Intimate partner violence against women in Spain: A medico-legal and criminological study

Judicial Actors' Understanding of the Mental Health Impacts of Intimate Partner Violence: A Scoping Review

Intimate partner violence (IPV) is a global public health issue that has grave physical and mental health consequences for millions of women. The judicial system plays a critical role in responding to IPV principally through the criminal justice system, family law, and/or child welfare jurisdictions. However, victims/survivors who interact with the legal system report negative experiences. An under-researched area of scholarship is the degree to which judicial actors understand the mental health impacts of IPV on victims/survivors and how they apply that knowledge in practice. This scoping review aimed to identify and synthesize existing scholarship on judicial actors' understanding of the mental health impacts of IPV on women survivors. We searched 10 databases (Medline, Scopus, PubMed, PsycINFO, EMBASE, Westlaw, HeinOnline, the Cochrane Library, and the Joanna Briggs Library databases) for studies published between 2000 and 2023. A total of 27 studies were included in the review. We identified five main themes, including: awareness of survivors' experiences, gap in judicial actors' knowledge, understanding of perpetrator tactics and risk factors, disclosing mental health problems, training, and guidance. The review highlights significant gaps in judicial actors' understanding of this issue and recommends strategies to increase the awareness and understanding of IPV among judicial actors. The findings can be used to justify future research to better understand the training and development needs of judicial actors to improve their level of awareness of the dynamics and impact of IPV and to make policy and practice recommendations to build the capacity of the judicial workforce.

Fracture variation in survivable versus fatal blunt force trauma associated with intimate partner violence

Intimate partner violence (IPV) is a global human rights issue that affects approximately 25% of women and 10% of men and is the leading cause of homicides of women worldwide. Multiple interventional studies have been conducted to screen for IPV; however, fractures associated with intimate partner homicide (IPH) have not been studied from a forensic anthropological perspective. Therefore, this study uses computed tomography scans of IPH victims (n=33) obtained from the New Mexico Office of the Medical Investigator to 1) classify and quantify perimortem craniofacial blunt force fractures, and 2) compare the IPH-related fractures to those associated with non-lethal IPV using previously published studies. The results indicate that IPH cases presented similarly to non-lethal IPV cases in that they were concentrated on the middle and lower face, but fractures were more frequent in the upper face and cranial vault in IPH cases. While IPH cases showed more fractures, they were not necessarily associated with extensive fracturing, as 75.8% of IPH victims had five or fewer fractures-the most common being comminuted and linear fractures, comprising 93.8% of IPH-related fractures. As IPV is significantly underreported, understanding the nuances of fracture patterns associated with IPH can help to aid holistic forensic investigations.

Analysis of the descriptive characteristics of female victims of violence applying to the domestic violence office of a court of law

INTRODUCTION AND PURPOSE

Intimate partner violence is a worldwide problem violating fundamental human rights. The aim of this study was to analyse the sociodemographic characteristics of women who have experienced intimate partner violence, the type and prevalence of violence, the mechanisms of injury as determined by forensic reports, the characteristics of the perpetrator, and the women's statements.

MATERIALS AND METHODS

This was a single-site descriptive study conducted at the Office of Domestic Violence and Violence Against Women of a Court of Law located in the city of Izmir in western Turkey. The researchers reviewed forensic medicine case reports and prosecutorial writs in this office's files for women over 18 who had experienced violence over the period 2016-2019. The study sample consisted of the judicial application files of women who had experienced intimate partner violence and met the inclusion criteria (n = 350). The data in the files were entered into a standard form prepared by the researchers according to the file content. Written permission was obtained from the Ministry of Justice and Ege University Ethics Committee, and the verbal consent of the Prosecuting Officer was also obtained for the research.

RESULTS

The ages of the women ranged from 19 to 80 years (mean age 35, SD 9.6), with 43.1% ranging from 30 to 39 years old. Of the women, 46.6% had a maximum primary school education, and 65.4% were homemakers. Incidents of intimate partner violence mainly occurred at home for 89.1% of women. A combination of verbal and physical violence was the most frequent form of violence affecting 303 women (83.4% of cases). The facial area was predominantly the target of attack for 59 (16.9%) victims, only the upper extremity for 55 (15.7%) and the face and upper extremity for 36 (10.2%) women. The statements of the victims of violence who described their experience were evaluated, and it was determined that the reasons for the emergence of violence were frequently alcohol and substance use, financial problems, jealousy, sexual problems, communication problems, and cheating.

CONCLUSION AND SUGGESTIONS

Most of the women in the study who had applied to law enforcement due to intimate partner violence were victims of physical violence. The descriptive information obtained from these files constitutes essential data for health professionals in their efforts to deliver primary healthcare to women who are victims of intimate partner violence. Health professionals can provide immediate protection by identifying women at high risk of violence, monitoring them more frequently, and activating the support mechanisms they need.

Oral and maxillofacial trauma in women assaulted by men: Systematic review and meta-analysis

BACKGROUND

Violence against women represents an urgent public health problem and has been an increasingly important topic in society's discussions and concerns. Although studies report a high prevalence of injuries to the face and head of women victims of intentional violence, this physical damage has never been investigated by grouped studies. Thus, the objective of this systematic review was to research the characteristics and the overall prevalence of oral-maxillofacial trauma in women victims of physical violence caused by men.

METHODS

Searches were carried out on Medline (via PubMed) and Lilacs (via Virtual Health Library) and on gray literature until June 16, 2020 (updated on February 12, 2021) without restriction on the year of publication or language.

RESULTS

A total of 27 studies involving 9,318 women victims of aggression by men and 3,738 oral-maxillofacial traumas were included. The prevalence of oral-maxillofacial trauma among all injuries in women was 51% (95% CI 28% - 74%). There was no significant difference in the chance of occurrence between soft tissue injuries (bruises, lacerations, abrasions, edema, erythema, and epistaxis) and hard tissue injuries (OR: 1.44, 95% CI: 0.43 - 4.80). The relationship between the victims and the aggressors was mainly that of intimate partners and relatives.

CONCLUSIONS

These results highlight the need for political and ethical reflection to prevent oral-maxillofacial trauma and ensure women's health and human rights.

Perceptions of Gender Violence in Spanish Adolescents

BACKGROUND

Gender violence among adolescents is a global problem. In the context of public healthcare, nursing professionals play an important role.

OBJECTIVE

The aim of this study was to determine awareness, information, and beliefs regarding gender violence in adolescents and identify their educational needs.

PARTICIPANTS AND SETTING

Data from a study conducted by the Spanish Centre for Sociological Research and the Government Office for Gender Violence in 2013 are used. The sample contained 698 adolescents aged 15-19 years.

METHODS

This is a secondary analysis of a data survey. Strengthening the Reporting of Observational Studies in Epidemiology guidelines are followed. Sociodemographic variables and seven topics of interest were analyzed: gender inequality, intimate relationships, definition of abuse, identification of abuse, awareness of cases of abuse in women, and informal and formal support networks.

RESULTS

The results show that adolescents are well informed, are aware of informal and formal support networks, use the word "respect," identify abuse and consider it unacceptable, and believe media coverage is useful in giving visibility to gender violence. No significant differences were found in gender, social class, or education, and their idea of romantic love remains intact.

CONCLUSIONS

The researchers conclude that, in Spain, adolescents' awareness of gender violence is strongly influenced by environmental and cultural factors, because of the prevalence of gender and intimate partner violence in the country. Formal interventions such as health education provided by either nursing professionals in schools or the broader community can have a positive effect on adolescent health. Primary care nurses should use these findings to support the development of health promotion programs for young adults.

Experience of Vulnerable Women Narrated through the Body-Mapping Technique

Vulnerable women are considered a priority in public policies and research agendas. It is necessary to understand better the specificities of their daily lives and the meanings they attribute to their experiences, as this undoubtedly contributes to more grounded and culturally appropriate practices. Additionally, innovative techniques in qualitative research are demanded in academia. This narrative research study was carried out with fourteen women from a Brazilian socioeconomically vulnerable neighborhood. We used the body-mapping technique to investigate the experiences of women with mental health disorders or psychosocial distress. The aim was to analyze the self-perception about daily stressors and discuss the feasibility of this technique to facilitate this group’s storytelling. Data collection was performed through focus groups, guided by the body-mapping technique steps, and supplemented with individual interviews. Interpersonal conflicts and violence were the main stressors. These strongly impacted the well-being of these women and their children. Some important personal qualities and resilience were identified. Body-mapping played a fundamental role in facilitating storytelling. It amplified the linguistic possibilities for participants to express their feelings and promoted reflections about the present, past, and glimpses into the future.

Intimate partner violence against women. Does violence decrease after the entry of the alleged offender into the criminal justice system?

Intimate partner violence (IPV) is simultaneously assumed as a serious crime and a major public health issue, having recurrences as one of its main characteristics and, consequently, re-entries of some alleged offenders in the criminal justice system (CJS). The main goal of this study is to assess if in cases of female victims of IPV, violence decreases after the first entry of the alleged offender in the CJS. A retrospective study was performed based on the analysis of police reports of alleged cases of IPV during a 4-year period. The final sample (n = 1 488) was divided into two groups according to the number of entries in the CJS (single or multiple) followed by a comparative approach. Results suggest that violence decreases after the first entry of alleged offenders in the CJS. Re-entries were found in only 15.5% of the cases but they were accountable for 3.3 times more crimes on average. Besides, victims of recidivism presented more injuries and required more medical care. Thus, a small group of alleged offenders seems to be more violent and accountable for most of the IPV crimes registered in the CJS suggesting that regardless of legal sanctions aiming to deter violence, these measures may not be enough for a certain group of offenders. This study sustains the need for a predictive model to quantify the risk of repeated IPV cases within the Portuguese population.

Violence against women in heterosexual couples: A review of psychological and medico-legal considerations

Intimate partner violence against women (IPVAW) is the most pervasive violation of women's rights worldwide, causing devastating lifelong damage. Victims can suffer physical, emotional or mental health problems, and experience detrimental effects in social, psychological and relational health with their families, especially children. Due to the complexity regarding violence against women in heterosexual couples, it is important to make a clear distinction between psychological and physical mistreatment, which also includes psychological violence. This differentiation is important in determining different emotional and psychological aspects of mistreatment in order to understand the reasons why some women stay in such relationships and to explain the personality profiles of victims and perpetrators. In this short narrative review, we have combined perspectives of depth psychology and attachment theory from studies on trauma, traumatic bonds and the perpetrator/victim complex in gender violence. We have also considered the growing literature on IPVAW as it relates to the medico-legal field. Our search strategy included intimate partner violence, attachment styles, risk factors and the victim/perpetrator relationship. Distinguishing the different types of IPVAW is a necessary step in understanding the complexity, causes, correlations and consequences of this issue. Above all, it enables the implementation of effective prevention and intervention strategies.

Maxillofacial and dental-related injuries from a Brazilian forensic science institute: Victims and perpetrators characteristics and associated risk factors

Background

Trauma due to external causes represents one of the greatest challenges for public health services in different regions around the world. This study aimed to determine the prevalence of facial trauma, associated risk factors, and classification of body injuries in individuals who underwent forensic examination in a Brazilian center.

Material and Methods

Data were collected at the Ceará State Forensic Medicine unit in a 12-year period. Sociodemographic data related to the etiological agent and lesions resulting from the bodily injury were recorded.

Results

Among 1,031 physical injury exams, physical aggression (p<0.001), male victims aged between 21 and 30 years (p<0.001), salaried workers (p<0.001), and soft tissue and dentoalveolar injuries were significant findings. Regarding aggression, domestic violence was prevalent (p<0.001), perpetrated by the victim's partner (p<0.001), using a blunt instrument during the aggression (p<0.001), and directly associated with soft tissue injury (p<0.001). In traffic accidents, the most common type was motorcycle accident (p<0.001), on weekdays (p=0.036), at nighttime (p=0.134), showing a significant association with bone fractures (p=0.001).

Conclusions

Oral and maxillofacial injuries obtained from a Brazilian forensic science center were significantly associated with sociodemographic and etiological factors. Key words:Forensic dentistry, facial trauma, violence, public health.

Intimate partner violence (IPV) types are common among Turkish women from high socioeconomic status and have differing effects on child abuse and contentment with life

OBJECTIVE

Intimate partner violence (IPV) against women is an important public health problem. In this study, we aimed to investigate the exposure of IPV types, child abuse and decrease in life contentment of married women from high socioeconomic status in Turkey.

METHODS

Data were collected using an online/written questionnaire and Contentment with Life Scale. The questionnaire included definitions of physical, emotional, economic and sexual IPV and asked how many times they experienced these types of abuse.

RESULTS

We found that physical, emotional, economic and sexual IPV exposure were 19%, 45.2%, 12.5%, and 6%, respectively, which suggest that IPV types were common in this group, too. Physical child abuse was higher among physical and emotional IPV victims (p=0004, p=0.02, respectively), while emotional child abuse was higher only among physical IPV victims (p=0.01). On the other hand, exposure to economic and sexual IPV was not related to any type of child abuse in this sample (p>0.05). Physical and economic IPV victims were statistically older (p=0.004, p<0.001, respectively), married for longer time (p<0.001 for both) and had relatively lower education level (p<0.001 for both), while sexual IPV victims had lower education level than non-victims (p=0.03). We demonstrated that physical-emotional and sexual intramarital IPV significantly reduce the women's contentment with life scores when compared with non-victims (p=0.02, p<0.001 and p=0.03, respectively).

CONCLUSION

IPV exposure is also severe among married women with high socioeconomic levels and is associated with child abuse in the family and a decrease in life contentment. Lengthened education period among women with similar socioeconomic levels may be an additional protective factor for IPV by delaying the age of marriage and increasing the individual income.

Health Professionals Who Suffer Intimate Partner Violence: A Descriptive, Multicenter, and Cross-Sectional Study

OBJECTIVE

The purpose of this study was to know who are the people who assist women, who work as a health professional in the Spanish Public Health System, when they suffer intimate partner violence (IPV).

METHODS

A descriptive, cross-sectional, multicenter study was conducted. The participants were female health professionals (N = 794) working within the Spanish Public Health System. The instrument used was Delgado, Aguar, Castellano, and Luna del Castillo's (2006) scale to measure ill-treatment of women.

RESULTS

Two hundred seventy women suffered IPV (34%). Of the female health professionals who suffered IPV, 25.9% had spoken with someone about the violence, most commonly talking to trusted people (24.3%), a psychologist (24.3%), health professionals (20%), and others (20%). Married female health professionals living with their current or last partner/husband, residing in an urban area, and with their own salary were least likely to speak about their problem.

CONCLUSION

Female health professionals who suffer IPV usually speak about this problem with trusted people instead of consulting a health professional, which may leave the problem in the private sphere. This can be because of victims not wanting to report the violence for fear of their intimate partner or wanting it to remain private. This may deprive the victims of the help they need. For this reason, the health services should establish screening for IPV not only for their patients but also for their workers.

Imaging of Violence Against the Elderly and the Women

Emergency department assessment is a critical opportunity to identify elder abuse and violence against women, which represent a growing problem, requiring the attention of health care systems. Elder abuse is most frequently perpetrated by family members because of the higher levels of stress, burnout, and financial problems affecting the caregivers that can even lead to deadly consequences. Intimate partner violence is defined as physical, sexual, or psychological harm caused to another by a current or former partner or spouse, and can range from a single acute hit to chronic battering, varying in frequency and severity. Radiologists have a critical role in detecting those injury findings suggestive of abuse and violence. When appropriate, additional information about the social circumstances in which an injury took place, linked with imaging findings, may also be helpful in diagnosing abuse. The purpose of this article is to highlight the role of diagnostic imaging in the detection of lesions compatible with domestic abuse in elderly patients and women, and to allow the recognition of the alterations most frequently associated with this type of violence.

Underage victims and perpetrators of murder in Italy: 2007-2015

From the epidemiological and criminological points of view, murders committed by minors, including both victims and perpetrators, differ from those observed in adults. Analysis of trends and characteristics of murders at national level could provide useful information to assess the phenomenon and address political and social choices aiming at preventing violence involving children and adolescents. This study focuses on the trends of murders in Italy during the period 2007-2015 and compares the data with those for other age groups. Data on murders regarding trends, gender, age and ethnic group from the Italian Institute of Statistics were analysed by chi-square with odds ratio and linear regression. Results show that, after standardization, murders involving minors as victims and perpetrators were less frequent with respect to data observed in all age groups. Trend analysis showed that murders involving minors remained stable in the period considered, but the stability of the rate of murders of minors was in contrast with reduced rates in other age groups. Among minors, males aged 14-17 are at higher risk of being the perpetrators and victims of homicide. The rate of perpetrators and victims among foreign-born minors was higher than that among the native-born. Further studies are needed to determine risk factors associated with these results and to propose preventive strategies through appropriate policies and interventions.

Violence committed by intimate partners of physicians, nurses and nursing assistants

AIM

To estimate the prevalence of intimate partner abuse in physicians, nurses and nursing assistants and risk factors in the Spanish Health Service.

BACKGROUND

In Spain, the national public health service is the most likely point of primary care access for victims of intimate partner violence. However, health professionals are also victims of violence by their intimate partner. Little research has been undertaken exploring the prevalence and risk factors of this abuse in health professionals.

METHODS

A cross-sectional multicenter study in professionals of both sexes who were working in the Spanish Public Health Service was performed. The health professionals completed an online survey of intimate violence abuse: for women, the screening of abuse against women by an intimate partner, and for men, the domestic violence screening tool in a family setting. A descriptive and comparative analysis was performed.

RESULTS

The sample consisted of 1071 professionals: 49.9% were physicians, 46.9% were nurses and 3.3% were nursing assistants. Of the participants, 26.6% had experienced some form of abuse, and 73.3% of the abused professionals had not spoken of their experience of abuse with anyone else.

CONCLUSION

Men experienced a lower incidence of intimate partner violence than women. In fact, 34% of the female participants were in an abusive relationship, which is a higher percentage than that observed in studies of the general Spanish female population (11.7%). It appears that being female and a nurse are risk factors for abuse.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

These data suggest the urgent implementation of action plans for the provision of support for the victims and for interventions aimed at reducing the problem. Better training and awareness-raising programmes that improve the detection of intimate partner violence and the care of its victims are also necessary.

Role of forensic medicine in evaluating non-fatal physical violence against women by their husbands in Jordan

OBJECTIVE

Intimate partner violence against women is a major health problem in most nations, but to date, there has been little awareness of the extent or seriousness of this issue in Jordan. Forensic medical practitioners play a significant role in diagnosing, evaluating and reporting these cases. The Jordanian judicial system is dependent on forensic reports. This study aims to assess the role of forensic medicine in evaluating the physical injuries sustained by women who are abused by their husbands.

METHOD

A retrospective review of 158 forensic reports of Jordanian women alleging assault by their husbands and who were seen at Jordan University Hospital over the period 2010-2015.

RESULTS

Of the 158 women who presented, 87 had multiple injuries. The majority of injuries were soft tissue injuries, but others included fractures, tympanic membrane perforation, burns and neck contusions. Twelve women were pregnant at the time of the assessment. The period of incapacity caused by these injuries (an important factor for the Jordanian judicial system) was between 1 and 14 days.

CONCLUSION

Intimate partner violence can present with a range of injuries from relatively minor to potentially disabling or life threatening. Forensic medicine has a role in documenting and evaluating these injuries and advising the judicial system in these cases. These are all key elements in increasing the awareness of the nature and extent of this behavior and its impact on women (and men) and the wider society.

Domestic Violence Against Women In Turkey: A Systematic Review And Meta Analysis

AIM

This study was performed to determine the prevalence of and risk factors for domestic violence against women in Turkey.

BACKGROUND

The data about domestic violence against women point out a serious problem all around the world along with including cultural differences.

DESIGN

The prevalence of domestic violence against women was determined through a meta-analysis, and the risk factors were determined through a systematic review. A systematic search of eight electronic databases was conducted. In this study, 34 primary studies that were published between January 2000 and January 2015 were examined.

RESULTS

The highest prevalence belonged to verbal violence followed by physical, emotional, economic, and sexual violence. Despite different questioning methods, it was determined that 22 risk factors were most commonly examined in the studies, and these risk factors were summed up under three separate categories: socio demographical characteristics, well-being related characteristics and marriage related characteristics. It is of further interest that the most commonly examined characteristics were socio demographic characteristics.

CONCLUSION

Just as throughout the world, domestic violence is a common problem in Turkey.

RELEVANCE TO CLINICAL PRACTICE

Nurses and midwives should focus not only on women's disorders but also on the difficulties the patient faces in regard to being a family. It presents valid evidence to produce policies on violence prevention.