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Peraud W, Quintard B, Constant A. Factors associated with violence against women following the COVID-19 lockdown in France: Results from a prospective online survey. PLoS One 2021; 16:e0257193. [PMID: 34506545 PMCID: PMC8432875 DOI: 10.1371/journal.pone.0257193] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/26/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The aim of this research was to investigate the impact of the first COVID-19 lockdown (March 17th-May 11th 2020) on violence against women in France. METHODS A prospective survey was conducted online between April 2th 2020 and July 5th 2020. Female respondents were recruited from social media networks using the snowball sampling method. Data were collected three times: during (2-19 April) and at the end (11-25 May) of the first lockdown, and following the first lockdown (20 June- 05 July). Sociodemographic variables, lockdown living conditions, financial impact of COVID, and history of psychiatric disorder were evaluated, together with changes in psychological distress over the lockdown period, and the risk of being assaulted post lockdown. RESULTS Psychological distress was elevated and remained stable for most of the 1538 female respondents during lockdown. More than 7% of women were affected by physical or sexual violence post lockdown. Unwanted sexual contact accounted for the majority of abuse, but physical and sexual assault were also prevalent. The risk of being abused was higher for participants who had changed anxiety/insomnia symptoms over the lockdown period, and a history of abuse. DISCUSSION Women who experienced changes in anxiety/insomnia symptoms during the COVID-19 lockdown were at higher risk than others of being assaulted post lockdown, especially when they were already socially vulnerable. While social and psychological factors accounting for these changes warrant further investigation, communication and preventive measures during pandemics should include initiatives tailored to women more vulnerable to violence.
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Affiliation(s)
- William Peraud
- Department of Psychology, Bordeaux University, Bordeaux, France
| | - Bruno Quintard
- Department of Psychology, Bordeaux University, Bordeaux, France
| | - Aymery Constant
- Department of Social and Behavioral Sciences, EHESP School of Public Health, Rennes, France
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152
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Sezgin AU, Punamäki RL. Type of Traumatic Events, Mental Health Problems, and Posttraumatic Cognitions Among Eastern Anatolian Women. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP9501-NP9525. [PMID: 31271098 DOI: 10.1177/0886260519858385] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Both severity and type of trauma play a role in mental health consequences. Interpersonal trauma, especially sexual abuse and intentional assaultive violence, form a risk for posttraumatic stress disorder (PTSD). However, few studies have factually compared the impact of trauma types on mental health. This study examined whether interpersonal violence (IPV), natural disasters and accidents (NDA), and life-threat and war (LTW) are differently associated with mental health problems among women. It further examined the mediating role of posttraumatic cognitions (PTCs) among the abovementioned three types of traumatic events and mental health problems. The participants were 1,569 Eastern Anatolian women (16-72 years of age). Traumatic events were assessed with the Life Events Checklist (LEC), mental health with the Diagnostic and statistical manual of mental disorders (5th ed.; DSM-5) diagnostic criteria for PTSD, psychiatric distress symptoms with the GHQ-28 (General Health Questionnaire) scales, and PTCs with the self-related and other-related scales of the Posttraumatic Cognitions Inventory (PTCI). As hypothesized, IPV was more significantly associated with PTSD, anxiety, and somatization symptoms than with NDA. The LTW was significantly associated with all symptoms. Both self-related and other-related PTCs partially mediated the association of both IPV and NDA with mental health problems. The findings are discussed from the perspectives of women and human rights, emphasizing also the importance of cognitive processing of traumatic experiences in enhancing good mental health.
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153
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Affiliation(s)
- Heidi Stöckl
- London School of Hygiene and Tropical Medicine, London, UK
- Ludwig Maximilian University, Munich, Germany
| | - Zara Quigg
- Liverpool John Moores University, Liverpool, UK
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154
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Orr C, Preen D, Fisher C, Sims S, O'Donnell M. Trends in Hospital Admissions for Intimate Partner Violence in Australian Mothers With Children Born From 1990 to 2009. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:6998-7017. [PMID: 30813820 DOI: 10.1177/0886260519832905] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study aims to determine the prevalence, and trends over time, of Western Australian (WA) mothers who were victims of intimate partner violence (IPV) requiring hospital admission. The study investigated the prevalence of all mothers and the specific prevalence of Aboriginal and non-Aboriginal mothers. A population-based cohort study using de-identified linked health data of mothers of children born from 1990 to 2009 in WA was carried out. The prevalence of hospitalizations for IPV in mothers of children born in the period 1990-2009 (per 1,000 births) was calculated. Results indicate that the overall prevalence of hospital admissions for mothers assaulted 12 months prior to their child's birth month increased in the period 1990-2009, from 2.7 to 7.7 per 1,000 births. There was also an increase in the overall prevalence of hospital admissions of mothers who were assaulted 12 months prior to the birth month and 36 months after the birth month, from 8.9 per 1,000 births in 1990 to 19.4 per 1,000 births in 2009. In addition, being Aboriginal, having a mother <30 years of age, and being of low SES significantly increased the odds of having a mother with an IPV admission. This study highlights that while there has been an increase in the prevalence of IPV admissions for mothers of children born from 1990 to 2009 in WA, the level of prevalence has remained persistent for the last decade for the whole population. However, non-Aboriginal mothers have seen an increase in prevalence in the last decade. This increase is associated with the introduction of the Z63.0 code in International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM). This study highlights the importance of prioritizing groups for targeted early intervention and prevention as well as the need for culturally appropriate strategies to reduce the burden of interpersonal violence.
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Affiliation(s)
- Carol Orr
- The University of Western Australia, Perth, Australia
- Telethon Kids Institute, The University of Western Australia, Perth Australia
- The University of Notre Dame Australia, Fremantle, Australia
| | - David Preen
- The University of Western Australia, Perth, Australia
| | | | - Scott Sims
- Telethon Kids Institute, The University of Western Australia, Perth Australia
| | - Melissa O'Donnell
- Telethon Kids Institute, The University of Western Australia, Perth Australia
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155
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Bukuluki P, Kisaakye P, Etti B, Ocircan M, Bev RR. Tolerance of Violence against Women and the Risk of Psychosocial Distress in Humanitarian Settings in Northern Uganda. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8103. [PMID: 34360397 PMCID: PMC8345785 DOI: 10.3390/ijerph18158103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 07/05/2021] [Accepted: 07/19/2021] [Indexed: 12/02/2022]
Abstract
BACKGROUND Violence against women (VAW) remains a public health concern, which can sometimes lead to mental or psychological stress among other negative consequences. DATA AND METHODS we fitted a binary logistic regression model on 657 respondents from host and refugee settings in three humanitarian districts (Adjumani, Obongi, and Lamwo) to examine the determinants of psychosocial stress. RESULTS experience of psychosocial distress is higher among refugees than host populations. Results indicate a higher proportion of respondents who ever experienced psychosocial stress in the 6 months preceding the survey among those who believed that a woman should tolerate violence (59% vs. 53%). Respondents who believed that a woman should tolerate violence had higher odds of experiencing psychosocial stress than their counterparts who believed a woman should not tolerate violence (OR = 6.86; 95%CI = 1.23-38.22). The likelihood to experience psychosocial stress was higher among females (OR = 6.94; 95%CI = 1.76-27.32), those with primary education (OR = 4.73; 95%CI = 1.24-18.00), and respondents with less than USD 2.7 as personal income one month before the survey (OR = 3.37; 95%CI = 1.32-8.62). Respondents who said that women should engage in income generation activities had higher odds to experience psychosocial stress (OR = 0.39; 95%CI = 0.17-0.89). CONCLUSION results suggest that income and positive attitudes toward female-led income generating activities act as protective measures against psychosocial distress. Given the associations between VAW and psychosocial distress, efforts aimed at prevention and response to VAW in humanitarian settings should integrate mental health and psychosocial support interventions.
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Affiliation(s)
- Paul Bukuluki
- School of Social Sciences, Makerere University, Kampala 7062, Uganda
| | - Peter Kisaakye
- School of Statistics and Planning, Makerere University, Kampala 7062, Uganda;
| | - Bonny Etti
- Save the Children, Kampala 12018, Uganda; (B.E.); (M.O.); (R.-R.B.)
| | - Micheal Ocircan
- Save the Children, Kampala 12018, Uganda; (B.E.); (M.O.); (R.-R.B.)
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156
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Askeland IR, Birkeland MS, Lømo B, Tjersland OA. Changes in Violence and Clinical Distress Among Men in Individual Psychotherapy for Violence Against Their Female Partner: An Explorative Study. Front Psychol 2021; 12:710294. [PMID: 34367034 PMCID: PMC8342763 DOI: 10.3389/fpsyg.2021.710294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 06/21/2021] [Indexed: 11/13/2022] Open
Abstract
Most interventions for men who have acted violently toward their partner have been conducted as group interventions within a criminal justice context. Therefore, few studies have examined individual psychotherapy and how such interventions may reduce partner violence. In this study, we aimed to describe changes in violence, and changes in clinical distress in men undergoing individual psychotherapy targeting their use of partner violence, at a clinic organized within a psychosocial health care context. This is a naturalistic prospective study of men voluntarily receiving individual psychotherapy for their use of violence against their female partner. Participants were 84 male clients, and data on their use of physical violence, physical controlling violence, property violence and psychological violence were collected pretreatment, posttreatment and at follow-up 1.5 years after treatment from both the men, and their partners (n = 58). The percentage of use of all types of violence during a typical month the last year decreased from pretreatment to follow-up, according to both the men, and their partners. Over the course of treatment, use of all types of self-reported violence during the last month was reduced, however, this was only partially confirmed by their partners. Number of sessions was associated with a lower risk of having used physical and physically controlling violence 1.5 years after treatment. Alcohol abuse or dependency, or qualifying for one or more psychiatric diagnoses, were not associated with levels or change in use of violence. On average, the men's clinical distress declined over the course of psychotherapy. The findings suggest that individual psychotherapy may be a promising and worthwhile intervention for intimate partner violence. Studies with more elaborate designs are needed to identify the core mechanisms of psychotherapy for violence, and to corroborate these results with higher levels of evidence.
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Affiliation(s)
- Ingunn Rangul Askeland
- Norwegian Centre for Violence and Traumatic Stress Studies, NKVTS, Oslo, Norway
- Alternative to Violence-ATV, Oslo, Norway
| | | | - Bente Lømo
- Norwegian Centre for Violence and Traumatic Stress Studies, NKVTS, Oslo, Norway
- Alternative to Violence-ATV, Oslo, Norway
| | - Odd Arne Tjersland
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
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157
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Harvey S, Abramsky T, Mshana G, Hansen CH, Mtolela GJ, Madaha F, Hashim R, Kapinga I, Watts C, Lees S, Kapiga S. A cluster randomised controlled trial to evaluate the impact of a gender transformative intervention on intimate partner violence against women in newly formed neighbourhood groups in Tanzania. BMJ Glob Health 2021; 6:e004555. [PMID: 34301673 PMCID: PMC8311325 DOI: 10.1136/bmjgh-2020-004555] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/16/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Violence against women is a global public health concern; around a quarter of women will experience intimate partner physical or sexual violence during their lifetime. We assessed the impact of a gender transformative intervention for women designed to prevent intimate partner violence (IPV). METHODS We conducted a cluster randomised controlled trial in Mwanza city, Tanzania, among women in newly formed neighbourhood groups to evaluate a 10-session participatory intervention that aims to empower women, prevent IPV and promote healthy relationships. Following a baseline interview, groups were randomly assigned (1:1 ratio) to the intervention or control arm. An intention-to-treat analysis was conducted to assess the impact of the intervention on the main outcomes, assessed 24 months postintervention. These included past-year physical IPV and sexual IPV (primary); past-year emotional abuse; and acceptability and tolerance of IPV. RESULTS Between September 2015 and February 2017, 1265 women were recruited in 66 neighbourhoods and randomly allocated to intervention (n=627 women in 33 neighbourhoods) or control (n=638 women in 33 neighbourhoods). Assessment of outcomes was completed for 551 (88%) intervention and 575 (90%) control women. Among intervention women, 113 (21%) reported physical IPV compared with 117 (20%) control women (adjusted OR (aOR) 0.98, 95% CI 0.72 to 1.33, p=0.892), and 109 (20%) intervention women reported sexual IPV compared with 121 (21%) control women (aOR 0.98, 95% CI 0.72 to 1.32, p=0.881). Intervention women reported less emotional abuse (aOR 0.74, 95% CI 0.56 to 0.98, p=0.035), and were less likely to express attitudes accepting of IPV (aOR 0.49, 95% CI 0.36 to 0.66, p<0.001), and beliefs that IPV is a private matter (aOR 0.54, 95% CI 0.38 to 0.78, p=0.001), or should be tolerated (aOR 0.48, 95% CI 0.34 to 0.66, p<0.001). CONCLUSION These results indicate that the intervention was effective in reducing emotional abuse and positively impacting attitudes and beliefs condoning IPV, but was not sufficient to reduce physical or sexual IPV. TRIAL REGISTRATION NUMBER NCT02592252.
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Affiliation(s)
- Sheila Harvey
- Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
- Mwanza Intervention Trials Unit, National Institute for Medical Research Mwanza Research Centre, Mwanza, Tanzania
| | - Tanya Abramsky
- Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Gerry Mshana
- Sexual and Reproductive Health, National Institute for Medical Research Mwanza Research Centre, Mwanza, Mwanza, Tanzania
| | - Christian Holm Hansen
- Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Grace J Mtolela
- Mwanza Intervention Trials Unit, National Institute for Medical Research Mwanza Research Centre, Mwanza, Tanzania
| | - Flora Madaha
- Mwanza Intervention Trials Unit, National Institute for Medical Research Mwanza Research Centre, Mwanza, Tanzania
| | - Ramadhan Hashim
- Mwanza Intervention Trials Unit, National Institute for Medical Research Mwanza Research Centre, Mwanza, Tanzania
| | - Imma Kapinga
- Mwanza Intervention Trials Unit, National Institute for Medical Research Mwanza Research Centre, Mwanza, Tanzania
| | - Charlotte Watts
- Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Shelley Lees
- Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Saidi Kapiga
- Mwanza Intervention Trials Unit, National Institute for Medical Research Mwanza Research Centre, Mwanza, Tanzania
- Sexual and Reproductive Health, National Institute for Medical Research Mwanza Research Centre, Mwanza, Mwanza, Tanzania
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158
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al'Absi M, Allen AM. Impact of Acute and Chronic Cannabis Use on Stress Response Regulation: Challenging the Belief That Cannabis Is an Effective Method for Coping. Front Psychol 2021; 12:687106. [PMID: 34276511 PMCID: PMC8283823 DOI: 10.3389/fpsyg.2021.687106] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/21/2021] [Indexed: 11/16/2022] Open
Abstract
Although research has only recently started to examine the impact of cannabis use on stress response, there is some evidence that indicates acute and chronic impacts of cannabis on these processes. In this paper, we review processes involved in regulating the stress response and we review the influence of acute and chronic exposure to cannabis on patterns and regulation of the stress response. We also highlight the role of stress as a risk factor for initiation and maintenance of cannabis use. In this context, we examine moderating variables, including sex and life adversity. In light of recent observations indicating increasing prevalence of cannabis use during pregnancy, we provide additional focus on cannabis use in this vulnerable population, including how acute and chronic stress may predispose some individuals to use cannabis during pregnancy. While this line of research is in its infancy, we review available articles that focus on the perinatal period and that examined the association between cannabis use and various life stressors, including partner violence, job loss, and lack of housing. We also review psychiatric co-morbidities (e.g., post-traumatic stress disorder, anxiety). A better understanding of the way stress and cannabis use relate within the general population, as well as within certain subgroups that may be at a greater risk of using and/or at greater risk for adverse outcomes of use, may lead to the development of novel prevention and intervention approaches.
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Affiliation(s)
- Mustafa al'Absi
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN, United States
| | - Alicia M Allen
- Department of Family and Community Medicine, University of Arizona, Tucson, AZ, United States
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159
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Ranganathan M, Heise L, Peterman A, Roy S, Hidrobo M. Cross-disciplinary intersections between public health and economics in intimate partner violence research. SSM Popul Health 2021; 14:100822. [PMID: 34095429 PMCID: PMC8164083 DOI: 10.1016/j.ssmph.2021.100822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/30/2021] [Accepted: 05/11/2021] [Indexed: 01/22/2023] Open
Abstract
Research on intimate partner violence (IPV) has progressed in the last decade in the fields of public health and economics, with under-explored potential for cross-fertilisation. We examine the theoretical perspectives and methodological approaches that each discipline uses to conceptualise and study IPV and offer a perspective on their relative advantages. Public health takes a broad theoretical perspective anchored in the socio-ecological framework, considering multiple and synergistic drivers of IPV, while economics focuses on bargaining models which highlight individual power and factors that shape this power. These perspectives shape empirical work, with public health examining multi-faceted interventions, risk and mediating factors, while economics focuses on causal modelling of specific economic and institutional factors and economic-based interventions. The disciplines also have differing views on measurement and ethics in primary research. We argue that efforts to understand and address IPV would benefit if the two disciplines collaborated more closely and combined the best traditions of both fields.
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Affiliation(s)
- Meghna Ranganathan
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Tavistock Place, WC1H 9SH, London, UK
| | - Lori Heise
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health and Johns Hopkins University School of Nursing, 615 N. Wolfe Street, Room E4644, 21205, Baltimore, MD, USA
| | - Amber Peterman
- Department of Public Policy, Abernathy Hall CB #3435, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27516, USA
| | - Shalini Roy
- Poverty Health and Nutrition Division, International Food Policy Research Institute, 1201 I St NW, Washington, DC, 20005, USA
| | - Melissa Hidrobo
- Poverty Health and Nutrition Division, International Food Policy Research Institute, 1201 I St NW, Washington, DC, 20005, USA
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160
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Daundasekara SS, Schuler BR, Hernandez DC. RETRACTED: Independent and combined associations of intimate partner violence and food insecurity on maternal depression and generalized anxiety disorder. J Anxiety Disord 2021; 81:102409. [PMID: 33932633 DOI: 10.1016/j.janxdis.2021.102409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 12/28/2020] [Accepted: 04/21/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Sajeevika Saumali Daundasekara
- Department of Health, & Health Performance, University of Houston, 3875 Holman Street, Garrison Gymnasium, Room 104, Houston, TX, 77204-6015, United States.
| | - Brittany R Schuler
- School of Social Work, Temple University, Ritter Annex 549, 1301 Cecil B. Moore Ave., Philadelphia, PA, 19122, United States.
| | - Daphne C Hernandez
- University of Texas Health Science Center, Cizik School of Nursing, 6901 Bertner Avenue, Houston, TX, 77030-3901, United States.
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161
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Thurston AM, Stöckl H, Ranganathan M. Natural hazards, disasters and violence against women and girls: a global mixed-methods systematic review. BMJ Glob Health 2021; 6:e004377. [PMID: 33958379 PMCID: PMC8112410 DOI: 10.1136/bmjgh-2020-004377] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/09/2021] [Accepted: 03/04/2021] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Disasters triggered by climate and other natural hazards are increasing in frequency, severity and duration worldwide. Disasters disproportionately impact women and girls, with some evidence suggesting that violence against women and girls (VAWG) increases in disaster settings. Suggested risk factors for postdisaster VAWG include increased life stressors, failure of law enforcement, exposure to high-risk environments, exacerbation of existing gender inequalities and unequal social norms. We aim to systematically appraise the global literature on the association between disasters from natural hazards and VAWG. METHODS We conducted a systematic review using the following databases: Embase, Global Health, Medline, PubMed and Social Policy and Practice and searched grey literature. We included quantitative, qualitative or mixed-methods studies published in English language that examined the association between disasters from natural hazards and VAWG. We summarised the findings using a narrative synthesis approach. RESULTS Of 555 non-duplicate records, we included a total of 37 quantitative, qualitative and mixed-methods studies. Among the quantitative studies, eight studies found a positive association between disaster exposure and increased VAWG, and four additional studies found positive associations with some violence types but not others. Qualitative findings offered insights into three hypothesised pathways: disaster exposure associated with (1) an increase of stressors that trigger VAWG; (2) an increase of enabling environments for VAWG and (3) an exacerbation of underlying drivers of VAWG. CONCLUSION As the first known global systematic review on the relationship between disasters from natural hazards and VAWG, this review contributes to the evidence base. We were limited by the quality of quantitative studies, specifically study designs, the measurement of variables and geographic scope. The severe health consequences of VAWG and increasing frequency of extreme events means that rigorously designed and better quality studies are needed to inform evidence-based policies and safeguard women and girls during and after disasters.
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Affiliation(s)
- Alyssa Mari Thurston
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Heidi Stöckl
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Meghna Ranganathan
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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162
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Patel R, Gupte SS, Srivastava S, Kumar P, Chauhan S, Govindu MD, Dhillon P. Experience of gender-based violence and its effect on depressive symptoms among Indian adolescent girls: Evidence from UDAYA survey. PLoS One 2021; 16:e0248396. [PMID: 33765009 PMCID: PMC7993765 DOI: 10.1371/journal.pone.0248396] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 02/26/2021] [Indexed: 10/29/2022] Open
Abstract
BACKGROUND Violence against women has been one of the most prominent issue and a major public health concern. It is a principle violation of basic human rights and has both physical and mental effect on the victim. This study focuses on married and unmarried girls aged 15 to 19 years, belonging to Uttar Pradesh and Bihar, India. This study attempts to examine depression level among married and unmarried girls who have faced violence against them. With the unprecedented growth in social networking, online digital platform and its accessibility, the study also brings out the pertinent aspect of internet based violence and its psychological outcome on adolescent girls. Hence, the study can be seen as an important and needed value addition to the existing pool of knowledge on the subject. METHODS The study uses Understanding the lives of adolescents and young adults (UDAYA) project data for Uttar Pradesh and Bihar. Depressive symptoms among adolescent girl is the outcome variable of the study. Descriptive statistic and bivariate analysis has been used to get to preliminary results. Chi-squared test is used to test the significant of variables. Further, multi-variate analysis (logistic regression) was used. RESULTS Almost 29, 23 and 26 percent of married adolescent girls had faced emotional, physical and sexual violence respectively. It was found that about five per cent of unmarried and eight per cent of married girls had high depressive symptoms. It was found that unmarried adolescent girls who had witnessed their father beating mother were 71 percent more likely to suffer from higher depressive symptoms [OR: 1.71, 1.09-2.69]. Adolescents who faced perpetrated bullying had 90 per cent [OR: 1.90, 1.32-2.72] and 86 per cent [OR: 1.86, 0.98-3.52] higher likelihood to suffer from higher depressive symptoms. CONCLUSION The study goes beyond intimate partner violence and includes various covariates to explain the association between violence and depressive symptoms among married and unmarried adolescents. Hence, more inclusive policies are needed to address the issue of violence against women as the spectrum of the violence is expanding with time.
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Affiliation(s)
- Ratna Patel
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | | | - Shobhit Srivastava
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, India
| | - Pradeep Kumar
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, India
| | - Shekhar Chauhan
- Department of Population Policies and Programmes, International Institute for Population Sciences, Mumbai, India
- * E-mail:
| | - Mani Deep Govindu
- Karnataka Health Promotion Trust (KHPT), Bengaluru, Karnataka, India
| | - Preeti Dhillon
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, India
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163
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Pakhomova TE, Dietrich JJ, Closson K, Smit J, Hornschuh S, Smith P, Beksinska M, Ndung'u T, Brockman M, Gray G, Kaida A. Intimate Partner Violence, Depression, and Anxiety Are Associated With Higher Perceived Stress Among Both Young Men and Women in Soweto and Durban, South Africa. FRONTIERS IN REPRODUCTIVE HEALTH 2021; 3:638116. [PMID: 36304031 PMCID: PMC9580652 DOI: 10.3389/frph.2021.638116] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 02/19/2021] [Indexed: 12/14/2022] Open
Abstract
Objectives: Psychological stress is an important determinant of health, including for mental well-being and sexual health. However, little is known about the prevalence and psychosocial and sexual health correlates of perceived stress among young people in South Africa, where elevated life-stressors are an important driver of health inequities. This study examines the association between intimate partner violence (IPV), psychosocial and sexual health, and perceived stress, by gender, among South African adolescents and young adults. Methods: Using baseline survey data from AYAZAZI, a cohort study enrolling youth (16–24 years) from Durban and Soweto, we used the 10-item Perceived Stress Scale (PSS-10) to measure the degree to which an individual perceives their life situations as unpredictable, uncontrollable, and overloaded. Possible scores range between 0 and 40; higher scores indicating higher perceived stress. Crude and adjusted gender-stratified linear regression models examined associations between sexual health factors, experiences (young women) and perpetration (young men) of IPV, anxiety (APA 3-item Scale, ≥2 = probable anxiety), and depression (10-item CES-D Scale, ≥10 = probable depression) and perceived stress. Multivariable models adjusted for age, income, sexual orientation, and financial dependents. Results: Of the 425 AYAZAZI participants, 60% were young women. At baseline, 71.5% were students//learners and 77.2% earned ≤ ZAR1600 per month (~$100 USD). The PSS-10 had moderate reliability (α = 0.70 for young women, 0.64 for young men). Young women reported significantly higher mean PSS scores than young men [18.3 (6.3) vs. 16.4 (6.0)]. In adjusted linear regression models, among young women experiences of IPV (β = 4.33; 95% CI: 1.9, 6.8), probable depression (β = 6.63; 95% CI: 5.2, 8.1), and probable anxiety (β = 5.2; 95% CI: 3.6, 6.8) were significantly associated with higher PSS scores. Among young men, ever perpetrating IPV (β = 2.95; 95% CI: 0.3, 5.6), probable depression (β = 6; 95% CI: 4.3, 7.6), and probable anxiety (β = 3.9; 95% CI: 2.1, 5.8) were significantly associated with higher perceived stress. Conclusion: We found that probable depression, anxiety, perpetration of IPV among young men, and experiences of IPV among young women, were associated with higher perceived stress. Critical efforts are needed to address the gendered stressors of young men and women and implement services to address mental health within violence prevention efforts.
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Affiliation(s)
| | - Janan Janine Dietrich
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Kalysha Closson
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Jenni Smit
- Maternal Adolescent and Child Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Stefanie Hornschuh
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Patricia Smith
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Mags Beksinska
- Maternal Adolescent and Child Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Thumbi Ndung'u
- Africa Health Research Institute, Durban, South Africa
- HIV Pathogenesis Programme, The Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa
- Max Planck Institute for Infection Biology, Berlin, Germany
- Division of Infection and Immunity, University College London, London, United Kingdom
| | - Mark Brockman
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Glenda Gray
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- Office of the President, South African Medical Research Council, Cape Town, South Africa
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- *Correspondence: Angela Kaida
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Abstract
BACKGROUND Interpersonal violence, such as intimate partner violence, sexual assault, and adverse childhood experiences, is a significant global health concern. A major challenge to nurses and others working in the field of interpersonal violence deals with the complexity involved in measuring interpersonal violence. Numerous validated instruments exist; however, there is no standard approach for scoring these instruments. There is also a tendency to examine different forms of violence separately, not accounting for the known co-occurrence of violence. This has led to confusion as the interpretation of results often differs depending on the specific method used. OBJECTIVES The purpose of this article is to summarize the major methods for scoring interpersonal violence measures and implications of each approach with a specific focus on co-occurrence. METHODS The article begins with a summary of the primary goals of measuring interpersonal violence, major methods for scoring interpersonal violence measures, along with scoring challenges. We then provide a case exemplar examining the relationship between interpersonal violence and posttraumatic stress disorder symptoms to illustrate how scoring methods can affect study results and interpretation of findings. RESULTS Our article shows that each scoring method provides a different picture of the distribution of interpersonal violence experiences and varies regarding the ease of interpretation. Scoring methods also affect interpretation of associations between interpersonal violence and other factors, such as having statistical power to detect significant associations. Accounting for the co-occurrence is critical for making accurate inferences by identifying potential confounding interactions between different types of violence. DISCUSSION The application of different scoring methods leading to varying interpretations highlights the need for researchers to be purposeful when selecting a method and even applying multiple methods when possible. Recommendations are provided to assist researchers and providers when making decisions about the use of scoring methods in different contexts.
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165
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Pilkington PD, Noonan C, May T, Younan R, Holt RA. Early maladaptive schemas and intimate partner violence victimization and perpetration: A systematic review and meta-analysis. Clin Psychol Psychother 2021; 28:1030-1042. [PMID: 33527558 DOI: 10.1002/cpp.2558] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 01/22/2021] [Indexed: 11/08/2022]
Abstract
Young's early maladaptive schemas represent a possible pathway between childhood adversity and Intimate Partner Violence (IPV). The aim of this review was to synthesize the evidence on early maladaptive schemas and IPV. PubMed, PsycInfo, and CINAHL databases were searched, in compliance with PRISMA, to identify peer reviewed studies that reported on the relationship between schema or schema domain scores and IPV victimization or perpetration. Based on nine included studies, meta-analyses indicated that IPV victimization showed a moderate association with the Disconnection and Rejection and Impaired Autonomy domains, and a small association with Other-Directedness. The Mistrust Abuse and Vulnerability to Harm schemas were moderately correlated with victimization. Mistrust Abuse was also implicated in perpetration but insufficient data were available for meta-analysis. The evidence suggests that being a victim of IPV is associated with an expectation that one's needs for love and safety will not be met and doubt regarding one's capacity to handle responsibilities or succeed in life.
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Affiliation(s)
- Pamela D Pilkington
- School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Clare Noonan
- School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Tamara May
- Department of Paediatrics, Monash University, Clayton, Victoria, Australia
| | - Rita Younan
- Schema Therapy Institute, Carlton, Victoria, Australia
| | - Ruth A Holt
- Schema Therapy Canberra, Canberra, Australian Capital Territory, Australia
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166
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Intimate Partner Violence against Women with Disabilities in Spain: A Public Health Problem. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020728. [PMID: 33467762 PMCID: PMC7830792 DOI: 10.3390/ijerph18020728] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 11/16/2022]
Abstract
Violence against women with disabilities is a social problem with important consequences for their physical and mental health. The World Health Organization (WHO) declared violence against women as a public health priority issue in 1996 and the fact that violence is used by the intimate partner and upon women with disabilities exacerbates the situation. Therefore, this is an issue that must be addressed from a public health viewpoint. Violence is studied from various aspects: Physical, psychological, sexual, or social control, and its multiple consequences in women's health and the use of health services. In this perspective, with the data from the VI Violence against Women Macro-survey 2019 (VWM-2019) and adjusted to Spain, this study examines the incidence of intimate partner violence and its consequences in the health of women with disabilities and its impact on health services. Using binary logistic regression, the greater vulnerability of this group to these attacks is stated and the need to address this issue to improve the health of these people is brought to light.
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167
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Brown SJ, Conway LJ, FitzPatrick KM, Hegarty K, Mensah FK, Papadopoullos S, Woolhouse H, Giallo R, Gartland D. Physical and mental health of women exposed to intimate partner violence in the 10 years after having their first child: an Australian prospective cohort study of first-time mothers. BMJ Open 2020; 10:e040891. [PMID: 33371030 PMCID: PMC7754634 DOI: 10.1136/bmjopen-2020-040891] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To investigate mental and physical health of mothers exposed to recent and early postpartum intimate partner violence (IPV) in the 10 years after having their first child. DESIGN Prospective pregnancy cohort study. SETTING Women were recruited at six metropolitan public maternity hospitals in Melbourne, Australia and followed up at 1, 4 and 10 years post partum. STUDY MEASURES Exposure to physical and/or emotional IPV was measured using the Composite Abuse Scale at 1, 4 and 10 years. At 10-year follow-up, mothers reported on physical and mental health, and functional health status. PARTICIPANTS 1507 first-time mothers enrolled at mean of 15 weeks' gestation. RESULTS One in three women experienced IPV during the 10 years after having their first child. Women experiencing recent IPV (19.1%) reported worse physical and mental health than women not reporting IPV. Compared with women not reporting IPV, women experiencing recent IPV had higher odds of poor functional health status (Adj OR=4.5, 95% CI 3.2 to 6.3), back pain (Adj OR=2.0, 95% CI 1.4 to 2.9), incontinence (Adj OR=1.8, 95% CI 1.2 to 2.6), depressive symptoms (Adj OR=4.9, 95% CI 3.2 to 7.5), anxiety (Adj OR=5.1, 95% CI 3.0 to 8.6) and post-traumatic stress symptoms (Adj OR=7.2, 95% CI 4.6 to 11.1) at 10 years. Women with past IPV at 1 and/or 4 years (15.7% of the cohort) also had higher odds of physical and mental health problems. There was evidence of a gradient in health outcomes by recency of exposure to IPV. CONCLUSIONS Both recent and past exposure to IPV are associated with poor maternal physical and mental health 10 years after a first birth. Health services and advocacy organisations providing support to women need to be aware of the consistent relationship between IPV and a range of physical and mental health conditions, which may persist even after IPV appears to have ceased.
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Affiliation(s)
- Stephanie J Brown
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Laura J Conway
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Kelly M FitzPatrick
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Kelsey Hegarty
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
| | - Fiona K Mensah
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Sandra Papadopoullos
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Hannah Woolhouse
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Rebecca Giallo
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Deirdre Gartland
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
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Yaya S, Anjorin SS, Adenini SA. Intimate partner violence, contextual factors and under-5 mortality: a multilevel analysis of cross-sectional surveys from 20 Sub-Saharan African countries. BMJ Glob Health 2020; 5:e003531. [PMID: 33272941 PMCID: PMC7716669 DOI: 10.1136/bmjgh-2020-003531] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/17/2020] [Accepted: 10/17/2020] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Under-5 mortality remains a public health concern in low-income and middle-income countries. Africa contributes about one-fifth of the burden of global under-5 mortality; intimate partner violence (IPV) and polygyny, which are highly prevalent on the continent, have been linked to under-5 mortality at the individual level. This study examined the relationship between IPV and polygyny as contextual factors and the experience of under-5 mortality among women in Sub-Saharan Africa (SSA). METHODS We used data from the Demographic and Health Surveys (DHS) of 20 African countries with available data between 2010 and 2018 as of April 2020. We defined the experience of under-5 mortality as a woman's loss of at least one child before their fifth birthday. The DHS primary sampling unit was used to define contextual factors. The study involved a multilevel logistic regression analysis of 227 121 women of childbearing age (15-49). RESULTS A quarter (24.5%) of women have lost at least one child under 5 years old, more than two-thirds (40.1%) have experienced at least one form of IPV, and about two-thirds of women were in polygynous union. Our multilevel logistic regression showed that parity, polygynous union and experience of IPV were strongly associated with women's experience of under-5 mortality. The results showed that 39.9% and 19.2% of variances in odds of a woman losing a child before their fifth birthday are attributable to community-level and country-level factors, respectively. Contextual prevalence of IPV, polygynous union and gender equity attenuate the strength of associations observed at the individual level. The interaction between contextual prevalence of polygyny and IPV exacerbates the risk of under-5 mortality. Women in SSA countries with higher Human Development Index were less likely to experience under-5 mortality. CONCLUSION This study established that beyond individual-level effects, contextual prevalence of IPV and polygyny and their interactions shape women's experience of under-5 mortality in Africa. In designing policies and interventions to address under-5 mortality, contextual factors, especially those linked to culturally laden social norms and practices, must be considered to ensure effectiveness and sustainable impact.
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Affiliation(s)
- Sanni Yaya
- School of International Development and Global Studies, University of Ottawa Faculty of Social Sciences, Ottawa, Ontario, Canada
- The George Institute for Global Health, Imperial College London, London, United Kingdom
| | - Seun Stephen Anjorin
- Warwick Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, University of Warwick, Coventry, West Midlands, United Kingdom
| | - Sunday A Adenini
- Programme in Demography and Population Studies, Schools of Public Health and Social Sciences, University of Witwatersrand CISA, Johannesburg, South Africa
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169
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Cintora P, Laurent HK. Childhood Trauma Exposure Exacerbates the Impact of Concurrent Exposure to Intimate Partner Violence on Women's Posttraumatic Symptoms. J Trauma Stress 2020; 33:1102-1110. [PMID: 32557954 DOI: 10.1002/jts.22545] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 02/26/2020] [Accepted: 02/28/2020] [Indexed: 11/06/2022]
Abstract
Although it is well established that intimate partner violence (IPV) is detrimental to women's mental health, it remains unclear to what extent symptoms can be attributed to the proximal effects of IPV exposure itself as opposed to more stable scarring effects or co-occurring risk factors. Heterogeneity in the magnitude of IPV effects further suggests that IPV-exposed individuals are differentially susceptible to disorder, and an investigation of moderating factors that may make women more vulnerable is warranted. We used a prospective longitudinal study of low-income mothers followed from 3 to 18 months postpartum to distinguish the concurrent mental health effects of IPV exposure from overall person-level IPV-mental health associations, as well as to test the moderating role of prior relational traumatic experiences in the form of childhood maltreatment. Multilevel modeling results demonstrated a unique concurrent association between increasing IPV and women's posttraumatic symptoms over time, even after controlling for an overall association between mean IPV and symptom levels. The effects of concurrent IPV were heightened in women who reported a history of childhood maltreatment. Model effects were medium to large, R2 = .27-.35. The implications of these findings for the identification of and intervention with women at the highest risk for relational trauma-related mental health difficulties are discussed.
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Affiliation(s)
- Patricia Cintora
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Heidemarie Kaiser Laurent
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.,Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
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170
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McNaughton Reyes HL, Graham LM, Chen MS, Baron D, Gibbs A, Groves AK, Kajula L, Bowler S, Maman S. Adolescent dating violence prevention programmes: a global systematic review of evaluation studies. THE LANCET CHILD & ADOLESCENT HEALTH 2020; 5:223-232. [PMID: 33220790 DOI: 10.1016/s2352-4642(20)30276-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/18/2020] [Accepted: 08/10/2020] [Indexed: 11/16/2022]
Abstract
Adolescent dating violence negatively affects millions of young people worldwide. Through a global systematic review, we synthesised evidence from rigorous studies of prevention programmes for adolescent dating violence. Our aims were to: (1) describe the breadth of research in this area and evidence of programme effects, and (2) identify gaps in the evidence base. We included experimental and controlled quasi-experimental programme evaluations, published before Jan 1, 2020, that assessed effects on victimisation or perpetration, or both, in adolescent dating violence and in which at least half of the study population was 10-19 years old. Study design, programme elements, and outcomes were compared between evaluations implemented in high-income countries (HICs) and low-income and middle-income countries (LMICs). 52 evaluations met inclusion criteria, of which 20 (38%) were implemented in LMICs. Evaluations in HICs were more likely to assess effects on adolescent dating violence victimisation and perpetration, rather than just victimisation, than those in LMICs, and they were also more likely to include boys and girls, as opposed to just a single sex. Overall, 26 (50%) of the 52 evaluations reported a significant preventive effect on at least one outcome for adolescent dating violence, of which nine were implemented in LMICs. Across LMICs and HICs, findings suggest research is needed to shed light on how adolescent dating violence prevention programmes work and to identify whether programme effects generalise across different settings, outcomes, and subgroups. TRANSLATIONS: For the Chinese, French and Spanish translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- H Luz McNaughton Reyes
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Laurie M Graham
- School of Social Work, University of Maryland, Baltimore, MD, USA
| | - May S Chen
- Division of Violence Prevention, National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Deborah Baron
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Andrew Gibbs
- Gender and Health Research Unit, South African Medical Research Council, Durban, South Africa
| | - Alison K Groves
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | | | - Sarah Bowler
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Suzanne Maman
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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171
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Murray SM, Skavenski Van Wyk S, Metz K, Mulemba SM, Mwenge MM, Kane JC, Alto M, Venturo-Conerly KE, Wasil AR, Fine SL, Murray LK. A qualitative exploration of mechanisms of intimate partner violence reduction for Zambian couples receiving the Common Elements Treatment Approach (CETA) intervention. Soc Sci Med 2020; 268:113458. [PMID: 33126100 DOI: 10.1016/j.socscimed.2020.113458] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/03/2020] [Accepted: 10/13/2020] [Indexed: 11/26/2022]
Abstract
RATIONALE Despite well-established associations between alcohol use, poor mental health, and intimate partner violence (IPV), limited attention has been given to how psychological and behavioral interventions might prevent or treat IPV in low- and middle-income countries. OBJECTIVE In a recent randomized controlled trial in Lusaka, Zambia, transdiagnostic cognitive-behavioral psychotherapy (the Common Elements Treatment Approach; CETA) demonstrated significant treatment effects on men's alcohol use and women's IPV victimization in couples in which hazardous alcohol use by the male and intimate partner violence against the female was reported. In this study, we sought to gain a more in-depth understanding of mechanisms of behavior change among CETA participants. METHODS We conducted 50 semi-structured in-depth interviews and 4 focus groups with a purposeful sample of adult men and women who received CETA between April and October 2018. Transcripts were analyzed using an inductive constant comparison approach by a team of US- and Zambia-based coders. RESULTS Participants described interrelated mechanisms of change, including the use of safety strategies to not only avoid or prevent conflict but also to control anger; reductions in alcohol use that directly and indirectly reduced conflict; and, positive changes in trust and understanding of one's self and their partner. Several overarching themes also emerged from the data: how gender norms shaped participants' understanding of violence reduction strategies; the role of household economics in cycles of alcohol and violence; and, deleterious and virtuous intercouple dynamics that could perpetuate or diminish violence. CONCLUSIONS Results suggest important avenues for future research including the potential for combining CETA with poverty reduction or gender norms focused interventions and for incorporating cognitivebehavioral skills into community level interventions.
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Affiliation(s)
- Sarah M Murray
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, USA.
| | | | - Kristina Metz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, USA
| | | | | | - Jeremy C Kane
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, USA
| | | | | | | | - Shoshanna L Fine
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, USA
| | - Laura K Murray
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, USA
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172
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Chandan JS, Thomas T, Bradbury-Jones C, Russell R, Bandyopadhyay S, Nirantharakumar K, Taylor J. Female survivors of intimate partner violence and risk of depression, anxiety and serious mental illness. Br J Psychiatry 2020; 217:562-567. [PMID: 31171045 DOI: 10.1192/bjp.2019.124] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Internationally, intimate partner violence (IPV) cohorts have demonstrated associations with depression and anxiety. However, this association has not yet been described in a UK population, nor has the association with serious mental illness (SMI). AIMS To explore the relationship between IPV exposure and mental illness in a UK population. METHOD We designed a retrospective cohort study whereby we matched 18 547 women exposed to IPV to 74 188 unexposed women. Outcomes of interest (anxiety, depression and SMI) were identified through clinical codes. RESULTS At baseline, 9174 (49.5%) women in the exposed group had some form of mental illness compared with 17 768 (24.0%) in the unexposed group, described as an adjusted odds ratio of 2.62 (95% CI 2.52-2.72). Excluding those with mental illness at baseline, 1254 exposed women (incidence rate 46.62 per 1000 person-years) went on to present with any type of mental illness compared with 3119 unexposed women (incidence rate 14.93 per 1000 person-years), with an aIRR of 2.77 (95% CI 2.58-2.97). Anxiety (aIRR 1.99, 95% CI 1.80-2.20), depression (aIRR 3.05, 95% CI 2.81-3.31) and SMI (aIRR 3.08, 95% CI 2.19-4.32) were all associated with exposure to IPV. CONCLUSIONS IPV remains a significant public health issue in the UK. We have demonstrated the significant recorded mental health burden associated with IPV in primary care, at both baseline and following exposure. Clinicians must be aware of this association to reduce mental illness diagnostic delay and improve management of psychological outcomes in this group of patients.
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Affiliation(s)
- Joht Singh Chandan
- Academic Clinical Fellow in Public Health, Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, UK
| | - Tom Thomas
- Clinical Research Fellow, Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, UK
| | - Caroline Bradbury-Jones
- Reader in Nursing, School of Nursing, College of Medical and Dental Sciences, University of Birmingham, UK
| | - Rebecca Russell
- Public Health Registrar, Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, UK
| | - Siddhartha Bandyopadhyay
- Professor of Economics and Director of the Centre of Crime, Justice and Policing, Department of Economics, University of Birmingham, UK
| | - Krishnarajah Nirantharakumar
- Senior Clinical Lecturer, Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, UK
| | - Julie Taylor
- Professor of Child Protection, School of Nursing, College of Medical and Dental Sciences, University of Birmingham, Birmingham Women's and Children's Hospitals NHS Foundation Trust, UK
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173
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Meyer SR, Lasater ME, García-Moreno C. Violence against older women: A systematic review of qualitative literature. PLoS One 2020; 15:e0239560. [PMID: 32970746 PMCID: PMC7514024 DOI: 10.1371/journal.pone.0239560] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 09/08/2020] [Indexed: 11/23/2022] Open
Abstract
The majority of the existing evidence-base on violence against women focuses on women of reproductive age (15–49), and globally there is sparse evidence concerning patterns of and types of violence against women aged 50 and older. Improved understanding of differing patterns and dynamics of violence older women experienced is needed to ensure appropriate policy or programmatic responses. To address these gaps in the evidence, we conducted a systematic review of qualitative literature on violence against older women, including any form of violence against women, rather than adopting a specific theoretical framework on what types of violence or perpetrators should be included from the outset, and focusing specifically on qualitative studies, to explore the nature and dynamics of violence against older women from the perspective of women. Following pre-planned searches of 11 electronic databases, two authors screened all identified titles, abstracts and relevant full texts for inclusion in the review. We extracted data from 52 manuscripts identified for inclusion, and conducted quality assessment and thematic synthesis from the key findings of the included studies. Results indicated that the vast majority of included studies were conducted in high-income contexts, and did not contain adequate information on study setting and context. Thematic synthesis identified several central themes, including the intersection between ageing and perceptions of, experiences of and response to violence; the centrality of social and gender norms in shaping older women’s experiences of violence; the cumulative physical and mental health impact of exposure to lifelong violence, and that specific barriers exist for older women accessing community supports and health services to address violence victimization. Our findings indicated that violence against older women is prevalent and has significant impacts on physical and mental well-being of older women. Implications for policy and programmatic response, as well as future research directions, are highlighted.
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Affiliation(s)
- Sarah R. Meyer
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
- * E-mail:
| | - Molly E. Lasater
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Claudia García-Moreno
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Li Y, Herbell K, Bloom T, Sharps P, Bullock LF. Adverse Childhood Experiences and Mental Health among Women Experiencing Intimate Partner Violence. Issues Ment Health Nurs 2020; 41:785-791. [PMID: 32401637 PMCID: PMC8486341 DOI: 10.1080/01612840.2020.1731636] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
This study described the frequency of different adverse childhood experience (ACE) types described by women with recent IPV and examined the effects of each ACE type on women's mental health. Over 70% of women reported parental separation or divorce, over 40% reported childhood sexual assault, and around 40% had a mother who was treated violently. Childhood physical abuse and sexual assault were associated with more severe posttraumatic stress disorder or depressive symptoms. Comprehensive interventions that address not only the effects of IPV but also the enduring effects of ACEs are needed to promote mental health for survivors of IPV.
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Affiliation(s)
- Yang Li
- Sinclair School of Nursing, University of Missouri, Columbia, Missouri, USA
| | - Kayla Herbell
- College of Nursing, the Ohio State University, Columbus, Ohio, USA
| | - Tina Bloom
- Sinclair School of Nursing, University of Missouri, Columbia, Missouri, USA
| | - Phyllis Sharps
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Linda F.C. Bullock
- School of Nursing, University of Virginia, Charlottesville, Virginia, USA
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Leight J, Deyessa N, Verani F, Tewolde S, Sharma V. An intimate partner violence prevention intervention for men, women, and couples in Ethiopia: Additional findings on substance use and depressive symptoms from a cluster-randomized controlled trial. PLoS Med 2020; 17:e1003131. [PMID: 32810147 PMCID: PMC7433854 DOI: 10.1371/journal.pmed.1003131] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 07/15/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is linked to substance use by male perpetrators and is associated with an increased risk of depression for women who experience violence. Unite for a Better Life (UBL) is a gender-transformative intervention delivered to men, women, and couples in Ethiopia; previous evidence demonstrated the intervention significantly reduced experience of and perpetration of IPV when delivered to men and led to more equitable household task-sharing when delivered to men and couples. The aim of this analysis is to assess engagement in the UBL intervention and to examine the relationship between random assignment to the intervention and men's past-year substance use and women's reported depressive symptoms as measured at the individual level. METHODS AND FINDINGS A sample of 64 villages in Gurague zone, Ethiopia, was randomly allocated to 4 arms (men's UBL, women's UBL, couples' UBL, or control). In each village, 106 households were randomly sampled, and households in the intervention arms were invited to participate in UBL, consisting of 14 sessions delivered by trained facilitators. Households in the control arm were offered a short educational session on IPV. Descriptive data on participant engagement in the intervention are reported, and outcomes assessed in an intention-to-treat (ITT) analysis include male use of substances (alcohol and khat) and women's depressive symptoms as measured by the Patient Health Questionnaire (PHQ-9). Results from both adjusted and unadjusted specifications are reported, the latter adjusting for baseline covariates including age, education level, marriage length, polygamy, socioeconomic status, months between intervention and endline, and the baseline level of the outcome variable. The baseline sample includes 6,770 respondents surveyed in 2014-2015, and follow-up data were available from 88% of baseline respondents surveyed in 2017-2018; the majority of respondents report no education, and 61% are Muslim. Respondents reported high attendance rates and engagement in the intervention. In addition, there was evidence of a significant reduction in frequent past-year alcohol intoxication self-reported by men (adjusted odds ratio [AOR] = 0.56, 95% CI 0.36-0.85, p = 0.007), and a significant increase in the probability of frequent khat use self-reported by men (AOR = 3.09, 95% CI 1.37-6.96, p = 0.007), both observed in the couples' UBL arm at 24 months' follow-up relative to the control arm. There was a significant increase in symptoms of moderate depression among women in the women's UBL arm only (AOR = 1.65, 95% CI 1.13-2.41, p = 0.010), again relative to the control arm. There was no evidence of shifts in symptoms of mild or severe depression. The primary limitation of this study is the reliance on self-reported data around sensitive behaviors. CONCLUSIONS The findings suggest that the UBL intervention was associated with a reduction in men's use of alcohol when delivered to couples, but there was no evidence of a decrease in reported symptoms of depression among women in any experimental arm, and some evidence of an increase in symptoms of moderate depression in the women's UBL arm. Further research should explore how to optimize IPV prevention interventions to target related risks of mental health and substance use. TRIAL REGISTRATION Clinicaltrials.gov NCT02311699; Socialscienceregistry.org AEARCTR-0000211.
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Affiliation(s)
- Jessica Leight
- International Food Policy Research Institute, Washington, DC, United States of America
| | - Negussie Deyessa
- Ethiopian Public Health Association, Addis Ababa, Ethiopia
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | - Vandana Sharma
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
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Chandan JS, Gokhale KM, Bradbury-Jones C, Nirantharakumar K, Bandyopadhyay S, Taylor J. Exploration of trends in the incidence and prevalence of childhood maltreatment and domestic abuse recording in UK primary care: a retrospective cohort study using 'the health improvement network' database. BMJ Open 2020; 10:e036949. [PMID: 32499272 PMCID: PMC7279643 DOI: 10.1136/bmjopen-2020-036949] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES Describe the epidemiology of childhood maltreatment and domestic abuse (in women). DESIGN Analysis of longitudinal records between 1 January 1995 to 31 December 2018. SETTING UK primary care database: 'The Health Improvement Network' (THIN). PARTICIPANTS 11 831 850 eligible patients from 787 contributing practices. Childhood maltreatment and domestic abuse (women only) were defined as the presence of a recorded Read code. OUTCOME MEASURES The incidence rate (IR) and prevalence of childhood maltreatment (in children aged 0-18 years) and domestic abuse (in women aged over 18) between 1996 and 2017. An adjusted incidence rate ratio (aIRR) is given to examine the differences in IRs based on sex, ethnicity and deprivation. RESULTS The age and gender breakdown of THIN has been previously reported to be representative of the UK population, however, there is substantial missing information on deprivation quintiles (<20%) and ethnicity (approximately 50%). The IR (IR 60.1; 95% CI 54.3 to 66.0 per 100 000 child years) and prevalence (416.1; 95% CI 401.3 to 430.9 per 100 000 child population) of childhood maltreatment rose until 2017. The aIRR was greater in patients from the most deprived backgrounds (aIRR 5.14; 95% CI 4.57 to 5.77 compared with least deprived) and from an ethnic minority community (eg, black aIRR 1.25; 1.04 to 1.49 compared with white). When examining domestic abuse in women, in 2017, the IR was 34.5 (31.4 to 37.7) per 100 000 adult years and prevalence 368.7 (358.7 to 378.7) per 100 000 adult population. Similarly, the IR was highest in the lowest socioeconomic class (aIRR 2.30; 2.71 to 3.30) and in ethnic minorities (South Asian aIRR 2.14; 1.92 to 2.39 and black aIRR 1.64; 1.42 to 1.89). CONCLUSION Despite recent improvements in recording, there is still a substantial under-recording of maltreatment and abuse within UK primary care records, compared with currently existing sources of childhood maltreatment and domestic abuse data. Approaches must be implemented to improve recording and detection of childhood maltreatment and domestic abuse within medical records.
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Affiliation(s)
- Joht Singh Chandan
- University of Warwick Warwick Medical School, Coventry, UK
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Krishna Margadhamane Gokhale
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Caroline Bradbury-Jones
- School of Nursing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Krishnarajah Nirantharakumar
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | | | - Julie Taylor
- School of Nursing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
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Torralbas Fernández A, Calcerrada Gutierrez M. Colonialism, gender and mental health in psychology: a view from Eastern Cuba. Int Rev Psychiatry 2020; 32:340-347. [PMID: 32643460 DOI: 10.1080/09540261.2020.1733941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The present paper invites a critical reflection, from a decolonial perspective, on the importance of considering gender in the approach to mental health problems. From a methodological point of view, this critical position includes consideration of the hermeneutic condition of the intersection between gender, race and other social historical determinants. It also explores the development and the incorporation of a gender perspective as an expression of decolonial thought, in approaches to mental health in the Cuban context. The paper draws on the critique of colonial thought in relation to psychology and gender. It analyses the history and the development of these ideas from the academic experience developed in the East of Cuba, a place on the periphery, a context that is distant and distinct from Havana, which is often seen as the main scientific centre and point of reference. As such, this paper includes a critique of colonial power with respect to the geographical location of the profession of psychology. In this way, it contributes to the central objective of promoting awareness of decolonial thinking, with an emphasis principally on gender and as a way to favour the professional development of clinical psychology in all of Cuba.
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Chandan JS, Keerthy D, Zemedikun DT, Okoth K, Gokhale KM, Raza K, Bandyopadhyay S, Taylor J, Nirantharakumar K. The association between exposure to childhood maltreatment and the subsequent development of functional somatic and visceral pain syndromes. EClinicalMedicine 2020; 23:100392. [PMID: 32637892 PMCID: PMC7329705 DOI: 10.1016/j.eclinm.2020.100392] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Childhood maltreatment is a global public health issue linked to a vast mortality and morbidity burden. This study builds on current literature to explore the risk of developing central sensitivity syndromes (CSS) (consisting of somatic and visceral pain syndromes) subsequent to childhood maltreatment exposure. METHODS A retrospective population based open cohort study using the UK primary care database, 'The Health Improvement Network,' between 1st January 1995-31st December 2018. 80,657 adult patients who had experienced childhood maltreatment or maltreatment related concerns (exposed patients) were matched to 161,314 unexposed patients by age and sex. Outcomes of interest were the development of CSS: either somatic (Fibromyalgia, chronic fatigue syndrome, temporomandibular joint disorder, chronic lower back pain, chronic headache, myofascial pain syndrome and restless leg syndrome) or visceral (Interstitial cystitis, vulvodynia, chronic prostatitis and irritable bowel syndrome) in nature. Effect sizes are presented as adjusted incidence rate ratios (aIRR) with confidence intervals (CI). Models were adjusted for the following covariates at cohort entry: age, sex, deprivation, anxiety, depression and serious mental ill health. RESULTS The average age at cohort entry was 23.4 years and the median follow was 2.2 years. There was an increased risk of developing fibromyalgia (aIRR 2.06; 95% CI 1.71-2.48), chronic fatigue syndrome (1.47; 1.08-2.00), chronic lower back pain (1.99; 1.68-2.35), restless leg syndrome (1.82; 1.41-2.35) and irritable bowel syndrome (1.15; 1.08-1.22) when compared to the unexposed group, whereas no statistical association was seen with the development of temporomandibular joint disorder (1.00; 0.88-1.13), chronic headache (1.04; 0.59-1.86), interstitial cystitis (1.19; 0.51-2.74), vulvodynia (0.65; 0.34-1.26), chronic prostatitis (0.34; 0.07-1.77) and myofascial pain syndrome (0.88; 0.36-2.14). Outcome numbers were low, most likely, due to the rarity of visceral conditions (aside from irritable bowel syndrome). The association between a history of childhood maltreatment and CSS were mainly observed in somatic CSS. INTERPRETATION The debilitating effects of CSS carry a substantial physical, psychological and economic burden to both the individuals who are diagnosed with them and the health services who serve them. Primary prevention approaches targeting childhood maltreatment as well as secondary preventative approaches should be considered to minimise the associated burden of CSS.
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Affiliation(s)
- Joht Singh Chandan
- Warwick Medical School, University of Warwick, Coventry CV47HL, United Kingdom
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, B152TT, United Kingdom
| | - Deepiksana Keerthy
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, B152TT, United Kingdom
| | - Dawit Tefra Zemedikun
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, B152TT, United Kingdom
| | - Kelvin Okoth
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, B152TT, United Kingdom
| | - Krishna Margadhamane Gokhale
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, B152TT, United Kingdom
| | - Karim Raza
- Arthritis Research, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, B152TT, United Kingdom
| | - Siddhartha Bandyopadhyay
- Centre of Crime, Justice and Policing, The Department of Economics, University of Birmingham, B152TT, United Kingdom
| | - Julie Taylor
- Child Protection, School of Nursing, College of Medical and Dental Sciences, University of Birmingham, B152TT, United Kingdom
- Birmingham Women's and Children's Hospitals NHS Foundation Trust, Birmingham, United Kingdom
| | - Krishnarajah Nirantharakumar
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, B152TT, United Kingdom
- Midlands Health Data Research UK, University of Birmingham B152TT, United Kingdom
- Corresponding author at: Institute of Applied Health Research, College of Medical and Dental sciences, University of Birmingham, B152TT
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Sharma V, Papaefstathiou S, Tewolde S, Amobi A, Deyessa N, Relyea B, Scott J. Khat use and intimate partner violence in a refugee population: a qualitative study in Dollo Ado, Ethiopia. BMC Public Health 2020; 20:670. [PMID: 32398069 PMCID: PMC7216323 DOI: 10.1186/s12889-020-08837-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 05/03/2020] [Indexed: 11/12/2022] Open
Abstract
Background Intimate partner violence (IPV) is the most common form of gender-based violence affecting women and girls worldwide and is exacerbated in humanitarian crises. There is evidence that substance use is associated with male perpetration of IPV. Consumption of khat —a plant containing amphetamines traditionally chewed in the horn of Africa and legal in some countries including Ethiopia—may increase risk of IPV toward women. This analysis aimed to assess perceptions on khat use among Somali refugees in Dollo Ado, Ethiopia and its association with IPV to inform an IPV and HIV prevention intervention. Methods A descriptive qualitative study comprising individual interviews (n = 30) and focus group discussions (n = 10) was conducted in Bokolmayo refugee camp in Dollo Ado, Ethiopia in October 2016. A purposive sample of male and female Somali refugees, religious and community leaders, and service providers (n = 110 individuals; 44 women and 66 men) was included. Trained interviewers from the camp conducted the interviews and discussion, which were audio recorded, transcribed and translated. A content analysis was conducted on coded excerpts from the transcripts to identify factors contributing to IPV toward women, including khat use. Results Participants reported that displacement has resulted in limited employment opportunities for men and increased idle time, which has led to increased khat use among men as a coping mechanism. Male khat use was perceived to be associated with perpetration of physical and sexual IPV through several mechanisms including increased anger and aggression and enhanced sexual desire. Khat use also contributes to intra-marital conflict as money allocated for a household is spent on purchasing khat. Conclusion Khat use should be addressed as part of IPV prevention programming in this context. Livelihood interventions and other strategies to improve economic conditions, should be explored in collaboration with refugee camp authorities and community leaders as a potential avenue to mitigate the impact of khat use on women and families.
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Affiliation(s)
- Vandana Sharma
- Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | | | - Samuel Tewolde
- Women and Health Alliance International Addis Ababa, Ethiopia and Paris, Paris, France
| | - Adaugo Amobi
- Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, USA
| | - Negussie Deyessa
- Addis Ababa University School of Public Health, Addis Ababa, Ethiopia
| | - Bridget Relyea
- Women and Health Alliance International Addis Ababa, Ethiopia and Paris, Paris, France
| | - Jennifer Scott
- Women and Health Alliance International Addis Ababa, Ethiopia and Paris, Paris, France.,Harvard Medical School, Boston, USA.,Beth Israel Deaconess Medical Center, Boston, USA
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180
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Ahmadabadi Z, Najman JM, Williams GM, Clavarino AM, d'Abbs P, Tran N. Intimate partner violence and subsequent depression and anxiety disorders. Soc Psychiatry Psychiatr Epidemiol 2020; 55:611-620. [PMID: 31912167 DOI: 10.1007/s00127-019-01828-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 12/24/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE The current longitudinal study examines the temporal association between different types of intimate partner violence (IPV) at early adulthood (21 years) and subsequent depression and anxiety disorders in young adulthood (30 years). METHODS Participants were from the Mater-University of Queensland Study of Pregnancy. A cohort of 1529 was available for analysis. IPV was measured using the Composite Abuse Scale at 21 years. At the 21 and 30-year follow-ups, major depression disorder and anxiety disorders were measured using the Composite International Diagnostic Interview. RESULTS We found a temporal relationship between almost all forms of IPV at 21 years and females' new cases of major depression disorder at 30 years. This association was not found for females who had previously been diagnosed with depression disorder. IPV did not predict the onset of new anxiety disorders, but it had a robust association with anxiety disorders in females with a previous anxiety diagnosis. We observed no significant link between IPV and males' subsequent major depression disorder. Interestingly, the experience of emotional abuse was a robust predictor of new cases of anxiety disorders but only for males. CONCLUSION Our results suggest the need for sex-specific and integrated interventions addressing both IPV and mental health problems simultaneously. IPV interventions should be informed by the extend to which pre-existing anxiety and depression may lead to different psychological responses to the IPV experience. Increased risk of anxiety disorders predicted by emotional abuse experienced by males challenges beliefs about invulnerability of men in the abusive relationships and demands further attention.
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Affiliation(s)
- Zohre Ahmadabadi
- School of Public Health, The University of Queensland, Herston Road, Herston, QLD, 4006, Australia.
| | - Jackob M Najman
- School of Public Health, The University of Queensland, Herston Road, Herston, QLD, 4006, Australia.,School of Social Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia
| | - Gail M Williams
- School of Public Health, The University of Queensland, Herston Road, Herston, QLD, 4006, Australia
| | - Alexandra M Clavarino
- School of Pharmacy, The University of Queensland, Woolloongabba, QLD, 4102, Australia
| | - Peter d'Abbs
- School of Public Health, The University of Queensland, Herston Road, Herston, QLD, 4006, Australia.,Menzies School of Health Research, Spring Hill, QLD, 4000, Australia
| | - Nam Tran
- Institute for Social Science Research, The University of Queensland, Indooroopilly, QLD, 4068, Australia
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Intimpartnergewalt: Kennzahlen, Tätercharakteristika, Risikoerfassung und -management. FORENSISCHE PSYCHIATRIE PSYCHOLOGIE KRIMINOLOGIE 2020. [DOI: 10.1007/s11757-020-00595-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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McNaughton Reyes HL, Maman S, Groves AK, Moodley D. Intimate partner violence and postpartum emotional distress among South African women: Moderating effects of resilience and vulnerability factors. Glob Public Health 2020; 15:1157-1167. [PMID: 32290779 DOI: 10.1080/17441692.2020.1751233] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In this study we aimed to identify factors that condition (i.e. buffer or exacerbate) the impact of exposure to intimate partner violence (IPV) on postpartum emotional distress among South African women. Hypothesised buffering factors included: socioeconomic status, family social support, and religiosity. Hypothesised exacerbating factors included: baseline distress, HIV status, and childhood abuse. Longitudinal analyses examined interactions between putative buffering and exacerbating factors and exposure to physical or sexual IPV, assessed during pregnancy (T1), as predictors of emotional distress, measured at 14 weeks (T2) and 9 months postpartum (T3). Consistent with hypotheses, at both T2 and T3 the impact of IPV exposure on emotional distress was significantly stronger among women who reported greater baseline distress and weaker among women of greater socioeconomic status. At T3, an interaction emerged with HIV status; the impact of IPV exposure on emotional distress was stronger for women who were diagnosed as HIV-positive during pregnancy. Findings support the need for targeted mental health promotion interventions for IPV-exposed women who are newly diagnosed with HIV and/or report high levels of emotional distress during pregnancy. Although more research is needed, findings also suggest that strengthening socioeconomic supports for IPV-exposed women may buffer impacts on postpartum mental health.
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Affiliation(s)
- H Luz McNaughton Reyes
- Department of Health Behavior, Gillings School of Global Public Health, UNC Chapel Hill, Chapel Hill, NC, USA
| | - Suzanne Maman
- Department of Health Behavior, Gillings School of Global Public Health, UNC Chapel Hill, Chapel Hill, NC, USA
| | - Allison K Groves
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Dhayendre Moodley
- Department of Obstetrics and Gynaecology, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
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Nair N, Daruwalla N, Osrin D, Rath S, Gagrai S, Sahu R, Pradhan H, De M, Ambavkar G, Das N, Dungdung GP, Mohan D, Munda B, Singh V, Tripathy P, Prost A. Community mobilisation to prevent violence against women and girls in eastern India through participatory learning and action with women's groups facilitated by accredited social health activists: a before-and-after pilot study. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2020; 20:6. [PMID: 32213182 PMCID: PMC7093987 DOI: 10.1186/s12914-020-00224-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 02/25/2020] [Indexed: 11/26/2022]
Abstract
Background Almost one in three married Indian women have ever experienced physical, sexual, or emotional violence from husbands in their lifetime. We aimed to investigate the preliminary effects of community mobilisation through participatory learning and action groups facilitated by Accredited Social Health Activists (ASHAs), coupled with access to counselling, to prevent violence against women and girls in Jharkhand, eastern India. Methods We piloted a cycle of 16 participatory learning and action meetings with women’s groups facilitated by ASHAs in rural Jharkhand. Participants identified common forms of violence against women and girls, prioritised the ones they wanted to address, developed locally feasible strategies to address them, implemented the strategies, and evaluated the process. We also trained two counsellors and two ASHA supervisors to support survivors, and gave ASHAs information about legal, health, and police services. We did a before-and-after pilot study involving baseline and endline surveys with group members to estimate preliminary effects of these activities on the acceptability of violence, prevalence of past year emotional and physical violence, and help-seeking. Results ASHAs successfully conducted monthly participatory learning and action meetings with 39 women’s groups in 22 villages of West Singhbhum district, Jharkhand, between June 2016 and September 2017. We interviewed 59% (679/1149) of women registered with groups at baseline, and 63% (861/1371) at endline. More women reported that violence was unacceptable in all seven scenarios presented to them at endline compared to baseline (adjusted Odds Ratio [aOR]: 1.87, 95%: 1.39–2.52). Fewer women reported experiencing emotional violence from their husbands in the last 12 months (aOR: 0.55, 95% CI: 0.43–0.71), and more sought help if it occurred (aOR: 2.19, 95% CI: 1.51–3.17). In addition, fewer women reported experiencing emotional or physical violence from family members other than their husbands in the last 12 months (aOR: 0.41, 95% CI: 0.32–0.53, and aOR: 0.36, 95% CI: 0.26–0.50, respectively). Conclusion Combining participatory learning and action meetings facilitated by ASHAs with access to counselling was an acceptable strategy to address violence against women and girls in rural communities of Jharkhand. The approach warrants further implementation and evaluation as part of a comprehensive response to violence.
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Affiliation(s)
| | - Nayreen Daruwalla
- Society for Nutrition, Education and Health Action, Mumbai, Maharashtra, India
| | - David Osrin
- Institute for Global Health, University College London, London, UK
| | | | | | | | | | - Megha De
- Ekjut, Chakradharpur, Jharkhand, India
| | - Gauri Ambavkar
- Society for Nutrition, Education and Health Action, Mumbai, Maharashtra, India
| | - Nibha Das
- Ekjut, Chakradharpur, Jharkhand, India
| | | | - Damini Mohan
- Society for Nutrition, Education and Health Action, Mumbai, Maharashtra, India
| | | | | | | | - Audrey Prost
- Institute for Global Health, University College London, London, UK.
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Longitudinal impacts of an online safety and health intervention for women experiencing intimate partner violence: randomized controlled trial. BMC Public Health 2020; 20:260. [PMID: 32098633 PMCID: PMC7043036 DOI: 10.1186/s12889-020-8152-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 01/02/2020] [Indexed: 12/29/2022] Open
Abstract
Background Responding to intimate partner violence (IPV) and its consequences is made complex by women’s diverse needs, priorities and contexts. Tailored online IPV interventions that account for differences among women have potential to reduce barriers to support and improve key outcomes. Methods Double blind randomized controlled trial of 462 Canadian adult women who experienced recent IPV randomly were assigned to receive either a tailored, interactive online safety and health intervention (iCAN Plan 4 Safety) or a static, non-tailored version of this tool. Primary (depressive symptoms, PTSD symptoms) and secondary (helpfulness of safety actions, confidence in safety planning, mastery, social support, experiences of coercive control, and decisional conflict) outcomes were measured at baseline and 3, 6, and 12 months later via online surveys. Generalized Estimating Equations were used to test for differences in outcomes by study arm. Differential effects of the tailored intervention for 4 strata of women were examined using effect sizes. Exit survey process evaluation data were analyzed using descriptive statistics, t-tests and conventional content analysis. Results Women in both tailored and non-tailored groups improved over time on primary outcomes of depression (p < .001) and PTSD (p < .001) and on all secondary outcomes. Changes over time did not differ by study arm. Women in both groups reported high levels of benefit, safety and accessibility of the online interventions, with low risk of harm, although those completing the tailored intervention were more positive about fit and helpfulness. Importantly, the tailored intervention had greater positive effects for 4 groups of women, those: with children under 18 living at home; reporting more severe violence; living in medium-sized and large urban centers; and not living with a partner. Conclusion This trial extends evidence about the effectiveness of online safety and health interventions for women experiencing IPV to Canadian women and provides a contextualized understanding about intervention processes and effects useful for future refinement and scale up. The differential effects of the tailored intervention found for specific subgroups support the importance of attending to diverse contexts and needs. iCAN is a promising intervention that can complement resources available to Canadian women experiencing IPV. Trial registration Clinicaltrials.gov ID NCT02258841 (Prospectively Registered on Oct 2, 2014).
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Chandan JS, Thomas T, Bradbury‐Jones C, Taylor J, Bandyopadhyay S, Nirantharakumar K. Risk of Cardiometabolic Disease and All-Cause Mortality in Female Survivors of Domestic Abuse. J Am Heart Assoc 2020; 9:e014580. [PMID: 32063124 PMCID: PMC7070197 DOI: 10.1161/jaha.119.014580] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 11/15/2019] [Indexed: 12/29/2022]
Abstract
Background Domestic abuse (DA) against women is a global public health problem. Although the possible health burden could be substantial, the associations between DA and subsequent cardiometabolic disease (cardiovascular disease, hypertension, and type 2 diabetes mellitus) and all-cause mortality are poorly understood. Methods and Results This retrospective cohort study consisted of UK-based primary care patients between January 1, 1995, to December 1, 2017. Overall, 18 547 women exposed to DA were matched to 72 231 unexposed women by age and lifestyle factors. The main outcomes, presented as adjusted incidence rate ratios (IRRs), were the risk of developing cardiovascular disease, hypertension, type 2 diabetes mellitus, and all-cause mortality. In total, 181 exposed women experienced a cardiovascular disease event compared with 644 of the unexposed control group, relating to an increased adjusted IRR of 1.31 (95% CI, 1.11-1.55; P=0.001). There was also an increased risk of subsequent type 2 diabetes mellitus (adjusted IRR: 1.51; 95% CI, 1.30-1.76; P<0.001) and all-cause mortality (adjusted IRR: 1.44; 95% CI, 1.24-1.67; P<0.001) following exposure to DA. This observation was not seen with hypertension (adjusted IRR: 0.99; 95% CI, 0.88-1.12; P=0.873). Conclusions There is an increased risk of subsequent cardiovascular disease, type 2 diabetes mellitus, and all-cause mortality in female survivors of DA. However, there is no association with the development of hypertension in this group, in keeping with previous literature. Considering the high prevalence of DA, clinicians should be made aware of the disproportionally increased risk and thus are encouraged to manage modifiable risk factors actively in this group.
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Affiliation(s)
- Joht Singh Chandan
- Institute of Applied Health ResearchCollege of Medical and Dental SciencesUniversity of BirminghamUnited Kingdom
- Warwick Medical SchoolUniversity of WarwickCoventryUnited Kingdom
| | - Tom Thomas
- Institute of Applied Health ResearchCollege of Medical and Dental SciencesUniversity of BirminghamUnited Kingdom
| | - Caroline Bradbury‐Jones
- School of NursingCollege of Medical and Dental SciencesUniversity of BirminghamUnited Kingdom
| | - Julie Taylor
- School of NursingCollege of Medical and Dental SciencesUniversity of BirminghamUnited Kingdom
- Birmingham Women's and Children's Hospitals NHS Foundation TrustBirminghamUnited Kingdom
| | | | - Krishnarajah Nirantharakumar
- Institute of Applied Health ResearchCollege of Medical and Dental SciencesUniversity of BirminghamUnited Kingdom
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186
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Coll CVN, Ewerling F, García-Moreno C, Hellwig F, Barros AJD. Intimate partner violence in 46 low-income and middle-income countries: an appraisal of the most vulnerable groups of women using national health surveys. BMJ Glob Health 2020; 5:e002208. [PMID: 32133178 PMCID: PMC7042580 DOI: 10.1136/bmjgh-2019-002208] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 12/29/2022] Open
Abstract
Introduction Intimate partner violence (IPV) against women is a critical public health issue that transcends social and economic boundaries and considered to be a major obstacle to the progress towards the 2030 women, children and adolescents’ health goals in low-income and middle-income countries (LMICs). Standardised IPV measures have been increasingly incorporated into Demographic and Health Surveys carried out in LMICs. Routine reporting and disaggregated analyses at country level are essential to identify populational subgroups that are particularly vulnerable to IPV exposure. Methods We examined data from 46 countries with surveys carried out between 2010 and 2017 to assess the prevalence and inequalities in recent psychological, physical and sexual IPV among ever-partnered women aged 15–49 years. Inequalities were assessed by disaggregating the data according to household wealth, women’s age, women’s empowerment level, polygyny status of the relationship and area of residence. Results National levels of reported IPV varied widely across countries—from less than 5% in Armenia and Comoros to more than 40% in Afghanistan. Huge inequalities within countries were also observed. Generally, richer and more empowered women reported less IPV, as well as those whose partners had no cowives. Different patterns across countries were observed according to women’s age and area of residence but in most cases younger women and those living in rural areas tend to be more exposed to IPV. Conclusion The present study advances the current knowledge by providing a global panorama of the prevalence of different forms of IPV across LMICs, helping the identification of the most vulnerable groups of women and for future monitoring of leaving no one behind towards achieving the elimination of all forms of violence among women and girls.
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Affiliation(s)
- Carolina V N Coll
- International Center for Equity in Health, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Fernanda Ewerling
- International Center for Equity in Health, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | | | - Franciele Hellwig
- International Center for Equity in Health, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Aluisio J D Barros
- International Center for Equity in Health, Universidade Federal de Pelotas, Pelotas, RS, Brazil
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187
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Bedford LE, Guo VY, Yu EYT, Wong CKH, Fung CSC, Lam CLK. Do Negative Emotional States Play a Role in the Association Between Intimate Partner Violence and Poor Health-Related Quality of Life in Chinese Women From Low-Income Families? Violence Against Women 2020; 26:2041-2061. [PMID: 31896311 DOI: 10.1177/1077801219892648] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
A cross-sectional analysis of a dataset of 156 participants in a health assessment program explored whether negative emotional states mediated the association between intimate partner violence (IPV) and health-related quality of life (HRQoL). Compared with IPV screen-negative participants, those who screened positive had significantly lower HRQoL and significantly higher levels of depression, anxiety, and stress. The inverse associations between the presence of IPV and HRQoL were found to be mediated by depression, anxiety, and stress. Therefore, interventions to alleviate negative emotions in women suffering from IPV have the potential to be useful in improving their HRQoL.
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Affiliation(s)
- Laura Elizabeth Bedford
- Department of Family Medicine and Primary Care, University of Hong Kong, Hong Kong SAR, China
| | | | - Esther Yee Tak Yu
- Department of Family Medicine and Primary Care, University of Hong Kong, Hong Kong SAR, China
| | - Carlos King Ho Wong
- Department of Family Medicine and Primary Care, University of Hong Kong, Hong Kong SAR, China
| | - Colman Siu Cheung Fung
- Department of Family Medicine and Primary Care, University of Hong Kong, Hong Kong SAR, China
| | - Cindy Lo Kuen Lam
- Department of Family Medicine and Primary Care, University of Hong Kong, Hong Kong SAR, China
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188
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Zietz S, Kajula L, McNaughton Reyes HL, Moracco B, Shanahan M, Martin S, Maman S. Patterns of adverse childhood experiences and subsequent risk of interpersonal violence perpetration among men in Dar es Salaam, Tanzania. CHILD ABUSE & NEGLECT 2020; 99:104256. [PMID: 31835233 PMCID: PMC7719339 DOI: 10.1016/j.chiabu.2019.104256] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 09/21/2019] [Accepted: 10/28/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs), including abuse and neglect, are consistently found to be predictors of perpetration of intimate partner violence (IPV) and peer violence (PV) in adulthood. Children are often exposed to patterns of ongoing and/or multiple-type polyvictimization throughout the life course. OBJECTIVES To identify and characterize patterns of ACEs among men in Dar es Salaam, Tanzania and to examine the relationship between these patterns and perpetration of intimate partner violence (IPV) and peer violence (PV) in adulthood. METHODS We used latent class analysis to identify respondents with similar patterns of ACEs. The analysis was conducted with a sample of 987 men. RESULTS We uncovered five distinct classes of men with specific patterns of ACEs. One consisted of nonvictims and four included various forms of polyvictimization. Men in the polyvictimization classes that included non-violent family dysfunction had significantly higher odds of perpetrating psychological IPV compared to the other three classes (AORs 2.33 and 3.04 compared to nonvictims). Men in the polyvictimization classes that included any sexual violence and/or non-violent family dysfunction had significantly higher odds of perpetrating PV compared to the other two classes (AORs 3.54, 6.10, and 7.42 compared to nonvictims). CONCLUSIONS These findings suggest that distinct patterns of exposure to ACEs among this population are differentially related to perpetration of IPV and PV in adulthood. These findings highlight the importance of child development interventions in low-and middle-income countries, both for the primary prevention of child adversity and for mitigation of the cognitive and emotional effects of ACEs.
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Affiliation(s)
- Susannah Zietz
- Duke Center for Child and Family Policy, Erwin Square Mill Building, 202 West Main Street, Bay C, Durham, NC, United States.
| | - Lusajo Kajula
- UNICEF Office of Research-Innocenti, Florence, Italy
| | - H Luz McNaughton Reyes
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Beth Moracco
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Meghan Shanahan
- Department of Maternal and Child Health, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Sandra Martin
- Department of Maternal and Child Health, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Suzanne Maman
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA
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189
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Sezgin AU, Punamäki RL. Impacts of early marriage and adolescent pregnancy on mental and somatic health: the role of partner violence. Arch Womens Ment Health 2020; 23:155-166. [PMID: 30955087 PMCID: PMC7183488 DOI: 10.1007/s00737-019-00960-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 03/18/2019] [Indexed: 11/26/2022]
Abstract
Researchers agree that early marriage (EM) and adolescent pregnancy (AP) can form severe risks for women's somatic, mental, and reproductive health, as well as on educational and social status. Yet, less is known about factors that may moderate or mediate these associations. This study examined, first, retrospectively the impacts of EM and AP on self-reported mental and somatic health among multicultural group of women living in Eastern Anatolia, Turkey. Second task was to analyze whether and how the partner violence would mediate and/or moderate between EM and AP and mental health problems. The participants were 1569 women (16-72 years of age), who reported their age of being married, first pregnancy, and demographic characteristics. They described their mental health status through General Health Questionnaire (GHQ-28: depressive, anxiety, social dysfunction, and somatization symptoms) and symptoms of posttraumatic stress disorder (PTSD; DSM-5). Women's reports of somatic illnesses were classified according to WHO-ICD-10. The revised conflict tactics scale, short form was used as a proxy to partner violence. Women who gave birth at 13-19 years of age reported more anxiety and somatization symptoms than later delivered, and those married younger than 25 showed a higher level of depressive symptoms than later married. Both AP and EM formed a heightened risk for somatic illnesses. The partner violence functioned as a moderator; AP was associated with especially high levels of depressive and anxiety symptoms among women exposed to sexual coercion in their marriage. Non-significant mediation analysis indicates that partner violence did not explain the severe impacts of the AP and EM on women's mental health. Yet, the AP and EM were associated with heightened level of partner violence. Adolescent pregnancy forms a comprehensive mental health risk, and both AP and EM were risks for somatic illnesses, such as cardiovascular problems. The mental health risk of AP further intensified if women experienced sexual coercion in their partnership. Our fundamental work is to abolish these patriarchal phenomena.
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Affiliation(s)
- Aysen Ufuk Sezgin
- Istanbul University, Istanbul Medical Faculty, Forensic Medicine Department, Istanbul, Turkey
| | - Raija-Leena Punamäki
- Faculty of Social Sciences/Psychology, Tampere University, Kalevankatu 5, Linna 4krs, FIM-33014, Tampere, Finland.
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190
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Logie CH, Okumu M, Mwima S, Hakiza R, Irungi KP, Kyambadde P, Kironde E, Narasimhan M. Social ecological factors associated with experiencing violence among urban refugee and displaced adolescent girls and young women in informal settlements in Kampala, Uganda: a cross-sectional study. Confl Health 2019; 13:60. [PMID: 31867053 PMCID: PMC6918605 DOI: 10.1186/s13031-019-0242-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 11/27/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Research on violence targeting urban forcibly displaced adolescent girls and young women (AGYW) is limited, particularly regarding polyvictimization (exposure to multiple forms of violence). Yet there is a global trend of refugee urbanization, and urban AGYW are at the nexus of violence disparities among adolescents, forcibly displaced persons, and slum dwellers. This study explored factors associated with young adulthood violence (> 16 years) (YAV) and intimate partner violence (IPV) among forcibly displaced AGYW in Kampala, Uganda. METHODS We conducted a cross-sectional survey with forcibly displaced AGYW aged 16-24 from five informal settlement (slum) communities across Kampala (Kabalagala, Rubaga, Kansanga, Katwe, Nsambya) using peer network sampling. We assessed YAV (experienced at age 16 or above) (sexual, physical, emotional violence) and recent (past 12-month) IPV (physical, sexual, control violence). We conducted descriptive statistics, followed by multinomial logistic regression analyses to explore social ecological factors (e.g., intrapersonal: depression; interpersonal: sexual relationship power, community: food insecurity) associated with experiencing YAV and YAV polyvictimization, and IPV and IPV polyvictimization. RESULTS Over half of participants (n = 333; mean age = 19.31; SD = 2.56, range = 16-24) reported YAV (n = 179; 53.7%) and 9.3% (n = 41) reported YAV polyvictimization. Most participants that were in an intimate relationship in the last 12 months (n = 200; 85.8%) reported IPV, among these, 45.5% reported one form of IPV and 54.5% reported IPV polyvictimization. In adjusted analyses, experiencing any YAV was significantly associated with: adolescent sexual and reproductive health (SRH) stigma; sexual relationship power; mobile app usage; depressive symptoms; childhood abuse; and childhood polyvictimization. In adjusted analyses YAV polyvictimization was associated with: depressive symptoms; childhood polyvictimization; sexual relationship power; and food insecurity. Recent IPV polyvictimization in adjusted analyses was associated with owning/using a mobile phone and depressive symptoms. Participants with higher sexual relationship power had lower odds of recent IPV polyvictimization. CONCLUSION Findings suggest that YAV and IPV polyvictimization require urgent attention among forcibly displaced AGYW in Kampala. Multi-level strategies are required to address intrapersonal e.g. (depression), interpersonal (e.g. childhood abuse, sexual relationship power) and community (e.g. adolescent SRH stigma, food insecurity) factors associated with experiencing violence. Future research can tailor approaches to advance health, agency and human rights among urban forcibly displaced AGYW.
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Affiliation(s)
- Carmen H. Logie
- Factor Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1V4 Canada
- Women’s College Research Institute, Women’s College Hospital, 76 Grenville St, Toronto, ON M5G 1N8 Canada
| | - Moses Okumu
- Factor Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1V4 Canada
- School of Social Work, University of North Carolina-Chapel Hill, 325 Pittsboro ST CB#3550, Chapel Hill, NC 27599 USA
- National STI Control Unit, Mulago Hospital, Kampala, Uganda
| | - Simon Mwima
- AIDS Control Program, Ministry of Health, Plot 6, Lourdel Road, Nakasero, Kampala, Uganda
- Most At Risk Population Initiative, Kampala, Uganda
| | - Robert Hakiza
- Most At Risk Population Initiative, Kampala, Uganda
- Young African Refugees for Integral Development (YARID), Nsambya Gogonya, Kampala, Uganda
| | | | - Peter Kyambadde
- National STI Control Unit, Mulago Hospital, Kampala, Uganda
- AIDS Control Program, Ministry of Health, Plot 6, Lourdel Road, Nakasero, Kampala, Uganda
- Most At Risk Population Initiative, Kampala, Uganda
| | | | - Manjulaa Narasimhan
- Department of Reproductive Health and Research, World Health Organization, 20 Avenue Appia, CH-1211, 27 Geneva, Switzerland
- World Health Organization, Department of Reproductive Health and Research, including the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme (HRP), Geneva, Switzerland
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191
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Romero-Martínez Á, Lila M, Moya-Albiol L. Long-Term Drug Misuse Increases the Risk of Cognitive Dysfunctions in Intimate Partner Violence Perpetrators: Key Intervention Targets for Reducing Dropout and Reoffending. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3792. [PMID: 31600946 PMCID: PMC6843147 DOI: 10.3390/ijerph16203792] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 09/24/2019] [Accepted: 10/03/2019] [Indexed: 12/02/2022]
Abstract
Intimate partner violence against women (IPVAW) is a major public health problem, with an important mortality rate in women across the world. In this regard, it has been well-established that drug misuse explains (at least in part) an increased risk of IPVAW perpetration. Even though alcohol is the most widely studied drug underlying IPVAW, other drugs, such as cannabis and cocaine also seem to be significant indicators of this type of violence. Nonetheless, little is known about mediators, such as cognitive domains that facilitate proneness to violence after drug consumption. Therefore, the primary objective of the present study was to compare drug misuse patterns and cognitive performance in a carefully selected sample of IPVAW perpetrators (n = 63) and a group of non-violent men (control group; n = 39). Second, we also aimed to study the association between different patterns of drug misuse and cognitive performance and several facets of IPVAW perpetration (i.e., severity of injuries and type of aggression). Our results revealed that IPVAW perpetrators showed considerably higher levels of sustained drug misuse (alcohol, cannabis, cocaine, and heroin) for years and worse cognitive performance than controls. Moreover, the highest drug misuse sustained over time was related to the worst cognitive performance and the highest IPVAW severity. Finally, alcohol and cocaine seemed to be related to IPVAW and risk of reoffending. Whereas, cannabis, heroin, and MDMA were related to the existence of a previous criminal record (delinquency without violence). Hence, research in this field would help to develop coadjutant treatments and intervention packages to reduce drug misuse in the initial stages, which in turn would reduce cognitive impairments in IPVAW perpetrators. These expected improvements might produce an increase in treatment adherence and a decrease in the risk of future IPVAW reoffending.
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Affiliation(s)
- Ángel Romero-Martínez
- Department of Psychobiology, University of Valencia, Avenida Blasco, Ibañez, 21 46010 Valencia, Spain.
| | - Marisol Lila
- Department of Social Psychology, University of Valencia, Avenida Blasco, Ibañez, 21 46010 Valencia, Spain.
| | - Luis Moya-Albiol
- Department of Psychobiology, University of Valencia, Avenida Blasco, Ibañez, 21 46010 Valencia, Spain.
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192
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Falb KL, Blackwell A, Stennes J, Hussein M, Annan J. Depressive symptoms among women in Raqqa Governorate, Syria: associations with intimate partner violence, food insecurity, and perceived needs. Glob Ment Health (Camb) 2019; 6:e22. [PMID: 31662877 PMCID: PMC6796320 DOI: 10.1017/gmh.2019.20] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 06/27/2019] [Accepted: 08/21/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Raqqa Governorate, Syria has recently been affected by overlapping conflicts related to the Syrian Civil war and occupation by ISIS, resulting in widespread displacement and disruption of economic livelihoods. However, little information is currently known about mental health needs and risk factors among women. Therefore, this study sought to examine potential risk factors for depressive symptoms among married women living in northern Syria. METHODS Data were collected between March and April 2018 as part of an evaluation of an International Rescue Committee cash transfer program targeted toward vulnerable households. Using cross-sectional data from 214 married women participating in the program, linear regression models were generated to explore the associations between depressive symptoms [nine-item Patient Health Questionnaire (PHQ-9)] and its potential risk factors, including food insecurity, perceived deprivation of basic needs [the Humanitarian Emergency Settings Perceived Needs Scale (HESPER) scale], and past-3-month intimate partner violence (IPV). RESULTS The average depressive symptom score was 10.5 (s.d.: 4.9; range: 2-27). In the final adjusted model, any form of recent IPV (β = 2.25; 95% CI 0.92-3.57; p = 0.001), severe food insecurity (β = 1.62; 95% CI 0.27-2.96; p = 0.02) and perceived needs (β = 0.38; 95% CI 0.18-0.57; p = 0.0002) were associated with an increase in depressive symptoms. CONCLUSION Study findings point to the need to address the mental health needs of women in conflict-affected areas of Syria. Programming to address risk factors for depression, including IPV and other factors associated with daily stressors such as food insecurity and deprivation of basic needs, may be effective in reducing depression in this population.
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Affiliation(s)
- K. L. Falb
- Research, Evaluation & Learning, International Rescue Committee, 1730 M St NW, Ste 505, Washington DC 20036, USA
| | - A. Blackwell
- Research, Evaluation & Learning, International Rescue Committee, 1730 M St NW, Ste 505, Washington DC 20036, USA
| | - J. Stennes
- Women's Protection & Empowerment, International Rescue Committee, 3 Bloomsbury Place, London WC1A 2QL, UK
| | - M. Hussein
- Women's Protection & Empowerment, International Rescue Committee, Dohuk, Iraq
| | - J. Annan
- Research, Evaluation & Learning, International Rescue Committee, 122 E 42nd St, NYC, NY 10068, USA
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193
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Grossman DC, Choucair B. Violence And The US Health Care Sector: Burden And Response. Health Aff (Millwood) 2019; 38:1638-1645. [DOI: 10.1377/hlthaff.2019.00642] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- David C. Grossman
- David C. Grossman is senior investigator at the Kaiser Permanente Washington Health Research Institute, in Seattle
| | - Bechara Choucair
- Bechara Choucair is senior vice president and chief community health officer at Kaiser Permanente in Oakland, California
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194
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Logie CH, Marcus N, Wang Y, Kaida A, O'Campo P, Ahmed U, O'Brien N, Nicholson V, Conway T, de Pokomandy A, Fernet M, Loutfy M. A longitudinal study of associations between HIV-related stigma, recent violence and depression among women living with HIV in a Canadian cohort study. J Int AIDS Soc 2019; 22:e25341. [PMID: 31328891 PMCID: PMC6643300 DOI: 10.1002/jia2.25341] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 06/05/2019] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Women living with HIV (WLHIV) experience stigma and elevated exposure to violence in comparison with HIV-negative women. We examined the mediating role of experiencing recent violence in the relationship between stigma and depression among WLHIV in Canada. METHODS We conducted a cohort study with WLHIV in three Canadian provinces. Recent violence was assessed through self-reported experiences of control, physical, sexual or verbal abuse in the past three months. At Time 1 (2013-2015) three forms of stigma were assessed (HIV-related, racial, gender) and at Time 2 (2015-2017) only HIV-related stigma was assessed. We conducted structural equation modelling (SEM) using the maximum likelihood estimation method with Time 1 data to identify direct and indirect effects of gender discrimination, racial discrimination and HIV-related stigma on depression via recent violence. We then conducted mixed effects regression and SEM using Time 1 and Time 2 data to examine associations between HIV-related stigma, recent violence and depression. RESULTS At Time 1 (n = 1296), the direct path from HIV-related stigma (direct effect: β = 0.200, p < 0.001; indirect effect: β = 0.014, p < 0.05) to depression was significant; recent violence accounted for 6.5% of the total effect. Gender discrimination had a significant direct and indirect effect on depression (direct effect: β = 0.167, p < 0.001; indirect effect: β = 0.050, p < 0.001); recent violence explained 23.15% of the total effect. Including Time 1 and Time 2 data (n = 1161), mixed-effects regression results indicate a positive relationship over time between HIV-related stigma and depression (Acoef: 0.04, 95% CI: 0.03, 0.06, p < 0.001), and recent violence and depression (Acoef: 1.95, 95% CI: 0.29, 4.42, p < 0.05), controlling for socio-demographics. There was a significant interaction between HIV-related stigma and recent violence with depression (Acoef: 0.04, 95% CI: 0.01, 0.07, p < 0.05). SEM analyses reveal that HIV-related stigma had a significant direct and indirect effect on depression over time (direct effect: β = 0.178, p < 0.001; indirect effect: β = 0.040, p < 0.001); recent violence experiences accounted for 51% of the total effect. CONCLUSIONS Our findings suggest that HIV-related stigma is associated with increased experiences of recent violence, and both stigma and violence are associated with increased depression among WLHIV in Canada. There is an urgent need for trauma-informed stigma interventions to address stigma, discrimination and violence.
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Affiliation(s)
- Carmen H Logie
- Factor‐Inwentash Faculty of Social WorkUniversity of TorontoTorontoOntarioCanada
- Women's College Research InstituteWomen's College HospitalTorontoOntarioCanada
| | - Natania Marcus
- Department of Applied Psychology and Human DevelopmentUniversity of TorontoTorontoOntarioCanada
| | - Ying Wang
- Factor‐Inwentash Faculty of Social WorkUniversity of TorontoTorontoOntarioCanada
| | - Angela Kaida
- Faculty of Health SciencesSimon Fraser UniversityVancouverBritish ColumbiaCanada
| | - Patricia O'Campo
- St. Michael's HospitalTorontoOntarioCanada
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Uzma Ahmed
- Factor‐Inwentash Faculty of Social WorkUniversity of TorontoTorontoOntarioCanada
| | - Nadia O'Brien
- Department of Family MedicineMcGill UniversityMontrealQuebecCanada
| | - Valerie Nicholson
- Faculty of Health SciencesSimon Fraser UniversityVancouverBritish ColumbiaCanada
| | - Tracey Conway
- Women's College Research InstituteWomen's College HospitalTorontoOntarioCanada
| | - Alexandra de Pokomandy
- Department of Family MedicineMcGill UniversityMontrealQuebecCanada
- Chronic Viral Illness ServiceMcGill University Health CentreMontrealQuebecCanada
| | - Mylène Fernet
- Department of SexologyUniversité du Québec à MontréalMontrealQuebecCanada
| | - Mona Loutfy
- Women's College Research InstituteWomen's College HospitalTorontoOntarioCanada
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
- Department of MedicineUniversity of TorontoTorontoOntarioCanada
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195
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Chandan JS, Thomas T, Bradbury-Jones C, Taylor J, Bandyopadhyay S, Nirantharakumar K. Intimate partner violence and temporomandibular joint disorder. J Dent 2019; 82:98-100. [DOI: 10.1016/j.jdent.2019.01.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/20/2019] [Accepted: 01/23/2019] [Indexed: 02/02/2023] Open
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196
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Musa A, Chojenta C, Geleto A, Loxton D. The associations between intimate partner violence and maternal health care service utilization: a systematic review and meta-analysis. BMC WOMENS HEALTH 2019; 19:36. [PMID: 30808353 PMCID: PMC6390526 DOI: 10.1186/s12905-019-0735-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 02/15/2019] [Indexed: 02/02/2023]
Abstract
Background Intimate partner violence exposes women to a wide range of health problems that can either directly or indirectly lead to maternal death. Although in a number of studies intimate partner violence has been associated with inadequate utilization of antenatal care and skilled delivery care, in other studies no association has been found. Therefore, we aimed to comprehensively review the evidence, and quantify the strength and direction of the association between intimate partner violence and utilizing adequate antenatal and skilled delivery care services. Method We systematically searched studies from MEDLINE, Embase, Psych INFO, CINAHL, and Maternity and Infant Care. Two independent reviewers screened the articles for eligibility. Quality and risk of bias in the articles were evaluated by using the Newcastle-Ottawa scale for observational studies. Pooled odds ratios and 95% confidence intervals were computed to estimate the association of intimate partner violence and antenatal care, and skilled delivery care. Random-effects models were used to allow for the significant heterogeneity that might possibly be found between studies. The degree of heterogeneity was expressed by using the I2 statistic. Results The meta-analyses have shown that women who experienced intimate partner violence had 25% decreased odds (AOR = 0.75, 95%CI = 0.61, 0.92) of using adequate antenatal care than those who did not experience IPV. Similarly, women who experienced IPV had 20% decreased odds (AOR = 0.8, 95%CI = 0.69, 0.92) of using skilled delivery care compared to those who did not experience IPV. Conclusion The meta-analyses indicated that experiencing intimate partner violence is associated with a lower likelihood of receiving adequate antenatal care and skilled delivery care. Both community-based and facility-based interventions that target the reduction of partner violence, and strictly implementing proven health facility-based counselling interventions, could aid in improving utilization of maternal health care services. Electronic supplementary material The online version of this article (10.1186/s12905-019-0735-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Abdulbasit Musa
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia. .,Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia.
| | - Catherine Chojenta
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
| | - Ayele Geleto
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.,Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
| | - Deborah Loxton
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
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Wyatt T, McClelland ML, Spangaro J. Readiness of newly licensed associated degree registered nurses to screen for domestic violence. Nurse Educ Pract 2019; 35:75-82. [DOI: 10.1016/j.nepr.2018.12.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 11/09/2018] [Accepted: 12/29/2018] [Indexed: 11/28/2022]
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Exposure to domestic violence and abuse and consultations for emergency contraception: nested case-control study in a UK primary care dataset. Br J Gen Pract 2018; 69:e199-e207. [PMID: 30510095 PMCID: PMC6400602 DOI: 10.3399/bjgp18x700277] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 09/20/2018] [Indexed: 01/24/2023] Open
Abstract
Background Evidence of an association between exposure to domestic violence and abuse (DVA) and use of emergency contraception (EC) is lacking in the UK. Aim To quantify the association between exposure to DVA and consultations for EC in general practice. Design and setting Nested case-control study in UK general practice. Method Using the Clinical Practice Research Datalink, the authors identified all women all women aged 15–49 years registered with a GP between 1 January 2011 and 31 December 2016. Cases with consultations for EC (n = 43 570) were each matched on age and GP against four controls with no consultations for EC (n = 174 280). The authors calculated odds ratios (ORs) and 95% confidence intervals (CIs) for the association between exposure to DVA in the previous year and consultations for EC. Covariates included age, ethnicity, socioeconomic status, pregnancy, children, alcohol misuse, and depression. Results Women exposed to DVA were 2.06 times more likely to have a consultation for EC than unexposed women (95% CI = 1.64 to 2.61). Women aged 25–39 years with exposure to DVA were 2.8 times more likely to have a consultation for EC, compared with unexposed women (95% CI = 2.08 to 3.75). The authors found some evidence of an independent effect of exposure to DVA on the number of consultations for EC (OR 1.48, 95% CI = 0.99 to 2.21). Conclusion A request for EC in general practice can indicate possible exposure to DVA. Primary care consultation for EC is a relevant context for identifying and responding to DVA as recommended by the World Health Organization and National Institute for Health and Care Excellence guidelines. DVA training for providers of EC should include this new evidence.
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