLUSIONS

Growing regional unemployment rates and income inequalities increase women's likelihood of IPV. In times of economic downturn, like the current one in Spain, this association may translate into an increase in women's vulnerability to IPV.

Adverse childhood experiences and intimate partner aggression in the US: sex differences and similarities in psychosocial mediation

Six in ten people in the general population have been exposed to adverse childhood experiences (ACEs). Intimate partner violence (IPV) is a major public health problem in the US. The main objective of this study was to assess sex differences in the role of posttraumatic stress disorder (PTSD), substance abuse, and depression as mediators in the association between ACEs and intimate partner aggression. 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 mediational role of PTSD, substance abuse and depression in the association between ACE constructs (neglect, physical/psychological abuse, sexual abuse, parental violence, and parental incarceration/psychopathology) and intimate partner aggression. Among men, PTSD mediated the relationship between sexual abuse and intimate partner aggression. However, among men and women, substance abuse mediated the relationship between physical and psychological abuse and intimate partner aggression. IPV programs geared towards aggressors should address abuse (sexual, physical and psychological), which occurred during childhood and recent substance abuse and PTSD. These programs should be implemented for men and women. Programs aimed at preventing abuse of children may help to reduce rates of depression and PTSD in adulthood, and subsequent intimate partner aggression.

Alcohol outlet density, drinking contexts and intimate partner violence: a review of environmental risk factors

Alcohol use is a robust predictor of intimate partner violence (IPV). A critical barrier to progress in preventing alcohol-related IPV is that little is known about how an individual's specific drinking contexts (where, how often, and with whom one drinks) are related to IPV, or how these contexts are affected by environmental characteristics, such as alcohol outlet density and neighborhood disadvantage. The putative mechanism is the social environment in which drinking occurs that may promote or strengthen aggressive norms. Once these contexts are known, specific prevention measures can be put in place, including policy-oriented (e.g., regulating outlet density) and individually oriented (e.g., brief interventions to reduce risk for spousal aggression) measures targeting at-risk populations. This paper reviews applicable theories and empirical research evidence that links IPV to drinking contexts and alcohol outlet density, highlights research gaps, and makes recommendations for future research.

Maternal exposure to intimate partner abuse before birth is associated with autism spectrum disorder in offspring

We sought to determine whether maternal (a) physical harm from intimate partner abuse during pregnancy or (b) sexual, emotional, or physical abuse before birth increased risk of autism spectrum disorder. We calculated risk ratios for autism spectrum disorder associated with abuse in a population-based cohort of women and their children (54,512 controls, 451 cases). Physical harm from abuse during pregnancy was not associated with autism spectrum disorder. However, autism spectrum disorder risk was increased in children of women who reported fear of partner or sexual, emotional, or physical abuse in the 2 years before the birth year (abuse in the year before the birth year: risk ratio = 1.58, 95% confidence interval = 1.04, 2.40; abuse in both of the 2 years before the birth year: risk ratio = 2.16, 95% confidence interval = 1.33, 3.50). Within-family results were similar, although did not reach statistical significance. Association of intimate partner abuse before the child's birth year with autism spectrum disorder in the child was not accounted for by gestation length, birth weight, maternal smoking or alcohol consumption during pregnancy, gestational diabetes, preeclampsia, or history of induced abortion.

Intergenerational violence in Burundi: Experienced childhood maltreatment increases the risk of abusive child rearing and intimate partner violence

BACKGROUND

Experiencing abuse during childhood affects the psychological well-being of individuals throughout their lives and may even influence their offspring by enhancing the likelihood of an intergenerational transmission of violence. Understanding the effects of childhood maltreatment on child-rearing practices and intimate partner violence might be of particular importance to overcome the consequences of violent conflicts in African societies.

OBJECTIVE

Using Burundi as an example, we aimed to explore the associations between childhood maltreatment, intimate partner violence, perceived partner intimidation, gender and the probability of violently acting out against one's own children or romantic partner.

METHODS

Amongst a sample of 141 men and 141 women in the capital of Burundi, we identified those who had biological children and those who lived or had lived in relationships. Using culturally appropriate instruments, we enquired about their exposure to childhood maltreatment and partner violence as well as their inclinations to act out violently.

RESULTS

We found that childhood maltreatment and perceived partner intimidation were strong predictors for the perpetration of violence against children. Moreover, we found that women were more likely to use violence against children if they experienced partner violence and less likely to resort to violence if they felt intimidated. Men were more likely to perpetrate violence against their partner. Childhood maltreatment was again a strong predictor. The more women experienced partner violence, the more they fought back.

CONCLUSIONS

Childhood maltreatment is a strong predictor for domestic violence and has to be addressed to interrupt the cycle of violence in post-conflict countries.

An Exploratory Study of Teen Dating Violence in Sexual Minority Youth

Objective

Teen dating violence (TDV) represents a serious social problem in adolescence and is associated with a host of physical and emotional consequences. Despite advances in identification of risk factors, prevention efforts, and treatment, the TDV literature has overwhelmingly used samples that do not assess sexual orientation or assume heterosexuality. Although a few studies have explicitly examined dating violence among sexual minorities in adolescents, methodological issues limit the generalizability of these findings, and no study to date has examined patterns of dating violence over time in sexual minority youth.

Method

An ethnically diverse sample of 782 adolescents completed self-report measures of dating violence, hostility, alcohol use, exposure to interparental violence, and sexual orientation.

Results

Sexual minority adolescents reported higher rates of both TDV perpetration and victimization, and this finding persisted across 2 years for perpetration but not victimization. Findings also revealed that traditional risk factors of TDV (i.e., alcohol use, exposure to interparental violence) were not associated with TDV for sexual minority youth, although sexual orientation itself emerged as a risk factor over and above covariates when considering severe (i.e., physical and sexual) dating violence perpetration.

Conclusions

Sexual minorities may be at a greater risk for TDV than their heterosexual peers. Findings are discussed within the context of a minority stress model. Future research is needed to parse out factors specifically related to sexual orientation from a stressful or invalidating environment.

The Intersection of Partner Violence and Adverse Childhood Experiences: Implications for Research and Clinical Practice

Violence against women continues to be a serious public health issue afflicting women worldwide. The intersection of Adverse Childhood Experiences (ACEs) and intimate partner violence is detrimental to a woman's well-being. This review aims to identify the types of ACEs reported by women who also report partner violence and the subsequent negative impact of this combination of experiences on the women's health. The evidence supports the cumulative effects of Adverse Childhood Experiences on women, particularly when coupled with experiences of intimate partner violence. Early interventions by providers have the potential to mitigate negative health outcomes of abused women and interrupt the intergenerational transmission of violence to their children.

Investigating the Role of Child Sexual Abuse in Intimate Partner Violence Victimization and Perpetration in Young Adulthood From a Propensity Score Matching Approach

The link between child sexual abuse and adult intimate partner violence surfaces throughout prior research. Nonetheless, methodologies investigating this cycle of violence predominantly involve descriptive, correlational, or traditional regression-based analyses that preclude more definitive statements about the empirical relationship between child sexual abuse and adult partner violence. In recognition of these limitations, the current study presents a quasi-experimental investigation into the relationship between sexual abuse in childhood and physical partner violence victimization and/or perpetration in young adulthood. Propensity score matching analysis of a national data set sampling over 4,000 young adults suggests that experiencing child sexual abuse influences adult intimate partner violence victimization and perpetration. Study implications and directions for future research are discussed.

Effect of physical intimate partner violence on body mass index in low-income adult women

This study aimed to assess whether physical intimate partner violence affects the nutritional status of adult women with different levels of body mass index (BMI). This was a population-based cross-sectional study with 625 women selected through complex multistage cluster sampling. Information on physical intimate partner violence was obtained with the Revised Conflict Tactics Scales, and nutritional status was measured as BMI (kg/m2). A quantile regression model was used to assess the effect of physical intimate partner violence at all percentiles of BMI distribution. Physical intimate partner violence occurred in 27.6% of the women (95%CI: 20.0; 35.2). Mean BMI was 27.9kg/m2 (95%CI: 27.1; 28.7). The results showed that physical intimate partner violence was negatively associated with BMI between the 25th and 85th percentiles, corresponding to 22.9 and 31.2kg/m2. The findings support previous studies indicating that physical intimate partner violence can reduce BMI in low-income women.

Individual and interpersonal risk factors for physical intimate partner violence perpetration by biological sex and ethnicity

Intimate partner violence (IPV) is a public health problem that reaches across age, sex, and ethnicity. In this study, we examined risk factors for physical IPV perpetration among young adult males and females from four ethnic groups. Data were taken from Waves 1-3 of the National Longitudinal Study of Adolescent Health (Add Health). The sample included 10,141 Wave 3 respondents (ages ranged from 18-27 years old) who reported being in a current romantic relationship. Physical IPV perpetration was reported by 14.10% of White, 23.28% of Black, 18.82% of Latino, and 18.02% of Asian males. Physical IPV perpetration was reported by 19.01% of White, 24.80% of Black, 25.97% of Latina, and 19.21% of Asian females. Following an ecological framework, proximal risk factors at intrapersonal and interpersonal levels were included in the analyses. Despite finding fairly consistent percentage of physical IPV perpetration across sample groups, the risk factors for physical IPV perpetration were rather uncommon across sex and ethnicity. Only 1 factor--psychological IPV perpetration toward a romantic partner--was consistently associated with physical IPV perpetration across all groups. Our findings have implications for tailoring prevention and intervention efforts toward risk factors of physical IPV perpetration that are uniquely associated with biological sex and ethnicity.

Discrepant Patterns of Heavy Drinking, Marijuana Use, and Smoking and Intimate Partner Violence: Results From the California Community Health Study of Couples

This study analyzed whether discrepant (husband or wife use only) or concordant (both partners use) patterns of heavy drinking, marijuana use, and smoking are associated with increased risk for male-to-female partner violence and female-to-male partner violence among adult couples. Based on a geographic sample of married or cohabiting couples residing in 50 California cities, logistic regression analyses were conducted using dyadic data on past-year partner violence, binge drinking and frequency of intoxication, marijuana use, and smoking. When all substance use patterns were included simultaneously, wife-only heavy drinking couples were at elevated risk for male-to-female partner violence, as were concordant marijuana-using couples. Husband-only marijuana discrepant couples were at increased risk for female-to-male partner violence. Further research is needed to explore the processes by which discrepant and concordant substance use patterns may contribute to partner aggression.