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Rojczyk P, Heller C, Seitz-Holland J, Kaufmann E, Sydnor VJ, Berger L, Pankatz L, Rathi Y, Bouix S, Pasternak O, Salat D, Hinds SR, Esopenko C, Fortier CB, Milberg WP, Shenton ME, Koerte IK. Intimate partner violence perpetration among veterans: associations with neuropsychiatric symptoms and limbic microstructure. Front Neurol 2024; 15:1360424. [PMID: 38882690 PMCID: PMC11178105 DOI: 10.3389/fneur.2024.1360424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 05/03/2024] [Indexed: 06/18/2024] Open
Abstract
Background Intimate partner violence (IPV) perpetration is highly prevalent among veterans. Suggested risk factors of IPV perpetration include combat exposure, post-traumatic stress disorder (PTSD), depression, alcohol use, and mild traumatic brain injury (mTBI). While the underlying brain pathophysiological characteristics associated with IPV perpetration remain largely unknown, previous studies have linked aggression and violence to alterations of the limbic system. Here, we investigate whether IPV perpetration is associated with limbic microstructural abnormalities in military veterans. Further, we test the effect of potential risk factors (i.e., PTSD, depression, substance use disorder, mTBI, and war zone-related stress) on the prevalence of IPV perpetration. Methods Structural and diffusion-weighted magnetic resonance imaging (dMRI) data were acquired from 49 male veterans of the Iraq and Afghanistan wars (Operation Enduring Freedom/Operation Iraqi Freedom; OEF/OIF) of the Translational Research Center for TBI and Stress Disorders (TRACTS) study. IPV perpetration was assessed using the psychological aggression and physical assault sub-scales of the Revised Conflict Tactics Scales (CTS2). Odds ratios were calculated to assess the likelihood of IPV perpetration in veterans with either of the following diagnoses: PTSD, depression, substance use disorder, or mTBI. Fractional anisotropy tissue (FA) measures were calculated for limbic gray matter structures (amygdala-hippocampus complex, cingulate, parahippocampal gyrus, entorhinal cortex). Partial correlations were calculated between IPV perpetration, neuropsychiatric symptoms, and FA. Results Veterans with a diagnosis of PTSD, depression, substance use disorder, or mTBI had higher odds of perpetrating IPV. Greater war zone-related stress, and symptom severity of PTSD, depression, and mTBI were significantly associated with IPV perpetration. CTS2 (psychological aggression), a measure of IPV perpetration, was associated with higher FA in the right amygdala-hippocampus complex (r = 0.400, p = 0.005). Conclusion Veterans with psychiatric disorders and/or mTBI exhibit higher odds of engaging in IPV perpetration. Further, the more severe the symptoms of PTSD, depression, or TBI, and the greater the war zone-related stress, the greater the frequency of IPV perpetration. Moreover, we report a significant association between psychological aggression against an intimate partner and microstructural alterations in the right amygdala-hippocampus complex. These findings suggest the possibility of a structural brain correlate underlying IPV perpetration that requires further research.
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Affiliation(s)
- Philine Rojczyk
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Carina Heller
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
- Department of Clinical Psychology, Friedrich Schiller University Jena, Jena, Germany
- German Center for Mental Health (DZPG), Halle-Jena-Magdeburg, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits underlying Mental Health (C-I-R-C), Halle-Jena-Magdeburg, Germany
| | - Johanna Seitz-Holland
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Elisabeth Kaufmann
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
- Department of Neurology, Ludwig-Maximilians-University, Munich, Germany
| | - Valerie J Sydnor
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
| | - Luisa Berger
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Lara Pankatz
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Yogesh Rathi
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Sylvain Bouix
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- Department of Software Engineering and IT, École de technologie supérieure, Montreal, QC, Canada
| | - Ofer Pasternak
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - David Salat
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, United States
- Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, MA, United States
- Massachusetts General Hospital Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA, United States
| | - Sidney R Hinds
- Department of Radiology and Neurology, Uniformed Services University, Bethesda, MD, United States
| | - Carrie Esopenko
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Catherine B Fortier
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - William P Milberg
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, United States
- Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Inga K Koerte
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- Graduate School of Systemic Neuroscience, Ludwig-Maximilians-University, Munich, Germany
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2
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Flanagan JC, Hogan JN, Massa AA, Jarnecke AM. Examining the role of posttraumatic stress disorder symptoms in intimate partner violence among couples with alcohol use disorder. Aggress Behav 2024; 50:e22137. [PMID: 38358256 PMCID: PMC10871553 DOI: 10.1002/ab.22137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/16/2024]
Abstract
Separate literatures indicate that both alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD) are robust risk factors for using intimate partner violence (IPV). Despite the strength of these relative literatures, and the common co-occurrence of AUD and PTSD, their combined effects on IPV have rarely been examined. This study begins to address this gap by exploring the moderating effects of provisional PTSD diagnosis on the relation between heavy alcohol consumption and physical IPV using a multilevel modeling approach. Participants were adult romantic couples (N = 100) with current AUD and a history of physical IPV in their relationship. Results from the between-couple comparison indicate that couples who reported more heavy drinking days also experienced more physical IPV when at least one partner had probable PTSD. However, the within-couple comparison indicated that among partners without a provisional PTSD diagnosis, those with fewer heavy drinking days compared to their partner also reported more physical IPV perpetration. These preliminary and exploratory findings require replication and extension but provide new and important information regarding the complex intersection of heavy drinking, PTSD, and IPV among couples with AUD.
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Affiliation(s)
- Julianne C. Flanagan
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina
| | - Jasara N. Hogan
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Andrea A. Massa
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina
| | - Amber M. Jarnecke
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
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3
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White SJ, Sin J, Sweeney A, Salisbury T, Wahlich C, Montesinos Guevara CM, Gillard S, Brett E, Allwright L, Iqbal N, Khan A, Perot C, Marks J, Mantovani N. Global Prevalence and Mental Health Outcomes of Intimate Partner Violence Among Women: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:494-511. [PMID: 36825800 PMCID: PMC10666489 DOI: 10.1177/15248380231155529] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The aim of this systematic review was to assess the magnitude of the association between types of intimate partner violence (IPV) and mental health outcomes and shed light on the large variation in IPV prevalence rates between low- to middle-income countries and high-income countries. The study is a systematic review and meta-analysis. The following databases were searched for this study: Cochrane, MEDLINE, EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and the Applied Social Sciences Index and Abstracts. The inclusion criteria for this study are as follows: quantitative studies published from 2012 to 2020 on IPV exposure in women aged 16+, using validated measures. Random effects meta-analyses and subgroup analysis exploring heterogeneity across population groups in different economic contexts are used in this study. In all, 201 studies were included with 250,599 women, primarily from high-income countries. Higher prevalence rates were reported for women's lifetime IPV than past year IPV. Lifetime psychological violence was the most prevalent form of IPV. Women in the community reported the highest prevalence for physical, psychological, and sexual violence in the past year compared to clinical groups. Perinatal women were most likely to have experienced lifetime physical IPV. Prevalence rates differed significantly (p = .037 to <.001) for "any IPV" and all subtypes by income country level. Meta-analysis suggested increased odds for all mental health outcomes associated with IPV including depression (odds ratio [OR] = 2.04-3.14), posttraumatic stress disorder (PTSD) (OR = 2.15-2.66), and suicidality (OR = 2.17-5.52). Clinical and community populations were exposed to high prevalence of IPV and increased likelihood of depression, PTSD, and suicidality. Future research should seek to understand women's perspectives on service/support responses to IPV to address their mental health needs. Work with IPV survivors should be carried out to develop bespoke services to reduce IPV in groups most at risk such as pregnant and/or help-seeking women.
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Affiliation(s)
| | | | | | | | | | | | | | - Emma Brett
- Anglia Ruskin University ARU, Cambridge, UK
| | | | | | | | - Concetta Perot
- King’s College London, London, UK
- Survivor Panel, London, UK
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4
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Mootz JJ, Spencer CM, Ettelbrick J, Kann B, Fortunato dos Santos P, Palmer M, Stith SM. Risk Markers for Victimization and Perpetration of Male-to-Female Physical Intimate Partner Violence in Sub-Saharan Africa: A Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:3433-3444. [PMID: 36373646 PMCID: PMC10583092 DOI: 10.1177/15248380221129589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Exposure to intimate partner violence (IPV) incurs significant public health consequences. Understanding risk markers can accelerate prevention and response efforts, important in settings like Sub-Saharan Africa (SSA) where resources are scarce. In this study, four databases were searched to identify studies that examined risk markers for male-to-female physical IPV. With application of the socioecological model, we analyzed 11 risk markers for male physical IPV perpetration (with 71 effect sizes) and 16 risk markers for female physical IPV victimization (with 131 effect sizes) in SSA from 51 studies. For male IPV perpetration, we found medium-to-large effect sizes for six risk markers: perpetrating emotional abuse and sexual IPV, witnessing parental IPV, being abused as a child, cohabitating (not married), and exhibiting controlling behaviors. We found small effect sizes for substance use. Employment, age, marital status, and education were not significant risk markers. For female IPV victimization, a medium effect size was found for post-traumatic stress symptoms. Small effect sizes were found for reporting depressive symptoms, being abused as a child, witnessing parental IPV, and reporting drug and alcohol use. Rural residence, approval of violence, length of relationship, income, education, employment, age, marital status, and religiosity were not significant risk markers. Findings highlight opportunities for screening and intervention at the couple level, show the need to test and incorporate interventions for IPV in mental health treatment, and emphasize the importance of further research on sociodemographic risk markers and the interventions that target them.
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Affiliation(s)
- Jennifer J. Mootz
- Columbia University, New York, NY, USA
- New York State Psychiatric Institute, USA
| | | | | | - Bianca Kann
- Columbia University, New York, NY, USA
- New York State Psychiatric Institute, USA
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5
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Lai K, Jameson JT, Russell DW. Prevalence and correlates of destructive behaviors in the US Naval Surface Forces from 2010-2020. BMC Psychol 2023; 11:103. [PMID: 37029407 PMCID: PMC10080869 DOI: 10.1186/s40359-023-01134-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 03/21/2023] [Indexed: 04/09/2023] Open
Abstract
PURPOSE To estimate the prevalence of domestic violence, sexual assault, and suicide for United States Navy (USN) personnel between 2010 and 2020 and identify potential associated factors. METHODS Official report data were used to calculate prevalence rates and odds ratios, accounting for sample and general USN population demographic data to assess differences in over- or underrepresentation of destructive behaviors. RESULTS Domestic violence and sexual assault offenders tended to be younger lower-ranked males. For sexual assaults, offenders were three times more likely to be senior to the victim, which was not the case for domestic violence. Females were overrepresented in terms of suicidal ideation and attempts relative to the USN population, while males accounted for more actual suicides. The relative rates of suicidal ideation and attempts for females exceeded those for males (i.e., comparing the sample rate against the USN male and female populations), but the sample proportion for completed suicides (compared to the USN population) were greater for males than for females. Those in the junior enlisted (E1-E3) paygrades exhibited greater odds of suicide attempts versus suicidal ideations relative to those in the Petty Officers (E4-E6) paygrades, although E4-E6s completed more suicides. CONCLUSION The descriptive profile of destructive behaviors in a representative sample of USN personnel provides an overview of the possible factors associated with destructive behaviors and includes an exploration of the relational dynamics and nature of the incidents. The results suggest that sexual assault and domestic violence are characterized by unique relational dynamics and that these destructive behaviors should not necessarily be classified together as male-oriented aggressions (i.e., mainly perpetrated by males against female victims). Those in the E1-E3 and E4-E6 paygrades displayed different patterns in suicidal ideation, attempts, and actual suicides. The results highlight individual characteristics to help inform the development of targeted policies, practices, and interventions for military and other hierarchical organizations (e.g., police).
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Affiliation(s)
- Kevin Lai
- Leidos, Naval Health Research Center, 329 Ryne Road, San Diego, CA, 92152, USA
| | - Jason T Jameson
- Leidos, Naval Health Research Center, 329 Ryne Road, San Diego, CA, 92152, USA
| | - Dale W Russell
- Commander, Naval Surface Force, U.S. Pacific Fleet, Coronado, CA, USA.
- Department of Psychiatry, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
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6
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Ramsoomar L, Gibbs A, Chirwa ED, Machisa MT, Alangea DO, Addo-Lartey AA, Dunkle K, Jewkes R. Pooled analysis of the association between mental health and violence against women: evidence from five settings in the Global South. BMJ Open 2023; 13:e063730. [PMID: 36921941 PMCID: PMC10030569 DOI: 10.1136/bmjopen-2022-063730] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
OBJECTIVES To describe associations between men's poor mental health (depressive and post-traumatic stress symptomatology) and their perpetration of intimate partner violence (IPV) and non-partner sexual violence (NPSV), and women's mental health and their experiences of IPV and NPSV in five settings in the Global South. DESIGN A pooled analysis of data from baseline interviews with men and women participating in five violence against women and girls prevention intervention evaluations. SETTING Three sub-Saharan African countries (South Africa, Ghana and Rwanda), and one Middle Eastern country, the occupied Palestinian territories. PARTICIPANTS 7021 men and 4525 women 18+ years old from a mix of self-selecting and randomly selected household surveys. MAIN OUTCOME MEASURES All studies measured depression symptomatology using the Centre for Epidemiological Studies-Depression, and the Harvard Trauma Scale for post-traumatic stress disorder (PTSD) symptoms among men and women. IPV and NPSV were measured using items from modified WHO women's health and domestic violence and a UN multicountry study to assess perpetration among men, and experience among women. FINDINGS Overall men's poor mental health was associated with increased odds of perpetrating physical IPV and NPSV. Specifically, men who had more depressive symptoms had increased odds of reporting IPV (adjusted OR (aOR)=2.13; 95%CI 1.58 to 2.87) and NPSV (aOR=1.62; 95% CI 0.97 to 2.71) perpetration compared with those with fewer symptoms. Men reporting PTSD had higher odds of reporting IPV (aOR=1.87; 95% CI 1.44 to 2.43) and NPSV (aOR=2.13; 95% CI 1.49 to 3.05) perpetration compared with those without PTSD. Women who had experienced IPV (aOR=2.53; 95% CI 2.18 to 2.94) and NPSV (aOR=2.65; 95% CI 2.02 to 3.46) had increased odds of experiencing depressive symptoms compared with those who had not. CONCLUSIONS Interventions aimed at preventing IPV and NPSV perpetration and experience must account for the mental health of men as a risk factor, and women's experience.
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Affiliation(s)
- Leane Ramsoomar
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- School of Health Systems and Public Health, University of the Pretoria, Gauteng, South Africa
| | - Andrew Gibbs
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- Department of Psychology, University of Exeter, Exeter, Devon, UK
| | - Esnat D Chirwa
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Mercilene T Machisa
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Deda Ogum Alangea
- Department of Population, Family & Reproductive Health, University of Ghana School of Public Health, Legon, Accra, Ghana
| | - Adolphina Addoley Addo-Lartey
- Department of Population, Family & Reproductive Health, University of Ghana School of Public Health, Legon, Accra, Ghana
| | - Kristin Dunkle
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
| | - Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- School of Health Systems and Public Health, University of the Pretoria, Gauteng, South Africa
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7
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Alves-Costa F, Lane R, Gribble R, Taylor A, Fear NT, MacManus D. Help-seeking for Intimate Partner Violence and Abuse: Experiences of Civilian Partners of UK Military Personnel. JOURNAL OF FAMILY VIOLENCE 2023; 38:509-525. [PMID: 35399200 PMCID: PMC8982908 DOI: 10.1007/s10896-022-00382-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/10/2022] [Indexed: 05/10/2023]
Abstract
There is evidence that Intimate Partner Violence and Abuse (IPVA) is more prevalent among military populations compared with civilian populations. However, there has been limited research into the help-seeking experiences of civilian victim-survivors who have experienced IPVA within relationships with military personnel. This qualitative study aimed to explore the experiences of, and barriers to, help-seeking for IPVA victimisation among civilian partners of military personnel in order to identify strategies to improve the management of IPVA both within the military and civilian sectors. The study adopted a descriptive cross-sectional study design and used qualitative research methods. One-to-one telephone interviews were conducted with civilian victim-survivors (n = 25) between January and August 2018. Interview transcripts were analysed using thematic analysis. Three superordinate themes were derived: (1) Drivers to help-seeking; (2) Barriers to help-seeking; and (3) Experiences of services. The findings indicate difficulties in help-seeking for IPVA among civilian partners of military personnel due to stigma, fear, dependency, poor understanding of IPVA, lack of appropriate and timely support, and a perceived lack of victim support. Difficulties in help-seeking were perceived by participants to be amplified by military culture, public perceptions of the military, military protection of personnel and the lack of coordination between civilian and military judicial services. This study reinforces the need for a military specific Domestic Abuse strategy, identifies vulnerable groups and highlights a need for both increased awareness and understanding of IPVA within civilian and military services in order to provide adequate victim protection.
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Affiliation(s)
- Filipa Alves-Costa
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, Camberwell, London, SE5 8AB UK
| | - Rebecca Lane
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, Camberwell, London, SE5 8AB UK
| | - Rachael Gribble
- King‘s Centre for Military Health Research, King‘s College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ UK
| | - Anna Taylor
- Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB UK
| | - Nicola T Fear
- King‘s Centre for Military Health Research, King‘s College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ UK
| | - Deirdre MacManus
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, Camberwell, London, SE5 8AB UK
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8
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Fovet T, Villa C, Belet B, Carton F, Bauer T, Buyle-Bodin S, D’Hondt F, Bouchard JP. Le psychotraumatisme en milieu pénitentiaire. ANNALES MÉDICO-PSYCHOLOGIQUES, REVUE PSYCHIATRIQUE 2022. [DOI: 10.1016/j.amp.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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9
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Lane R, Gribble R, Alves-Costa F, Taylor A, Howard LM, Fear NT, MacManus D. Intimate Partner Violence and Abuse: A Qualitative Exploration of UK Military Personnel and Civilian Partner Experiences. JOURNAL OF FAMILY VIOLENCE 2022:1-17. [PMID: 36373029 PMCID: PMC9638474 DOI: 10.1007/s10896-022-00446-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/18/2022] [Indexed: 05/25/2023]
Abstract
Purpose The prevalence of Intimate Partner Violence and Abuse (IPVA) perpetration and victimisation has been found to be higher in serving and ex-serving military samples compared to civilians. Despite this, there is a lack of qualitative research exploring the IPVA experiences of couples in which one or both partners are serving or have served in the military. This qualitative study aimed to explore IPVA experiences within the UK military community from the perspective of serving and ex-serving military personnel and civilian partners of UK military personnel. Method One-to-one telephone interviews were conducted with 40 serving and ex-serving military personnel (29 male, 11 female) and 25 female civilian partners. Data was analysed using thematic analysis. Results Four superordinate themes were derived: (1) patterns and directions of IPVA, (2) types of IPVA, (3) perceived drivers of IPVA and (4) perceived impact of IPVA. The findings point to frequent bidirectional abuse in part driven by poor communication and emotion regulation, whilst also highlighting the experiences of severe IPVA victimisation of civilian partners by military personnel motivated by power and control. Perceived drivers of both IPVA perpetration and victimisation include military factors borne of military culture or training, alcohol and mental health difficulties. Conclusion These results highlight the role of cultural norms, as well as the role of emotion dysregulation, poor communication skills and mental health difficulties in explaining and perpetuating abuse within ecological theoretical frameworks of violence among couples within which one or both partners are serving or ex-serving military personnel.
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Affiliation(s)
- Rebecca Lane
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, SE5 8AB Camberwell, London, UK
| | - Rachael Gribble
- King’s Centre for Military Health Research, Weston Education Centre, King’s College London, 10 Cutcombe Road, SE5 9RJ London, UK
| | - Filipa Alves-Costa
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, SE5 8AB Camberwell, London, UK
- Barnet, Enfield & Haringey Mental Health NHS Trust (North London Forensic Service), London, UK
| | - Anna Taylor
- Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, WC1E 7HB London, UK
| | - Louise M Howard
- Section of Women’s Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Dr Crespigny Park, SE5 8AF London, UK
| | - Nicola T Fear
- King’s Centre for Military Health Research, Weston Education Centre, King’s College London, 10 Cutcombe Road, SE5 9RJ London, UK
| | - Deirdre MacManus
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, SE5 8AB Camberwell, London, UK
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10
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MacManus D, Short R, Lane R, Jones M, Hull L, Howard LM, Fear NT. Intimate partner violence and abuse experience and perpetration in UK military personnel compared to a general population cohort: A cross-sectional study. Lancet Reg Health Eur 2022; 20:100448. [PMID: 35813966 PMCID: PMC9256655 DOI: 10.1016/j.lanepe.2022.100448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Research exploring prevalence of, and factors associated with, increased risk of experiencing or perpetrating Intimate Partner Violence and Abuse (IPVA) in military communities is limited. This study aimed to describe IPVA prevalence in a military sample, explore the role of military-specific risk factors, and draw comparisons with a general population cohort. Methods We utilised data from a sample of military personnel participating in a cohort study of the health and wellbeing of UK military personnel who reported having an intimate relationship in the previous 12 months (n = 5557). To allow for comparison with civilian populations, participants from a general population cohort study in England (n = 6075) were matched on age and sex to the military cohort (n = 8093). Findings The 12-month prevalences of IPVA experience and perpetration in the military sample were 12.80% (95% CI 11.72–13.96%) and 9.40% (8.45–10.45%), respectively. Factors associated with both increased IPVA experience and perpetration included childhood adversity, relationship dissatisfaction, military trauma, and recent mental health and alcohol misuse problems. Compared to the civilian cohort, adjusted odds (95% CI) of IPVA experience and perpetration were higher in the military: 2.94 (2.15–4.01) and 3.41 (1.79–6.50), respectively. Interpretation This study found higher prevalences of IPVA experience and perpetration in the military compared to the general population cohort and highlighted both non-military and military factors associated with increased risk of both. Relationship dissatisfaction, military trauma and mental health difficulties mark key areas for IPVA prevention and management efforts to target. Funding Funded by the UK Ministry of Defence and National Institute of Health Research.
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Umukoro OS, Okurame DE. Influence of financial strain on intimate partner violence and the moderating role of employment status among wives in Nigerian military homes. MILITARY PSYCHOLOGY 2022; 35:215-222. [PMID: 37133544 PMCID: PMC10197983 DOI: 10.1080/08995605.2022.2104587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
This study examines the influence of financial strain on intimate partner violence (physical and psychological) experienced by wives of military personnel in Nigeria. The moderating role of employment status was also sought. Data was collected using a structured questionnaire made up of standardized scales with appropriate psychometric properties. Participants of the cross-sectional survey were purposively sampled and comprised 284 female spouses of military personnel in South-Western Nigerian. Results indicated a significant difference in the level of physical [t(282) = 6.775; p < .05] and psychological violence [t(282) = 8.388; p < .05] reported by participants with high and low financial strain. Employment status did not moderate the influence of financial strain on both dimensions of intimate partner violence (β1 = 0.027; p > .05; β2 = 0.052; p > .05) and accounted for an insignificant R2 increase of 0.01% and 0.08%, respectively. The practical implications of findings for intervention and future studies were discussed.
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Cowlishaw S, Freijah I, Kartal D, Sbisa A, Mulligan A, Notarianni M, Couineau AL, Forbes D, O’Donnell M, Phelps A, Iverson KM, Heber A, O’Dwyer C, Smith P, Hosseiny F. Intimate Partner Violence (IPV) in Military and Veteran Populations: A Systematic Review of Population-Based Surveys and Population Screening Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148853. [PMID: 35886702 PMCID: PMC9316917 DOI: 10.3390/ijerph19148853] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/13/2022] [Accepted: 07/14/2022] [Indexed: 12/23/2022]
Abstract
Intimate partner violence (IPV) may be a major concern in military and veteran populations, and the aims of this systematic review were to (1) provide best available estimates of overall prevalence based on studies that are most representative of relevant populations, and (2) contextualise these via examination of IPV types, impacts, and context. An electronic search of PsycINFO, CINHAL, PubMed, and the Cochrane Library databases identified studies utilising population-based designs or population screening strategies to estimate prevalence of IPV perpetration or victimisation reported by active duty (AD) military personnel or veterans. Random effects meta-analyses were used for quantitative analyses and were supplemented by narrative syntheses of heterogeneous data. Thirty-one studies involving 172,790 participants were included in meta-analyses. These indicated around 13% of all AD personnel and veterans reported any recent IPV perpetration, and around 21% reported any recent victimisation. There were higher rates of IPV perpetration in studies of veterans and health service settings, but no discernible differences were found according to gender, era of service, or country of origin. Psychological IPV was the most common form identified, while there were few studies of IPV impacts, or coercive and controlling behaviours. The findings demonstrate that IPV perpetration and victimisation occur commonly among AD personnel and veterans and highlight a strong need for responses across military and veteran-specific settings. However, there are gaps in understanding of impacts and context for IPV, including coercive and controlling behaviours, which are priority considerations for future research and policy.
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Affiliation(s)
- Sean Cowlishaw
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
- Correspondence:
| | - Isabella Freijah
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
| | - Dzenana Kartal
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
| | - Alyssa Sbisa
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
| | - Ashlee Mulligan
- Atlas Institute for Veterans and Families, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, ON K1Z 7K4, Canada; (A.M.); (M.N.); (P.S.); (F.H.)
| | - MaryAnn Notarianni
- Atlas Institute for Veterans and Families, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, ON K1Z 7K4, Canada; (A.M.); (M.N.); (P.S.); (F.H.)
| | - Anne-Laure Couineau
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
| | - David Forbes
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
| | - Meaghan O’Donnell
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
| | - Andrea Phelps
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
| | - Katherine M. Iverson
- Women’s Health Sciences Division, National Center for PTSD, Veterans Affairs Boston Healthcare System, 150 South Huntington Street, Boston, MA 02130, USA;
- Department of Psychiatry, Boston University School of Medicine, 72 E Concord Street, Boston, MA 02118, USA
| | - Alexandra Heber
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8N 3K7, Canada;
- Veterans Affairs Canada, Charlottetown, PE C1A 8M9, Canada
| | - Carol O’Dwyer
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
| | - Patrick Smith
- Atlas Institute for Veterans and Families, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, ON K1Z 7K4, Canada; (A.M.); (M.N.); (P.S.); (F.H.)
| | - Fardous Hosseiny
- Atlas Institute for Veterans and Families, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, ON K1Z 7K4, Canada; (A.M.); (M.N.); (P.S.); (F.H.)
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Adejimi AA, Sekoni OO, Fawole OI. A Comparative Assessment of Intimate Partner Violence Perpetration among Male Military Personnel and Civil Servants in Ibadan, Nigeria. JOURNAL OF FAMILY VIOLENCE 2022; 37:43-448. [PMID: 35342224 PMCID: PMC8954813 DOI: 10.1007/s10896-020-00235-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/14/2020] [Indexed: 06/14/2023]
Abstract
The mode of training and work of the military personnel is different from that of civil servants and may affect their relationships with their intimate partners. This study assessed and compared the prevalence and correlates of self-reported Intimate Partner Violence (IPV) perpetration against female partners by male military personnel and civil servants in Ibadan, south-western Nigeria. A cross sectional survey of 1240 respondents, comprising 631 military personnel and 609 civilians, was conducted using a multistage sampling technique. A self-administered questionnaire was used to collect data on the respondents' characteristics and the different types of IPV perpetrated by them. Chi square test was used to compare the proportions of the different types of IPV perpetration and logistic regression analysis was used to determine the predictors of IPV perpetration in the two study groups. Military personnel reported significantly more IPV such as physical abuse, psychological abuse and controlling behaviors than the civil servants. Childhood exposure to inter-parental IPV and history of physical fight with another woman significantly increased the odds of perpetration of each type and any form of IPV in the two populations after controlling for other variables. Military personnel were significantly more likely to perpetrate any form of IPV than the civil servants. IPV was prevalent in both groups but was more among the military personnel. There is a need for multidisciplinary interventions such as psycho-education and conflict management skills to address violence against female intimate partners especially among the military population in Nigeria.
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Affiliation(s)
- Adebola A. Adejimi
- Department of Community Health and Primary Care, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Lagos, Nigeria
- Department of Community Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria
| | - Olutoyin O. Sekoni
- Department of Community Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria
| | - Olufunmilayo I. Fawole
- Department of Epidemiology and Medical Statistics, University of Ibadan/University College Hospital, Ibadan, Nigeria
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Relationship conflict and partner violence by UK military personnel following return from deployment in Iraq and Afghanistan. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1795-1805. [PMID: 35661897 PMCID: PMC9167453 DOI: 10.1007/s00127-022-02317-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 05/18/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Risk of violence by UK military personnel, both towards non-family and family, has been found to be higher post-deployment. However, no UK research to date has attempted to examine relationship conflict and intimate partner violence (IPV) in this period. This study estimated the prevalence of and risk factors for post-deployment relationship conflict and partner violence in UK military personnel. METHODS We utilised data on military personnel who had deployed to Iraq and/or Afghanistan (n = 5437), drawn from a large cohort study into the health and well-being of UK military personnel. RESULTS 34.7% reported relationship conflict (arguing with partner) and 3.4% reported perpetrating physical IPV post-deployment. Males were more likely than females to report relationship conflict. There were similar rates of self-reported physical IPV perpetration among males and females. Among our male sample, factors associated with both relationship conflict and physical IPV perpetration post-deployment included being in the Army compared with the Royal Air Force, higher levels of childhood adversity, higher levels of military trauma exposure and recent mental health and alcohol misuse problems. Being over 40 at time of deployment (vs being under 25) and having deployed in a combat role were also associated with relationship conflict, but not physical IPV perpetration. CONCLUSIONS Deployment-related variables and mental health and alcohol misuse problems were found to be key factors associated with post-deployment relationship conflict and IPV. Services providing health or welfare support to military personnel must collaborate with mental health services and consider history of deployment, and particularly deployment-related trauma, in their assessments to improve identification and management of intimate partner violence and abuse in military communities.
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Fovet T, Wathelet M, Amad A, Horn M, Belet B, Benradia I, Roelandt JL, Thomas P, Vaiva G, D'Hondt F. Trauma exposure and PTSD among men entering jail: A comparative study with the general population. J Psychiatr Res 2021; 145:205-212. [PMID: 34929470 DOI: 10.1016/j.jpsychires.2021.12.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/27/2021] [Accepted: 12/10/2021] [Indexed: 12/17/2022]
Abstract
Research has consistently shown high levels of post-traumatic stress disorder (PTSD) in correctional settings. We aimed to compare the prevalences of trauma exposure, subthreshold PTSD, and full PTSD in incarcerated people with those observed in the general population. We used the Mini-International Neuropsychiatric Interview to screen for psychiatric disorders among men upon admission to jail (N = 630) and non-incarcerated men living in the same geographic area (the northern district of France; N = 5793). We utilized a multinomial regression model to assess the association between admission to jail and the prevalences of trauma exposure, subthreshold PTSD, and full PTSD. We employed logistic regression models to verify the interaction between admission to jail and PTSD status on the presence of psychiatric comorbidities. Full PTSD was overrepresented among men in jail after adjustment for all covariates (OR [95% CI] = 3.49 [1.55-7.85], p = 0.002). The association between PTSD status and the presence of at least one psychiatric comorbidity was also more important upon admission to jail than in the general population. Admission to jail was not associated with a higher prevalence of trauma exposure (OR [95% CI] = 1.12 [0.85-1.46], p = 0.419) or subthreshold PTSD (OR [95% CI] = 1.17 [0.81-1.68], p = 0.413). These results suggest higher prevalence rates of full PTSD and psychiatric comorbidities associated with PTSD symptoms in incarcerated people than in the general population. The provision of trauma-focused interventions tailored to these clinical specificities should be considered for the jail population.
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Affiliation(s)
- Thomas Fovet
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France.
| | - Marielle Wathelet
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France; Fédération régionale de recherche en psychiatrie et santé mentale, Hauts-de, France
| | - Ali Amad
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Fédération régionale de recherche en psychiatrie et santé mentale, Hauts-de, France
| | - Mathilde Horn
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France
| | - Bettina Belet
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France
| | - Imane Benradia
- EPSM Lille Métropole, Centre Collaborateur de l'Organisation Mondiale de la Santé pour la recherche et la formation en santé mentale, Lille, France
| | - Jean-Luc Roelandt
- EPSM Lille Métropole, Centre Collaborateur de l'Organisation Mondiale de la Santé pour la recherche et la formation en santé mentale, Lille, France; ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France
| | - Pierre Thomas
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Fédération régionale de recherche en psychiatrie et santé mentale, Hauts-de, France
| | - Guillaume Vaiva
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France
| | - Fabien D'Hondt
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France
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Taylor PL, O'Donnell S, Wuest J, Scott-Storey K, Vincent C, Malcom J. The Mental Health Effects of Cumulative Lifetime Violence in Men: Disruptions in the Capacity to Connect with Others and Finding Ways to Reengage. Glob Qual Nurs Res 2021; 8:23333936211021576. [PMID: 34212068 PMCID: PMC8216408 DOI: 10.1177/23333936211021576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 05/11/2021] [Accepted: 05/13/2021] [Indexed: 11/15/2022] Open
Abstract
We report qualitative findings of our Men's Violence Gender and Health Study, a multiple method study using a sequential design in which we explored the mental health manifestations of cumulative lifetime violence in men. Survey results revealed that higher cumulative lifetime violence scores were significantly associated with higher scores on depression, post-traumatic stress disorder, and anxiety in a community sample of men (n = 685) living in Eastern Canada. To obtain a deeper understanding of men's scores, we used an interpretive description approach to analyze data derived from 32 participant interviews. The main mental health manifestation of cumulative lifetime violence is perceptual interference, a sense of being disconnected or detached from others. This is managed by rectifying detachment, a process that includes efforts to gain connections with others. Findings suggest mental health needs in men with cumulative lifetime violence contradict gender role expectations to be stoic. Implications for nurses are explored.
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Affiliation(s)
| | | | - Judith Wuest
- University of New Brunswick, Fredericton, Canada
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Liu N, Cao Y, Qiao H, Ma H, Li J, Luo X, Li CSR, Zhang Y, Zhang N. Traumatic Experiences and PTSD Symptoms in the Chinese Male Intrafamilial Physical Violence Perpetrators: A Comparative and Structural Equation Modeling Study. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:2841-2861. [PMID: 29562817 PMCID: PMC7480215 DOI: 10.1177/0886260518764103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We aimed to compare traumatic experiences among the groups of perpetrators with or without violent pedigree, and establish a structural model of posttraumatic stress disorder (PTSD) symptoms as mediators of traumatic experiences and severe intrafamilial physical violence among Chinese male perpetrators. A cross-sectional survey and a face-to-face interview were conducted to examine intimate partner violence (IPV) perpetration and violent pedigree, childhood maltreatment, other traumatic events, PTSD symptoms, and severe intrafamilial physical violence in a community sample of 229 abusive men and 303 controlled men in China. Using structural equation modeling (SEM) techniques, the scores of the questionnaires were entered into the theoretical model and calculated. Findings demonstrated that the numbers of the traumatic events in four groups were significantly different with a declining trend, and the SEM data had an adequate fit. The loadings of pathways from childhood witness domestic violence (DV) to severe physical violence (SPV) were more salience than other pathways, and the indirect effect of every pathway, except for the childhood witness DV to PTSD symptoms, on severe intrafamilial physical violence in the model was significant. The results suggest that PTSD symptoms cluster as mediator of the intergenerational transmission of SPV perpetration in Chinese abusive men. Childhood witness IPV has effects on adulthood perpetration of IPV.
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Affiliation(s)
- Na Liu
- Department of Medical Psychology, Nanjing Medical University, Affiliated Nanjing Brain Hospital, Nanjing, Jiangsu Province, P.R. China
- Mental Health Institute, Second Xiangya Hospital of Central South University, Changsha, Hunan Province, P.R. China
| | - Yuping Cao
- Mental Health Institute, Second Xiangya Hospital of Central South University, Changsha, Hunan Province, P.R. China
| | - Huifen Qiao
- Department of Medical Psychology, Nanjing Medical University, Affiliated Nanjing Brain Hospital, Nanjing, Jiangsu Province, P.R. China
| | - Hui Ma
- Department of Medical Psychology, Nanjing Medical University, Affiliated Nanjing Brain Hospital, Nanjing, Jiangsu Province, P.R. China
| | - Jijun Li
- Department of Medical Psychology, Nanjing Medical University, Affiliated Nanjing Brain Hospital, Nanjing, Jiangsu Province, P.R. China
| | - Xingguang Luo
- Department of Psychiatry, Yale University School of medicine, New Haven, CT, USA
| | - Chiang-shan Ray Li
- Department of Psychiatry, Yale University School of medicine, New Haven, CT, USA
| | - Yalin Zhang
- Mental Health Institute, Second Xiangya Hospital of Central South University, Changsha, Hunan Province, P.R. China
| | - Ning Zhang
- Department of Medical Psychology, Nanjing Medical University, Affiliated Nanjing Brain Hospital, Nanjing, Jiangsu Province, P.R. China
- Nanjing Neuropsychiatric Institute; Nanjing, Jiangsu Province, P.R. China
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Mental disorders and intimate partner violence perpetrated by men towards women: A Swedish population-based longitudinal study. PLoS Med 2019; 16:e1002995. [PMID: 31846461 PMCID: PMC6917212 DOI: 10.1371/journal.pmed.1002995] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 11/18/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) against women is associated with a wide range of adverse outcomes. Although mental disorders have been linked to an increased risk of perpetrating IPV against women, the direction and magnitude of the association remain uncertain. In a longitudinal design, we examined the association between mental disorders and IPV perpetrated by men towards women in a population-based sample and used sibling comparisons to control for factors shared by siblings, such as genetic and early family environmental factors. METHODS AND FINDINGS Using Swedish nationwide registries, we identified men from 9 diagnostic groups over 1998-2013, with sample sizes ranging from 9,529 with autism to 88,182 with depressive disorder. We matched individuals by age and sex to general population controls (ranging from 186,017 to 1,719,318 controls), and calculated the hazard ratios of IPV against women. We also estimated the hazard ratios of IPV against women in unaffected full siblings (ranging from 4,818 to 37,885 individuals) compared with the population controls. Afterwards, we compared the hazard ratios for individuals with psychiatric diagnoses with those for siblings using the ratio of hazard ratios (RHR). In sensitivity analyses, we examined the contribution of previous IPV against women and common psychiatric comorbidities, substance use disorders and personality disorders. The average follow-up time across diagnoses ranged from 3.4 to 4.8 years. In comparison to general population controls, all psychiatric diagnoses studied except autism were associated with an increased risk of IPV against women in men, with hazard ratios ranging from 1.5 (95% CI 1.3-1.7) to 7.7 (7.2-8.3) (p-values < 0.001). In sibling analyses, we found that men with depressive disorder, anxiety disorder, alcohol use disorder, drug use disorder, attention deficit hyperactivity disorder, and personality disorders had a higher risk of IPV against women than their unaffected siblings, with RHR values ranging from 1.7 (1.3-2.1) to 4.4 (3.7-5.2) (p-values < 0.001). Sensitivity analyses showed higher risk of IPV against women in men when comorbid substance use disorders and personality disorders were present, compared to risk when these comorbidities were absent. In addition, increased IPV risk was also found in those without previous IPV against women. The absolute rates of IPV against women ranged from 0.1% to 2.1% across diagnoses over 3.4 to 4.8 years. Individuals with alcohol use disorders (1.7%, 1,406/82,731) and drug use disorders (2.1%, 1,216/57,901) had the highest rates. Our analyses were restricted to IPV leading to arrest, suggesting that the applicability of our results may be limited to more severe forms of IPV perpetration. CONCLUSIONS Our results indicate that most of the studied mental disorders are associated with an increased risk of perpetrating IPV towards women, and that substance use disorders, as principal or comorbid diagnoses, have the highest absolute and relative risks. The findings support the development of IPV risk identification and prevention services among men with substance use disorders as an approach to reduce the prevalence of IPV.
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Misca G, Forgey MA. The Role of PTSD in Bi-directional Intimate Partner Violence in Military and Veteran Populations: A Research Review. Front Psychol 2017; 8:1394. [PMID: 28861023 PMCID: PMC5559770 DOI: 10.3389/fpsyg.2017.01394] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 07/31/2017] [Indexed: 11/13/2022] Open
Abstract
Evidence supporting the higher prevalence of PTSD linked to combat-related trauma in military personnel and veteran populations is well-established. Consequently, much research has explored the effects that combat related trauma and the subsequent PTSD may have on different aspects of relationship functioning and adjustment. In particular, PTSD in military and veterans has been linked with perpetrating intimate partner violence (IPV). New research and theoretical perspectives suggest that in order to respond effectively to IPV, a more accurate understanding of the direction of the violence experienced within each relationship is critical. In both civilian and military populations, research that has examined the direction of IPV's, bi-directional violence have been found to be highly prevalent. Evidence is also emerging as to how these bi-directional violence differ in relation to severity, motivation, physical and psychological consequences and risk factors. Of particular importance within military IPV research is the need to deepen understanding about the role of PTSD in bi-directional IPV not only as a risk factor for perpetration but also as a vulnerability risk factor for victimization, as findings from recent research suggest. This paper provides a timely, critical review of emergent literature to disentangle what is known about bi-directional IPV patterns in military and veteran populations and the roles that military or veterans' PTSD may play within these patterns. Although, this review aimed to identify global research on the topic, the majority of research meeting the inclusion criteria was from US, with only one study identified from outside, from Canada. Strengths and limitations in the extant research are identified. Directions for future research are proposed with a particular focus on the kinds of instruments and designs needed to better capture the complex interplay of PTSD and bi-directional IPV in military populations and further the development of effective interventions.
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Affiliation(s)
- Gabriela Misca
- Institute of Health and Society, University of WorcesterWorcester, United Kingdom
| | - Mary Ann Forgey
- Graduate School of Social Services, Fordham UniversityNew York, NY, United States
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Joharimoghadam A, Ghoreyshi-Hefzabad SM, Kheirkhah-Sabetghadam S. Comparison of characteristics and outcomes of percutaneous coronary intervention in military and non-military men. J ROY ARMY MED CORPS 2017; 163:288-292. [PMID: 28073825 DOI: 10.1136/jramc-2016-000713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 11/25/2016] [Accepted: 12/01/2016] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Living in a military environment, as a unique job and lifestyle, may affect the physical and mental status of military personnel. Coronary artery disease (CAD) status and outcomes of percutaneous coronary intervention (PCI) in military personnel as a unique part of each society are less investigated. METHOD In a registry-based study, data of 338 military men and 1954 non-military men who underwent successful PCI from March 2012 to March 2013 were analysed. The primary endpoint was major adverse cardiac events (MACE) after hospital discharge during 1-year follow-up. RESULTS Military men were significantly younger and had a higher frequency of hypertension, familial history of CAD and cigarette smoking. Other risk factors were more prevalent in non-military men. PCI for ST-segment elevation myocardial infarction and lower left ventricular ejection fraction were also more prevalent in soldiers. After mean follow-up duration of 12.3 months, MACE that was defined as the composite endpoint of all-cause mortality, non-fatal myocardial infarction or target vessel revascularisation was similar in both groups (HR=1.01 (95% CI 0.88 to 1.16); p=0.872). By adjustment for confounding factors, results were unchanged. CONCLUSIONS Although there are a number of differences in basic and procedural characteristics between military and non-military men who underwent PCI, 1-year clinical outcomes of this procedure are not different in these patient groups.
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Affiliation(s)
- Adel Joharimoghadam
- Cardiology Department, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - S-M Ghoreyshi-Hefzabad
- Cardiology Department, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
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Sparrow K, Kwan J, Howard L, Fear N, MacManus D. Systematic review of mental health disorders and intimate partner violence victimisation among military populations. Soc Psychiatry Psychiatr Epidemiol 2017; 52:1059-1080. [PMID: 28748307 PMCID: PMC5581819 DOI: 10.1007/s00127-017-1423-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Accepted: 07/14/2017] [Indexed: 11/27/2022]
Abstract
PURPOSE There is growing awareness of the problem of intimate partner violence (IPV) among military populations. IPV victimisation has been shown to be associated with mental disorder. A better understanding of the link between IPV and mental disorder is needed to inform service development to meet the needs of military families. We aimed to systematically review the literature on the association between IPV victimisation and mental health disorders among military personnel. METHODS Searches of four electronic databases (Embase, Medline, PsycINFO, and Web of Science) were supplemented by reference list screening. Heterogeneity among studies precluded a meta-analysis. RESULTS Thirteen studies were included. There was stronger evidence for an association between IPV and depression/alcohol problems than between IPV and PTSD. An association between IPV and mental health problems was more frequently found among veterans compared to active duty personnel. However, the link between IPV and alcohol misuse was more consistently found among active duty samples. Finally, among active duty personnel psychological IPV was more consistently associated with depression/alcohol problems than physical/sexual IPV. The review highlighted the lack of research on male IPV victimisation in the military. CONCLUSIONS There is evidence that the burden of mental health need may be significant among military personnel who are victims of IPV. The influence of attitudes towards gender in the military on research in this area is discussed. Further research is needed to inform development of services and policy to reduce IPV victimisation and the mental health consequences among military personnel.
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Affiliation(s)
- Katherine Sparrow
- Forensic and Neurodevelopmental Sciences Department, Institute of Psychiatry Psychology and Neuroscience, King’s College London, PO23, 16 De Crespigny Park, London, SE5 8AF UK
| | - Jamie Kwan
- Department of Psychological Medicine, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ UK
| | - Louise Howard
- David Goldberg Centre, Institute of Psychiatry Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, London, SE5 8AF UK
| | - Nicola Fear
- King’s Centre for Military Health Research, King’s College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ UK
| | - Deirdre MacManus
- Forensic and Neurodevelopmental Sciences Department, Institute of Psychiatry Psychology and Neuroscience, King's College London, PO23, 16 De Crespigny Park, London, SE5 8AF, UK.
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Diehle J, Brooks SK, Greenberg N. Veterans are not the only ones suffering from posttraumatic stress symptoms: what do we know about dependents' secondary traumatic stress? Soc Psychiatry Psychiatr Epidemiol 2017; 52:35-44. [PMID: 27770173 PMCID: PMC5227001 DOI: 10.1007/s00127-016-1292-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 10/10/2016] [Indexed: 11/10/2022]
Abstract
PURPOSE Previous research has mainly focused on veterans' mental health problems, especially on posttraumatic stress disorder (PTSD). Less is known about the impact that the veteran's experienced potentially traumatic events (PTEs) might have on their significant others. Therefore, we reviewed the scientific literature to find out what is known about the prevalence of secondary traumatic stress (STS) in significant others of veterans. METHODS We systematically searched Pubmed, PsycINFO, Embase, Cochrane Library and PILOTS for relevant articles. This search resulted in 3100 records from which we included 48 articles. RESULTS Two studies that reported on parental PTSD did not find evidence that parents were affected by their offspring's experience. Nine studies that reported on PTSD in mainly adult children of veterans found only scant evidence that children were affected by their parent's experienced PTE. Twenty-seven studies investigated PTSD symptoms in partners of veterans. Here results varied largely between studies with PTSD rates between 0 and 51 %. CONCLUSIONS Overall, we found the strongest evidence of STS in partners of help-seeking veterans with PTSD. The lack of clarity provided by the currently available evidence suggests a pressing need for further work to examine this subject in more detail.
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Affiliation(s)
- Julia Diehle
- King's Centre for Military Health Research, Department of Psychological Medicine, Institute of Psychiatry, King's College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ, UK.
| | | | - Neil Greenberg
- King’s Centre for Military Health Research, Department of Psychological Medicine, Institute of Psychiatry, King’s College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ UK ,Academic Department of Military Mental Health, Department of Psychological Medicine, King’s College London, London, UK
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Posttraumatic Stress and Youth Violence Perpetration: a Population-Based Cross-Sectional Study. Eur Psychiatry 2016; 40:88-95. [DOI: 10.1016/j.eurpsy.2016.08.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 08/23/2016] [Accepted: 08/23/2016] [Indexed: 11/19/2022] Open
Abstract
AbstractBackgroundExposure to trauma was found to increase later violent behaviours in youth but the underlying psychopathological mechanisms are unclear. This study aimed to test whether posttraumatic stress disorder (PTSD) is related to violent behaviours and whether PTSD symptoms mediate the relationship between the number of trauma experiences and violent behaviours in adolescents.MethodThe present study is based on a nationally representative sample of 9th grade students with 3434 boys (mean age = 15.5 years) and 3194 girls (mean age = 15.5 years) in Switzerland. Lifetime exposure to traumatic events and current PTSD were assessed by the use of the University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index (UCLA-RI). Logistic regression was used to assess associations between PTSD and violent behaviours, and structural equation modelling (SEM) was used to examine the meditation effects of PTSD.ResultsPTSD (boys: OR = 7.9; girls: OR = 5.5) was strongly related to violent behaviours. PTSD symptoms partially mediated the association between trauma exposure and violent behaviours in boys but not in girls. PTSD symptoms of dysphoric arousal were positively related to violent behaviours in both genders. Anxious arousal symptoms were negatively related to violent behaviours in boys but not in girls.ConclusionsIn addition to trauma, posttraumatic stress is related to violent outcomes. However, specific symptom clusters of PTSD seem differently related to violent behaviours and they do not fully explain a trauma-violence link. Specific interventions to improve emotion regulation skills may be useful particularly in boys with elevated PTSD dysphoric arousal in order to break up the cycle of violence.
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