The relationship between intimate partner violence and PTSD: an application of Cox regression with time-varying covariates

Domestic Violence in Asian Communities: A Scoping Review of Quantitative Literature

Domestic violence (DV) is a prevalent social problems that threaten individuals' health and well-being, and the issue of DV in Asian communities requires extensive and comprehensive investigation. Following the steps by Arksey and O'Malley, a scoping review was conducted to (a) summarize and synthesize existing quantitative evidence on the topic of DV in Asian immigrant communities in North America, and (b) identify research gaps in the literature to guide future work. Inclusion criteria were that (a) the studies must comprise a sample of Asian immigrants in North America, (b) the focus of the article was specifically on individuals' experiences of DV in the past year or lifetime, (c) DV was measured as either independent or dependent variable, (d) full-text publications written in English, (e) articles must be peer-reviewed, quantitative studies. On completion of the review process, 35 full-text articles were identified for review. Across studies, five main topics emerged: factors related to DV victimization, prevalence and forms of DV, individuals' attitudes and/or perceptions about DV, DV-related consequences, and intervention evaluation. Some less common topics include help-seeking behaviors and sources and culturally responsive scales. The findings of this review suggest that future research will benefit from using a nationally representative Asian sample and culturally sensitive tools, examining potential protective factors against DV victimization, and employing an experimental design to evaluate the effectiveness of culturally sensitive interventions. Policies should provide stronger support to agencies and practitioners to deliver culturally sensitive services.

Help-Seeking Among Battered Immigrant Filipina, Indian, and Pakistani Women in the United States: Perceived Barriers and Helpful Responses

This study examines the nature of helpful responses received and barriers to seeking help following the experience of intimate partner violence among women of Filipina, Indian, and Pakistani descent (N = 143) in the United States. Instead of aggregating women from diverse backgrounds, we investigated these groups of women separately. A content analysis found that while emotional support was the most helpful response, there were important variations by ethnicity and immigration position in the perceived helpfulness of various assistance resources as well as barriers to help-seeking. This study of disaggregated Asian immigrant groups enhances our understanding of both common and unique challenges faced by each immigrant group, which can inform development of socioculturally relevant intervention programs.

Comparing Recidivism of Sexual and Nonsexual Offenders: The Role of Humanist, Spiritual, and Religious Involvement

Some research has considered whether faith-informed programs help persons with a previous incarceration navigate a life away from crime. Few studies considered whether offense category moderates this relationship. Building upon studies that found a strong association between a prior sexual conviction and participation in religion in prison, we assess whether time spent in humanist, spiritual, and religious (HSR) programs in prison is associated with reconviction, separately for persons convicted of a sex offense and any other offense. Our results revealed that a higher level of participation in HSR programs was associated with a lower likelihood and rate of reconviction; however, this effect was more pronounced for persons with a prior sexual conviction. Supplementary analyses revealed that the use of religion in an extrinsic manner was beneficial, suggesting this group may look to religion to gain social support and overcome rejection and loneliness. Extrinsic religiosity among other groups, however, was associated with an increased risk of reconviction.

The weWomen and ourCircle randomized controlled trial protocol: A web-based intervention for immigrant, refugee and indigenous women with intimate partner violence experiences

Intimate partner violence (IPV), including homicides is a widespread and significant public health problem, disproportionately affecting immigrant, refugee and indigenous women in the United States (US). This paper describes the protocol of a randomized control trial testing the utility of administering culturally tailored versions of the danger assessment (DA, measure to assess risk of homicide, near lethality and potentially lethal injury by an intimate partner) along with culturally adapted versions of the safety planning (myPlan) intervention: a) weWomen (designed for immigrant and refugee women) and b) ourCircle (designed for indigenous women). Safety planning is tailored to women's priorities, culture and levels of danger. Many abused women from immigrant, refugee and indigenous groups never access services [WHY?] and research is needed to support interventions that are most effective and suited to the needs of abused women from these populations in the US. In this two-arm trial, 1250 women are being recruited and randomized to either the web-based weWomen or ourCircle intervention or a usual safety planning control website. Data on outcomes (i.e., safety, mental health and empowerment) are collected at baseline and at 3, 6, and 12 months post- baseline. It is anticipated that the findings will result in an evidence-based culturally tailored intervention for use by healthcare and domestic violence providers serving immigrant, refugee and indigenous survivors of IPV. The intervention may not only reduce risk for violence victimization, but also empower abused women and improve their mental health outcomes.

Invited commentary: disclosure of gender-based violence in developing countries

The evolving concept of gender-based violence (GBV) is a multifaceted issue of public health significance. Until recently, most studies examining GBV have been conducted in North America. In this issue of the Journal, Palermo et al. (Am J Epidemiol. 2014;179(5):602-612) report their secondary analyses involving approximately 300,000 women from 24 developing countries who participated in Demographic and Health Surveys between 2004 and 2011. The focus of their article is on the prevalence and determinants of disclosure of GBV to formal authorities, including health care or legal professionals, police, and nongovernmental organizations. Their results indicate a wide gap between prevalence of GBV (40%) and GBV disclosure (7%), implying an underestimation of GBV that ranges from 11- to 128-fold, depending on the region and type of reporting. The extent of underreporting of GBV also varied according to personal characteristics such as age, marital status and urban or rural residence. GBV has been linked to a myriad of health problems, and it has been shown that health care utilization is considerably higher among women who have experienced GBV. Primary and secondary prevention efforts should continue to target GBV, and creative ways of addressing GBV nondisclosure should take into account regional variations and personal characteristics of affected women.

Fear of past abusive partner(s) impacts current posttraumatic stress among women experiencing partner violence

This study examines the impact of fear of past abusive partner(s) on posttraumatic stress among 212 community-recruited women currently exposed to intimate partner violence (IPV). The path analysis model tested explained 60% of the variation in IPV-related posttraumatic stress. Findings revealed that fear of past abusive partner(s) was uniquely associated with the severity of current posttraumatic stress symptoms over and above the impact of current IPV or childhood abuse and neglect. Future research should continue examining women's subjective emotional experience of past and current victimization so as to further inform both clinical practice and intervention planning.

Intimate partner violence as a risk factor for postpartum depression among Canadian women in the Maternity Experience Survey

PURPOSE

Intimate partner violence is a worldwide public health concern that predominantly affects women of reproductive age. The purpose of this study was to evaluate the effect of exposure to intimate partner violence before, during, or after pregnancy on postpartum depression in a nationally representative sample of Canadian women.

METHODS

A cross-sectional analysis was performed with the use of data from the Maternity Experience Survey conducted by Statistics Canada in 2006. A population-based sample of 8542 women 15 years and older who delivered singleton live births was selected from all Canadian provinces and territories; of those, 6421 completed a computer-assisted telephone interview. Recent experiences with and threats of physical or sexual violence by an intimate partner were examined in relation to postpartum depression assessed through the Edinburgh Postpartum Depression Scale.

RESULTS

The prevalence of postpartum depression was 7.5% (95% confidence interval, 6.8-8.2). Controlling for confounders, odds of postpartum depression were significantly greater among women who reported partner violence in the past two years as opposed to those who did not (adjusted odds ratio, 1.61; 95% confidence interval, 1.06-2.45).

CONCLUSIONS

Intimate partner violence is positively associated with postpartum depression among Canadian women. Implications for healthcare practice are discussed.

Prevalence and predictors of posttraumatic stress disorder among victims of violence applying for state compensation

Many studies have focused on the predictive value of victims' emotions experienced shortly after violence exposure to identify those vulnerable for development of posttraumatic stress disorder (PTSD). However, many victims remain unidentified during the initial recovery phase, yet may still be highly in need of psychological help after substantial time since victimization has passed. Professionals involved in the settlement of civil damage claims filed by victims of violence may play an important role in referring victims with current psychological problems to appropriate treatment services, as they are likely to maintain relations with victims until all compensation possibilities have been exhausted. As an exploratory examination of this topic, the current study investigates the potential utility of file characteristics as predictors of chronic PTSD among 686 victims of violence who had applied for state compensation with the Dutch Victim Compensation Fund (DVCF) in 2006. Identification of significant predictors is preceded by estimating prevalence rates of PTSD. Results indicate that approximately 1 of 2 victims applying for state compensation in the Netherlands still have PTSD many years after victimization and claim settlement. Age, female sex, time since victimization, acquaintance with the perpetrator, violence-related hospitalization, and compensation for immaterial damage prove to be predictive of PTSD, although female sex and immaterial damage compensation fail to reach significance after adjusting for recalled peritraumatic distress severity. Implications for policy practice as well as strengths and limitations of the study are discussed.

Intimate partner violence and initiation of smoking and drinking: A population-based study of women in Yokohama, Japan

Intimate Partner Violence (IPV) is prevalent in the lives of women across the globe and has been found to be associated with substance use among women. As part of the World Health Organization's (WHO) cross-national research effort, this study examined the relationship between the experience of IPV and use of alcohol and tobacco among a probability sample of women aged 18-49 in Yokohama, Japan. Using retrospective data for 2000-2001, we employed methods of survival analysis that allowed an examination of the probability of initiating smoking and drinking subsequent to the experience of IPV. Experiencing IPV was associated with current smoking as well as initiation of smoking and current patterns of drinking. Women who had experienced IPV were more likely to be smoking at the time of the interview and tended to initiate smoking at earlier ages compared to those who had not experienced IPV. At any time point, the risk of starting to smoke was more than twice as high for women who had previously experienced IPV than for women who had not. In addition, women who had experienced IPV were more likely to drink heavily. The present study's findings clearly point to the need to enhance coordination between IPV prevention and substance abuse programs in order to improve the safety and wellbeing of women who have experienced IPV.

Post-traumatic stress disorder among Chinese women survivors of intimate partner violence: a review of the literature

Background

Post-traumatic stress disorder is one of the most prevalent mental health sequelae of intimate partner violence, and as a result, it has been extensively documented in Western literature. However, whether abused women from non-Western cultures experience similar post-traumatic responses to intimate partner violence is less documented.

Objectives

The objectives of this paper were (1) to review the literature for information about post-traumatic stress disorder among Chinese women survivors of intimate partner violence; (2) to provide a synthesis of the literature on post-traumatic stress disorder among abused Chinese women; and (3) to identify implications for practice and to suggest directions for research relating to post-traumatic stress disorder among abused Chinese women.

Design

A systematic review of the literature.

Data Sources

Following a systematic search for relevant literature in computerized databases and manual searches of English and Chinese language publications, five papers reporting on four studies conducted in China, Taiwan, Malaysia, and the United States were included in the review.

Review Methods

Abstracts meeting the inclusion criteria were reviewed independently by two of the authors and any discrepancies were resolved by discussion. Full papers for selected abstracts were then retrieved and assessed independently by the same reviewers.

Results

The present literature review revealed a paucity of information relating to post-traumatic stress disorder symptoms or diagnoses in abused Chinese women. Nevertheless, a link between post-traumatic stress disorder and intimate partner violence was demonstrated by the reviewed papers.

Conclusions

Caution should be exercised when making comparison of the findings across the four studies because of the inherent methodological differences. Also, as the assessment tools have not been validated for culture-bound interpretation of trauma and symptom manifestation, comparisons of findings for Chinese women to women in Western literature should be undertaken with due consideration. Implications for practice and recommendations for future research are discussed.

Intimate partner violence: perceptions of Samoan women

The purpose of this study was to examine cultural perceptions, awareness, responses, and actions recommended about IPV by Samoan women served by a Community Health Center (CHC). THEORETICAL FOUNDATION: This investigation is a part of a series of exploratory community based participatory research (CBPR) studies based on critical social theory.

RESEARCH DESIGN AND METHODS

This qualitative study was conducted using focus groups with Samoan women served by a health center. Analysis of qualitative data was accomplished using content analysis. Demographic data were analyzed using descriptive methods.

PARTICIPANTS

Eight Samoan women, 18 years and older participated in the focus groups.

PROCEDURE

The instruments were translated from English to Samoan and back translated into English. The facilitators conducted an initial focus group and a validation group with the same participants. Sessions were taped and transcribed in Samoan and back translated into English.

RESULTS

The women clearly identified IPV and were aware that it occurs in their cultural group. They identified multiple responses of individual women, families, and communities to IPV. In Samoa there was a formalized process for addressing this problem that has been changed in Hawai'i. The CHCs are viewed as an important resource for the families and can be a source of interventions.

IMPLICATIONS

Health care providers should be aware of differences between Western notions of independence and the ideals of interdependence held by specific cultural groups. The CHC personnel have raised questions about the appropriateness of using tools that were developed for use with Western women with immigrant women.

The role of emotional abuse in intimate partner violence and health among women in Yokohama, Japan

OBJECTIVES

As part of the World Health Organization's cross-national research effort, we investigated the relationship between various health indicators and the experience of intimate partner violence (IPV), which included emotional, physical, and sexual abuse, among women in Yokohama, Japan.

METHODS

We used multivariate logistic and negative binomial regression to examine the relationship between health status and IPV in a stratified cluster sample of 1371 women aged 18 to 49 years.

RESULTS

In 9 of 11 health indicators examined, the odds of experiencing health-related problems were significantly higher (P < .05) among those that reported emotional abuse plus physical or sexual violence than among those that reported no IPV, after we controlled for sociodemographic factors, childhood sexual abuse, and adulthood sexual violence perpetrated by someone other than an intimate partner. For most health indicators, there were no significant differences between those that reported emotional abuse only and those that reported emotional abuse plus physical or sexual violence.

CONCLUSIONS

The similarity of outcomes among those that reported emotional abuse only and those that reported emotional abuse plus physical or sexual violence suggests the need for increased training of health care providers about the effects of emotional abuse.

The alcohol use disorder and associated disabilities interview schedule-IV (AUDADIS-IV): reliability of new psychiatric diagnostic modules and risk factors in a general population sample

This study presents test-retest reliability statistics and information on internal consistency for new diagnostic modules and risk factors for alcohol, drug, and psychiatric disorders from the Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV). Test-retest statistics were derived from a random sample of 1899 adults selected from 34,653 respondents who participated in the 2004-2005 Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Internal consistency of continuous scales was assessed using the entire Wave 2 NESARC. Both test and retest interviews were conducted face-to-face. Test-retest and internal consistency results for diagnoses and symptom scales associated with posttraumatic stress disorder, attention-deficit/hyperactivity disorder, and borderline, narcissistic, and schizotypal personality disorders were predominantly good (kappa>0.63; ICC>0.69; alpha>0.75) and reliability for risk factor measures fell within the good to excellent range (intraclass correlations=0.50-0.94; alpha=0.64-0.90). The high degree of reliability found in this study suggests that new AUDADIS-IV diagnostic measures can be useful tools in research settings. The availability of highly reliable measures of risk factors for alcohol, drug, and psychiatric disorders will contribute to the validity of conclusions drawn from future research in the domains of substance use disorder and psychiatric epidemiology.

The subjective experience of trauma and subsequent PTSD in a sample of undocumented immigrants

Although a subjective component of trauma is commonly recognized in diagnosing posttraumatic stress disorder (PTSD), there are few studies that specifically address Criterion A2, and none addressing this issue among undocumented immigrants. We assessed 212 arriving undocumented immigrants with diverse trauma histories to investigate concordance between objective and subjective factors of trauma (Criteria A1 and A2) and across different types of trauma and PTSD. Concordance between Criteria A1 and A2 varied, with highest rates found for political violence. Interpersonal violence in general was associated with higher rates of PTSD. We identified a dose-response effect for PTSD, but this was not dependent on other events (i.e., other doses) meeting Criterion A2. Discussion focuses on Criterion A within the phenomenology of PTSD and the need to gauge subjective interpretations of trauma events among this population.

The prevalence and characteristics of intimate partner violence in a community study of Chinese American women

A community probability-sampled survey was done of 181 Chinese American women to investigate the prevalence and nature of intimate partner violence (IPV) in Chinese Americans. Of participants, 42% knew a Chinese woman who had experienced IPV. Also, 14% had experienced IPV themselves in their lifetime (8% severe and 6% minor), 3% in the previous year, and 2% currently. In Chinese American women who were ever married, the lifetime prevalence of IPV was 17%. IPV resulted in physical injuries for 31% of women and affected their work and education. Exploratory analysis suggests that relationship problems and partner's alcohol use may be risk factors for IPV in this group.

Intimate partner violence, welfare receipt, and health status of low-income african american women: a lifecourse analysis

Although the association among intimate partner violence (IPV), welfare receipt, and health status has been well-established, little is known about the temporal sequencing of these events. In a random sample of low-income African American women in an urban Midwestern county, lifecourse data about IPV and welfare receipt were obtained using the Life History Calendar method (D. Freedman, A. Thornton, D. Camburn, D. Alwin, & L. Young-DeMarco, 1988), along with data about mental and physical health status. Controlling for relevant factors, longitudinal analyses found that previous experience of IPV increased women's odds of receiving welfare benefits in a given year, but previous welfare receipt did not. Cumulative IPV, but not cumulative welfare receipt, was associated with current and past-year health problems. These findings are consistent with the hypothesis that IPV leads women to turn to welfare assistance, and that compromised physical and mental health due to past cumulative IPV interferes with women's gainful employment.

Individual and Dyadic Coping Strategies in the Aftermath of a Traumatic Experience

This study was designed to explore individual and dyadic coping strategies in the aftermath of a traumatic event. Eighteen persons having experienced a physical assault or a road accident within six to twelve months before the study, and eighteen matched control persons were recruited together with their partners. Each participant and his/her partner filled in several questionnaires on individual and dyadic coping strategies, level of stress and PTSD-symptomatology. Results indicate that participants having experienced a trauma, compared to controls, report a general lack of dyadic coping and, when facing daily hassles, specific decreases in individual coping strategies. These differences are discussed in the context of marital coping processes.

Relationship between emotional numbing and arousal symptoms in American women of Japanese descent who experienced interpersonal victimization

In recent years, studies of veterans and others who experienced various types of trauma have found a strong relationship between emotional numbing and arousal symptoms, challenging the current DSM-IV diagnostic criteria, which combines emotional numbing and avoidance symptoms in a single criterion. In this paper, we investigate emotional numbing symptoms in a community-based random sample of women of Japanese descent who had experienced interpersonal victimization, such as childhood abuse, intimate partner violence, and violence perpetrated by non-intimates (n = 202). Controlling for age, place of birth, and timing and severity of victimization, emotional numbing symptom counts were associated more strongly with arousal than avoidance symptoms, consistent with previous studies of veterans and assaulted women. In addition, emotional numbing symptom counts were significantly associated with age and, to a lesser degree, country of birth. Implications for research and practice are discussed.