The violent matrix: a study of structural, interpersonal, and intrapersonal violence among a sample of poor women

“How Am I Supposed to Act?”: Adapting Bronfenbrenner’s Ecological Systems Theory to Understand the Developmental Impacts of Multiple Forms of Violence

Experiences of and exposures to violence impact older adolescents and young adults in a myriad of ways. While typically conceptualized as interpersonal, other forms of violence, namely, structural and symbolic, can be harmful to development for this population. This study utilized qualitative methodologies, including ethnographic field notes and interviews, to capture the ways in which 12 young persons aged 16 to 20 from Philadelphia experience and conceptualize multiple forms of violence across neighborhood contexts. In total, 85 interviews and over 100 hours of field observations were conducted and analyzed using thematic analysis. Findings from this study demonstrate that multiple forms of violence are experienced and impact how young adults make meaning of their life experiences. Importantly, our study explores how these forms of violence occur in tandem across contexts. Whereby, aspects of young adult development and well-being are shaped by violence across the micro, meso, and macro systems with which they interact. Implications of this work include adapting Bronfenbrenner’s Ecological Systems Theory to include multiple forms of violence so that practitioners and researchers can better understand how forms of violence are enacted and the associated impacts on young adults.

The Role of Middle School Sports Involvement in Understanding High School Sexual Violence Perpetration

A number of studies have examined the association between male involvement in sports and sexual violence (SV) perpetration, especially among college-age males. Less is known about the association between sports involvement and SV perpetration for adolescent males and females. To address this gap, the current study examined sports involvement in middle school (no sports, no/low contact, and high contact) among 1,561 students, who were then followed into high school and asked about the frequency of SV perpetration. Results from logistic regression models indicated that, even after controlling for mother's education, race/ethnicity, SV perpetration in middle school, and traditional beliefs about masculinity and substance use, middle school sports participation was significantly associated with risk of SV perpetration in high school. Compared with youth who reported no sports involvement in middle school, youth categorized as no/low contact sports involvement had greater odds of SV perpetration in high school. Sex differences emerged, revealing that no/low contact sports involvement was associated with SV perpetration for females and high contact sports involvement was associated with SV perpetration for males, compared with no sports involvement. These findings suggest potential opportunities to intervene in middle school to improve coaching practices, enhance respectful relationships, and modify athletes' norms, attitudes, and behaviors to reduce risk for SV perpetration in high school.

"Did I see what I really saw?" Violence, percepticide, and dangerous seeing after an Immigration and Customs Enforcement raid

We use a violence framework to describe an Immigration and Customs Enforcement (ICE) raid, and the subsequent cultural and structural violence that played out in one community after the raid. First, we focus on testimonies given about the ICE raids at two city council meetings, compared with how the raids were characterized in the local paper. We document cultural and structural violence in the newspaper reporting, through ideology and narratives (as forms of cultural violence) and percepticide (as a form of structural violence). We then analyze the process undertaken by 9-12-year-old youth researchers to construct a problem definition, and the script they wrote to explain the problem. We describe the "dangerous seeing" they engaged in to decode fictions about violence and create a rupture for solidarity and social action. Finally, we examine how elementary school leadership responded to these youth. Through fieldnotes, we document the cultural violence (via the control of public space) and structural violence (via percepticide and the obscuring of the social origins of social problems) perpetrated by school leadership.

Stigma toward small babies and their mothers in Ghana: A study of the experiences of postpartum women living with HIV

Infants born to HIV-infected mothers are more likely to be low birthweight (LBW) than other infants, a condition that is stigmatized in many settings worldwide, including sub-Saharan Africa. Few studies have characterized the social-cultural context and response to LBW stigma among mothers in sub-Saharan Africa or explored the views of women living with HIV (WLHIV) on the causes of LBW. We purposively sampled thirty postpartum WLHIV, who had given birth to either LBW or normal birthweight infants, from two tertiary hospitals in Accra, Ghana. Using semi-structured interviews, we explored women's understanding of the etiology of LBW, and their experiences of caring for a LBW infant. Interviews were analyzed using interpretive phenomenology. Mothers assessed their babies' smallness based on the baby's size, not hospital-recorded birthweight. Several participants explained that severe depression and a loss of appetite, linked to stigma following an HIV diagnosis during pregnancy, contributed to infants being born LBW. Women with small babies also experienced stigma due to the newborns' "undesirable" physical features and other people's unfamiliarity with their size. Consequently, mothers experienced blame, reluctance showing the baby to others, and social gossip. As a result of this stigma, women reported self-isolation and depressive symptoms. These experiences were layered on the burden of healthcare and infant feeding costs for LBW infants. LBW stigma appeared to attenuate with increased infant weight gain. A few of the women also did not breastfeed because they thought their baby's small size indicated pediatric HIV infection. Among WLHIV in urban areas in Ghana, mother and LBW infants may experience LBW-related stigma. A multi-component intervention that includes reducing LBW incidence, treating antenatal depression, providing psychosocial support after a LBW birth, and increasing LBW infants' weight gain are critically needed.

A Framework for Race-Related Trauma in the Public Education System and Implications on Health for Black Youth

BACKGROUND

A combination of increased suicide in the past decade, documented high rates of anxiety and depression, and the preponderance of other behavioral and emotional regulation challenges place black youth at risk for school suspension and involvement in the juvenile justice system. Pointing to deficits in black youth and their families negates how forces of racism, whether unconscious or conscious, can disrupt well-being.

METHODS

A framework for race-related trauma in the public education system illustrates the interplay between macro-level forces, such as institutional and symbolic racism, and micro level forces of racism such as racial discrimination and violence. Identifying causal links between these forces and adverse academic and health outcomes for black youth can inform interventions and strategies to reduce race-related trauma.

RESULTS

The framework for race-related trauma is a multi-level analysis of racism and recognizes school districts facing economic restraints and school personnel turnover may face significant challenges in designing intervening strategies.

CONCLUSION

The framework guides change effort towards improving school climate and culture through preparing school professionals to meet the diverse needs of youth, strengthening family and community collaboration, and tackling those policies and behaviors that exclude and disconnect black youth.

Caste-based Oppression, Trauma and Collective Victimhood in Erstwhile South India: The Collective Therapeutic Potential of Theyyam

The decades of collective victimhood and trauma that the oppressed lower caste members in the southern state of India (Kerala) suffered in silence were less known to the world until the socio-religious reform movements offered a space for their collective expression of agitation and unrest. With no socially sanctioned channels to express their injustice and pain, the folk ritual of Theyyam often became the alternative for a cathartic release of transgenerational and collective victimhood and trauma long endured by people belonging to these communities. A common theme of Theyyam discussed in literature is the symbolic meaning of ‘empowerment’, ‘dissent’ and ‘protest’ that Theyyam takes on as the performer embodies a chosen deity. The ritual thereby becomes a temporary outlet for the collective rage, anger and resentment endured by people of the oppressed communities over the years. These insights have implied the healing potential of Theyyam as it offers a safe outlet for repressed trauma reactions for individuals as well as for the community, collectively. However, what is relevant to this discussion is the mechanism by which healing processes are activated in Theyyam. This article makes an effort in this direction—the focus is on understanding Theyyam as a psycho-cultural phenomenon and the collective therapeutic dynamics that it offers.

Police crackdowns, structural violence and impact on the well-being of street cannabis users in a Nigerian city

BACKGROUND

There is abundant literature on the impact of law enforcement on cannabis markets, but scant literature on the effects of law enforcement on cannabis users. This study undertook a qualitative exploration of police crackdowns as a form of structural violence and examined their impact on the well-being of street cannabis users in a Nigerian city.

METHODS

The study was qualitative and descriptive. It was carried out in Uyo, southern Nigeria. Ninety-seven (97) frequent cannabis users (78 males and 19 females) took part. They were aged between 21 and 34 years and recruited from 11 cannabis hot-points in the city. Data were collected through in-depth, individual interviews, conducted over six-months. Data analysis was thematic and data-driven, involving identifying themes, assigning codes, revising codes and verification by independent qualitative methodology experts.

RESULTS

Police crackdowns are commonly experienced by street cannabis users. These do not reduce cannabis use, but displace cannabis markets. Crackdowns are associated with police brutality, confiscation of funds, drugs and belongings, stigma and discrimination, arrest and incarceration, which impacts negatively on the health, livelihoods and well-being of cannabis users. Cannabis users try to escape arrest by running from police, disposing of cannabis, disguising themselves and, when caught, bribing officers to secure release.

CONCLUSION

Crackdowns constitute a form of structural violence in the everyday life of cannabis users, and have negative effects on their health and social and economic well-being. Cannabis use should be decriminalized de facto and arrested users directed to treatment and skills training programmes. Treatment and social services for users should be expanded and legal aid interventions should be mounted to support users in addressing discriminatory practices and human rights violations.

Applying Critical Race Theory to Group Model Building Methods to Address Community Violence

BACKGROUND

Group model building (GMB) is an approach to building qualitative and quantitative models with stakeholders to learn about the interrelationships among multilevel factors causing complex public health problems over time. Scant literature exists on adapting this method to address public health issues that involve racial dynamics.

OBJECTIVES

This study's objectives are to (1) introduce GMB methods, (2) present a framework for adapting GMB to enhance cultural responsiveness, and (3) describe outcomes of adapting GMB to incorporate differences in racial socialization during a community project seeking to understand key determinants of community violence transmission.

METHODS

An academic-community partnership planned a 1-day session with diverse stakeholders to explore the issue of violence using GMB. We documented key questions inspired by critical race theory (CRT) and adaptations to established GMB "scripts" (i.e., published facilitation instructions). The theory's emphasis on experiential knowledge led to a narrative-based facilitation guide from which participants created causal loop diagrams. These early diagrams depict how violence is transmitted and how communities respond, based on participants' lived experiences and mental models of causation that grew to include factors associated with race.

CONCLUSIONS

Participants found these methods useful for advancing difficult discussion. The resulting diagrams can be tested and expanded in future research, and will form the foundation for collaborative identification of solutions to build community resilience. GMB is a promising strategy that community partnerships should consider when addressing complex health issues; our experience adapting methods based on CRT is promising in its acceptability and early system insights.

In Their Own Voices

This study qualitatively examines the intersections of risk for intimate partner violence (IPV) and HIV infection in South Africa. Eighteen women seeking services for relationship violence were asked semistructured questions regarding their abusive experiences and HIV risk. Participants had experienced myriad forms of abuse, which reinforced each other to create a climate that sustained abuse and multiplied HIV risk. Male partners having multiple concurrent sexual relationships, and poor relationship communication compounded female vulnerability to HIV and abuse. A social environment of silence, male power, and economic constraints enabled abuse to continue. “Breaking the silence” and women's empowerment were suggested solutions.

“I Couldn’t go Anywhere”

The authors examine the narratives of 24 substance-addicted welfare recipients to understand how their neighborhoods provide a particular context for substance abuse, violence, and social isolation. The authors also examine the relationships among substance abuse, violence, and social isolation. Overall, these narratives indicate that place of residence influences one’s social networks and exposure to drugs, which subsequently influence women’s experiences with substance abuse and domestic violence. The authors suggest a cohesive framework for understanding women’s experiences, that of structural violence as experienced through neighborhood living conditions, which fosters social isolation and vulnerability to long-term drug use and domestic violence.

Networks of Violence in the Production of Young Women's Trajectories and Subjectivities

This paper focuses on the deployment and interdependence of different expressions of gendered and classed violence in shaping the choices, trajectories and subjectivities of young women on vocational beauty therapy courses. It takes as its premise the understanding that, far from simply being an aberrant expression of interpersonal or intergroup aggression, violence is embedded in social life in multiple and complex ways, reverberating through women's lives to reproduce disadvantage and subordination. The paper draws on theoretical and empirical investigations of the interrelationships between structural, direct and symbolic expressions of violence and asks what this literature can offer in challenging normative, often individualised, conceptions of violence. Drawing on an ethnographic case study of National Vocational Qualification (NVQ) beauty therapy courses and the young women undertaking them, I explore the accounts of students and their tutors on becoming and being ‘beauty girls’. I consider what these accounts might tell us about how forms of symbolic and interpersonal violence intersect with, reproduce and legitimise the violence involved in unequal and unjust socio-economic structures. I argue that the ways in which different forms of violence mutually reinforce each other at a micro-level produce an embodied ‘sense of limits’ that ultimately reproduces the structural violence of gendered and classed inequalities. The examples given illustrate both a ‘chronology of violence’ in young women's lives, and the way in which those lives can be understood, at least in part, as embedded in and shaped by networks of violence. Finally, I briefly consider examples of dissent and resistance, the conditions under which they might be possible and the ways in which, through the interplay of different forms of violence, they might also be curtailed.

A Social Ecological Model of Syndemic Risk affecting Women with and At-Risk for HIV in Impoverished Urban Communities

Syndemic risk is an ecological construct, defined by co-occurring interdependent socio-environmental, interpersonal and intrapersonal determinants. We posited syndemic risk to be a function of violence, substance use, perceived financial hardship, emotional distress and self-worth among women with and at-risk for HIV in an impoverished urban community. In order to better understand these interrelationships, we developed and validated a system dynamics (SD) model based upon peer-reviewed literature; secondary data analyses of a cohort dataset including women living with and at-risk of HIV in Bronx, NY (N = 620); and input from a Bronx-based community advisory board. Simulated model output revealed divergent levels and patterns of syndemic risk over time across different sample profiles. Outputs generated new insights about how to effectively explore multicomponent multi-level programs in order to strategically develop more effective services for this population. Specifically, the model indicated that effective multi-level interventions might bolster women's resilience by increasing self-worth, which may result in decreased perceived financial hardship and risk of violence. Overall, our stakeholder-informed model depicts how self-worth may be a major driver of vulnerability and a meaningful addition to syndemic theory affecting this population.

Mapping the role of structural and interpersonal violence in the lives of women: implications for public health interventions and policy

Background

Research on interpersonal violence towards women has commonly focused on individual or proximate-level determinants associated with violent acts ignores the roles of larger structural systems that shape interpersonal violence. Though this research has contributed to an understanding of the prevalence and consequences of violence towards women, it ignores how patterns of violence are connected to social systems and social institutions.

Methods

In this paper, we discuss the findings from a scoping review that examined: 1) how structural and symbolic violence contributes to interpersonal violence against women; and 2) the relationships between the social determinants of health and interpersonal violence against women. We used concept mapping to identify what was reported on the relationships among individual-level characteristics and population-level influence on gender-based violence against women and the consequences for women’s health. Institutional ethics review was not required for this scoping review since there was no involvement or contact with human subjects.

Results

The different forms of violence—symbolic, structural and interpersonal—are not mutually exclusive, rather they relate to one another as they manifest in the lives of women. Structural violence is marked by deeply unequal access to the determinants of health (e.g., housing, good quality health care, and unemployment), which then create conditions where interpersonal violence can happen and which shape gendered forms of violence for women in vulnerable social positions. Our web of causation illustrates how structural factors can have negative impacts on the social determinants of health and increases the risk for interpersonal violence among women.

Conclusion

Public health policy responses to violence against women should move beyond individual-level approaches to violence, to consider how structural and interpersonal level violence and power relations shape the ‘lived experiences’ of violence for women.

Electronic supplementary material

The online version of this article (doi:10.1186/s12905-015-0256-4) contains supplementary material, which is available to authorized users.

Intimate partner violence and drug-addicted women: from explicative models to gender-oriented treatments

Thanks to studies conducted over the past decades, it has been underlined how harmful consumption of alcohol or other substances and intimate partner violence are intertwined. What has been recognized is, in particular, how the relation between these two factors may be represented as a vicious cycle in which each of them influences the other, reciprocally. The aim of this paper is to offer an overview, firstly, about the global and European scenario of the spread of these constructs, delineating, then, the main explanation models that theorize their connection and those risk factors associated with the environmental settings which may play a significant role. The last part, finally, offers some starting points in order to provide efficient multidisciplinary approaches both to prevent and support victims, increasing their mental, physical, and emotional health.

The importance of resources and information in the lives of battered mothers

An increasing body of research has documented the overlap between intimate partner violence and child abuse. To date, very little research has explored mothers' perspectives on how child protection services (CPS) actually investigates and intervenes in families where intimate partner violence (IPV) as well as child abuse or neglect have occurred. The current research explores the complex role of information and resources in child protection investigations and interventions. In-person interviews were conducted with 19 mothers who had been battered and who had been involved with CPS because of the violence. Mothers reported difficulties in sharing information with and receiving information from CPS workers, but some also reported benefiting from information they received. Moreover, for a handful of women, the CPS intervention was a source of emotional strength. Implications for improving CPS interventions when IPV is occurring are discussed.

Racial discrimination: a continuum of violence exposure for children of color

This article reviews and examines findings on the impact of racial discrimination on the development and functioning of children of color in the US. Based on current definitions of violence and child maltreatment, exposure to racial discrimination should be considered as a form of violence that can significantly impact child outcomes and limit the ability of parents and communities to provide support that promotes resiliency and optimal child development. In this article, a conceptual model of the effects of racial discrimination in children of color is presented. The model posits that exposure to racial discrimination may be a chronic source of trauma in the lives of many children of color that negatively influences mental and physical outcomes as well as parent and community support and functioning. Concurrent exposure to other forms of violence, including domestic, interpersonal and/or community violence, may exacerbate these effects. The impact of a potential continuum of violence exposure for children of color in the US and the need for future research and theoretical models on children's exposure to violence that attend to the impact of racial discrimination on child outcomes are discussed.

Beyond the 50-minute hour: increasing control, choice, and connections in the lives of low-income women

Although poverty is associated with a range of mental health difficulties among women in this country, mainstream mental health interventions are not sufficient to meet the complex needs of poor women. This article argues that stress, powerlessness, and social isolation should become primary targets of our interventions, as they are key mediators of the relationship between poverty and emotional distress, particularly for women. Indeed, if ways are not found to address these conditions directly, by increasing women's control, choice, and connections, the capacity to improve the emotional well-being of impoverished women will remain limited at best. This is the first of 5 articles that comprise a special section of the American Journal of Orthopsychiatry, called "Beyond the 50-Minute Hour: Increasing Control, Choice, and Connections in the Lives of Low-Income Women." Together, these articles explore the nature and impact of a range of innovative mental health interventions that are grounded in a deep understanding of the experience of poverty. This introduction: (a) describes briefly how mainstream approaches fail to address the poverty-related mental health needs of low-income women; (b) illuminates the role of stress, powerlessness, and social isolation in women's lives; (c) highlights the ways in which the articles included in this special section address each of these by either adapting traditional mental health practices to attend to poverty's role in participants' lives or adapting community-based, social-justice-oriented interventions to attend to participants' mental health; and (d) discusses the research and evaluation implications of expanding mental health practices to meet the needs of low-income communities.

Feminist Relational Advocacy

This article describes a qualitative study of how low-income women who are struggling with symptoms of depression experience feminist relational advocacy, a new model that is informed by feminist, multicultural, and community psychology theories. Using qualitative content analysis of participant interviews, the authors describe the processes and outcomes of feminist relational advocacy from participants' perspectives; they also consider how emergent themes fit with principles of the model, including the importance of women's narratives, the inseparability of emotional and practical support, the centrality of the advocacy relationship, and oppression as a source of emotional distress. The article concludes with a discussion of the practice and research implications of the study, highlighting the possibilities of feminist relational advocacy as a new tool for counseling psychologists and the lessons for advocacy models in general.

Positioning Classism Within Counseling Psychology's Social Justice Agenda

Counseling psychologists have been instrumental in advancing a social justice agenda within the larger field of psychology. What is still missing within this agenda, however, is a fully developed consideration of classism within the spectrum of oppressions more commonly addressed in discussions of social justice and multiculturalism. The operations of classism can be difficult to see in a society that has long considered itself to be classless, and for counseling psychologists to undertake this work, they must initiate a deliberate effort to develop their awareness of classism as it affects their theory, research, and practice. In support of this end, the author presents a social justice conceptualization of classism, provides examples of classism at work, and outlines the resulting implications for counseling psychology practice.

Relationship violence and psychological distress among low-income urban women

In this paper, we examined the association between relationship violence and psychological distress among low-income urban women. Extending prior research, we considered the effects of relationship violence within the context of other chronic stressors that are common in the lives of these women. Using data from the Welfare, Children, and Families project (1999), a probability sample of 2,402 low-income women with children living in low-income neighborhoods in Boston, Chicago, and San Antonio, we predicted psychological distress with multiple measures of relationship violence, a wide range of sociodemographic variables, and several chronic stressors. Our results show that relationship violence is associated with higher levels of economic hardship, neighborhood disorder, and household disrepair. We also find that relationship violence is associated with higher levels of psychological distress, net of these other chronic stressors. Finally, we observe that the effects of relationship violence do not vary according to the chronic stressors under study. Because the adverse effects of relationship violence are similar for women despite other adverse circumstances, interventions and treatment efforts focused exclusively on relationship violence may make a unique contribution to the psychological well-being of low-income urban women.

Understanding, resisting, and overcoming oppression: toward psychopolitical validity

My first objective in this paper is to synthesize, synoptically, the literature on oppression and liberation with the contributions to this special issue. To fulfil this aim I introduce a framework for understanding, resisting, and overcoming oppression. The framework consists of psychopolitical well-being; experiences, consequences, and sources of oppression; and actions toward liberation. Each of these components is subdivided into 3 domains of oppression and well-being: collective, relational, and personal. Experiences of suffering as well as resistance and agency are part of the framework. My second objective is to offer ways of closing the gap between research and action on oppression and liberation. To do so I suggest 2 types of psychopolitical validity: epistemic and transformative.