The relationship between suicidal thinking and dating violence in a sample of adolescent abortion patients

Syndemic Profiles and Sexual Health Risks Among Sexually Exploited Adolescent Girls in Taiwan: A Latent Class Analysis

Sexually exploited adolescent girls are disproportionately affected by adverse psychosocial conditions, such as intra-familial child physical and sexual abuse, extra-familial violence and sexual assault, alcohol and drug use, and suicide. Syndemic theory suggests that these adverse psychosocial or syndemic conditions are concentrated and co-occurring in socially marginalized populations, including sexually exploited adolescents, and increase their sexual health risks, including pregnancy, abortion, and the acquisition of sexually transmitted diseases (STDs). To examine clusters of syndemic conditions, latent class analysis (LCA) was conducted to classify 335 sexually exploited girls in Taiwan into subgroups based on their probability of experiencing each syndemic condition. We used syndemic class membership to predict their sexual health outcomes, specifically pregnancy, abortion, and the acquisition of STDs. The results of LCA revealed three classes, which were "low-risk syndemic," "moderate-risk syndemic," and "high-risk syndemic." The risk of acquisition of STDs among sexually exploited girls in the "high-risk syndemic class" and "moderate-risk syndemic class" was 239% and 135% higher, respectively, than the risk of acquisition of STDs among sexually exploited girls in the "low-risk syndemic class." Differences between these three classes in pregnancy and abortion were not significant. Our findings support the syndemic theory that a pattern of syndemic conditions is associated with an increased risk of acquiring STDs. Interventions aimed at reducing the acquisition of STDs among sexually exploited girls in Taiwan should adopt a comprehensive approach to address co-occurring conditions.

A Randomized Control Trial to Test Dissemination of an Online Suicide Prevention Training For Intimate Partner Violence Hotline Workers

Purpose

Suicide risk is higher among violence-involved individuals. Intimate Partner Violence hotline workers are a critical source of support and can potentially be suicide prevention champions. Our primary goal was to examine the effectiveness of disseminating a free, online IPV-Suicide Prevention curriculum, via a randomized control trial, to hotline workers in ten states with the highest suicide and IPV homicide rates.

Method

We divided the country into five regions and, based on criterion, chose two states in each region to randomize into the two arms of the study. We examined training participation and engagement between the two approaches: (1) 'dissemination as usual' (control) using a National Domestic Violence Hotline email and a postcard to state/county IPV directors, versus (2) 'enhanced dissemination' (intervention) using a four-point touch method (postcard, phone call, email, and letter) to 'drive' participation.

Results

Participation increased in the intervention arm as approaches became more personal (i.e., email and phone calls vs. letters). Results indicate that traditional dissemination strategies such as email announcements and invitations are not as effective as varied and multiple touchpoints for IPV hotline staff.

Conclusion

Successful dissemination strategies to promote digital training should consider the value added by personalized connection. Future research is needed to understand how to offer effective and efficient web-based training to those providing IPV and child abuse services.

"Architects of Their Own Brain." Social Impact of an Intervention Study for the Prevention of Gender-Based Violence in Adolescence

Research in psychology has evidenced both the prevalence of gender-based violence among youth worldwide and the negative impacts that such violence has on the victims’ mental and physical health. Neuroscience has proven that violent intimate relationships harm the brain, while very simple social experiences can change the brain architecture in positive directions. Also, interventions that have been demonstrated to be successful in preventing and responding to gender violence in adolescence have been informed by psychology. This article reviews the social impact of psychology in the field of teen gender violence and then reports on the potential social impact achieved by an intervention study consisting of seven interventions framed by the research line on the preventive socialization of gender violence. The program was addressed to 15- and 16-year-old adolescents and focused on supporting free reconstruction of mental and affective models of attractiveness via critical analysis of the dominant coercive discourse, which links attraction to violence. The communicative methodology involved working with an Advisory Committee from the beginning of the study, as well as continuous dialog between the researchers and the participants, which was used to refine subsequent interventions. The results show that the program contributed to raising participants’ critical consciousness regarding the dominant coercive discourse in their life, provided the participant subjects with cognitive tools to better understand their own and others’ sexual-affective thinking, emotions, and behaviors, in favor of rejecting violence, and supported the modification of female adolescents’ sexual preferences for different types of men. Importantly, the findings also indicate that the interventions aided some participants’ use of the knowledge gained in the project to help their friends and communities in reflecting upon coercive patterns of sexual attraction, the quality of their intimate relationships, and the different effects of sexual violence and toxic relationships on health. Some individuals reported leaving toxic relationships after the interventions. This intervention research illustrates Santiago Ramón y Cajal’s metaphor, employed to explain plasticity: that every person, if s/he decides it, can be the architect of her or his own brain. With evidence-based cognitive tools within the reach of every adolescent, and upon individual free choice for transformation, a new sexual-affective socialization free from violence is possible.

Building a New Intimate Relationship After Experiencing Intimate Partner Violence in Victim-Survivors of South Korea

Intimate partner violence (IPV) refers to harmful acts occurring among members of an intimate relationship. Many studies have explored individuals' experiences of IPV as well as its consequences; however, so far, few studies have explored the lives of IPV victim-survivors after escaping from the violent relationship and the experiences of building new intimate relationships. Thus, the purpose of this study was to understand the young female adults' experience of building a new intimate relationship after ending their abusive relationship. This study used a qualitative phenomenological design to understand the women's lived experiences in their own voices, as suggested by Giorgi. In total, 13 young female adults in South Korea were recruited and interviewed. All interviews were audio-recorded and transcribed. Drawing on the interview data, we constructed the structure of their experiences through identifying five themes: (I) having difficulty in meeting new people, (II) starting to build a new relationship based on trauma, (III) struggling to escape the boundaries of the abuser, (IV) learning about healthy intimate relationships, and (V) something's wrong again. The findings were meaningful in that they showed how victim-survivors clearly needed care and support even after they escaped from their abusive relationships and began new ones. In addition, we found that some of them entered into another abusive relationship with their new partners. Finally, this study informs researchers and health professionals across the world about the experiences of IPV victims within specific cultural background. We hope that the findings of this study will contribute to building various interventions and programs for victim-survivors of IPV.

Who Are the Victims and Who Are the Perpetrators in Dating Violence? Sharing the Role of Victim and Perpetrator

BACKGROUND

Dating violence (DV) is a serious problem with devastating consequences. Often, research on DV has focused on two distinct groups: victims and perpetrators. However, there is growing evidence for a victim-perpetrator overlap model, which posits that those involved in DV are more likely to take on both roles, rather than either role on its own.

PURPOSE

We investigated the patterns of involvement in DV among those who identified themselves as victims or perpetrators in previous studies.

METHOD

This was a systematic review and meta-analysis. A total of 371 variables related to participants' previous and concurrent experiences of DV victimization or perpetration (202 variables related to victimization and 169 related to perpetration) were identified in 25 studies, which were found by systematically searching three databases: PubMed, Web of Science, and SCOPUS.

RESULTS

The majority of previous studies categorized study participants as either DV victims or perpetrators; however, those who identified themselves as either DV victims or DV perpetrators were more likely to assume the opposite role as well. Specifically, current DV perpetrators had a strong association with previous or concurrent victimization experiences, and current DV victims were similarly likely to have assumed the roles of both victim and perpetrator in their histories.

CONCLUSION

Further efforts should be put into avoiding categorization of those involved in violence; rather, they should be regarded as a single group. Additionally, evidence-based interventions should be developed for this population to help break the cycle of violence.

Reconstruction of Autobiographical Memories of Violent Sexual-Affective Relationships Through Scientific Reading on Love: A Psycho-Educational Intervention to Prevent Gender Violence

Violence in sexual-affective relationships among teens and young people is recognized as a social, educational, and health problem that has increased worldwide in recent years. Educational institutions, as central developmental contexts in adolescence, are key in preventing and responding to gender violence through implementing successful actions. In order to scientifically support that task, the research reported in this article presents and discusses a psycho-educational intervention focused on autobiographical memory reconstruction that proved to be successful in raising young women’s critical consciousness about the force of the coercive discourse upon sexual-affective experiences and memories. We examined among a sample of young women (n = 32, age range 17–30) whether reading a scholarly text about love, the Radical Love book, modified autobiographical memories of violent sexual-affective relationships in line with preventing future victimization. This group was compared with a control group (n = 31, age range 17–30). Memory reports were collected before and after the reading and coded to analyze their content, both quantitatively and qualitatively. Memory quality features were assessed with the Memory Quality Questionnaire (MMQ). A focus group was also conducted to examine the personal impact of the intervention on participants. Compared with controls, the experimental group had stronger critical memories (of episodes involving violence), an average decrease in positive emotions induced by recall, and an average increase in negative emotions. The results show the effectiveness of the reading intervention designed in relation to gender violence prevention, as they indicate the ability of the psycho-educational action to debilitate the force of the coercive discourse in young women’s memories. The findings both advance knowledge on the reconstructive nature of autobiographical memories of violent sexual-affective relationships in female youth and indicate the potential of memory-based interventions as an instrument to prevent and reduce gender violence in school contexts. Teachers and teaching staff, and educational psychologists, among others, can benefit from these results by expanding the tools they have to address gender violence among female adolescents and youth.

Narrative Exposure Therapy: A Proposed Model to Address Intimate Partner Violence-Related PTSD in Parenting and Pregnant Adolescents

Pregnant and parenting adolescents experience high rates of intimate partner violence (IPV) and its sequelae posttraumatic stress disorder (PTSD) and depression. Narrative exposure therapy (NET) is an innovative intervention that has demonstrated strong preliminary evidence in improving mental health. The specific aims of this article are 3-fold: (1) provide a brief background about IPV-related PTSD and depression among pregnant and parenting adolescents; (2) describe NET's theoretical principles, its therapeutic process, and provide a review of existing evidence; and (3) discuss NET as a potential treatment to address the mental health burden among adolescents experiencing IPV-related PTSD and depression.

Suicidal ideation in pregnancy: an epidemiologic review

Suicidal behaviors are the leading causes of injury and death worldwide, and are leading causes of maternal deaths in some countries. One of the strongest risk factors, suicidal ideation, is considered a harbinger and distal predictor of later suicide attempt and completion, and also presents an opportunity for interventions prior to physical self-harm. The purpose of this systematic epidemiologic review is to synthesize available research on antepartum suicidal ideation. Original publications were identified through searches of the electronic databases using the search terms pregnancy, pregnant women, suicidal ideation, and pregnan* and suicid* as root searches. We also reviewed references of published articles. We identified a total of 2626 articles through the electronic database search. After irrelevant and redundant articles were excluded, 57 articles were selected. The selected articles were original articles that focused on pregnancy and suicidal ideation. Of the 57 included articles, 20 reported prevalence, 26 reported risk factors, 21 reported consequences of antepartum suicidal ideation, and 5 reported on screening measures. Available evidence indicates that pregnant women are more likely than the general population to endorse suicidal ideation. Additionally, a number of risk factors for antepartum suicidal ideation were identified including intimate partner violence, <12-year education, and major depressive disorder. There is a need for enhanced screening for antepartum suicidal ideation. The few screening instruments that exist are limited as they were primarily developed to measure antepartum and postpartum depression. Given a substantial proportion of women with suicidal ideation that does not meet clinical thresholds of depression and given the stress-diathesis model that shows susceptibility to suicidal behavior independent of depressive disorders, innovative approaches to improve screening and detection of antepartum suicidal ideation are urgently needed.

Cyber Victimization, Psychological Intimate Partner Violence, and Problematic Mental Health Outcomes Among First-Year College Students

Both cyber victimization and psychological intimate partner violence (IPV) have been associated with negative mental health outcomes among adolescents and young adults. The present study examined relations among cyber victimization, psychological IPV, and mental health outcomes (depressive symptoms, antisocial behavior) among first-year college students. Consistent with polyvictimization theory, we hypothesized that cyber victimization and psychological IPV would be related to each other. We also hypothesized that each would uniquely contribute to depressive symptoms and antisocial behavior, after accounting for the other. Participants (N = 342, M age = 18.33 years; 50% male) completed questionnaires during a single lab visit. Results indicated that cyber victimization and psychological IPV were related to each other, and both contributed uniquely to depressive symptoms, but only cyber victimization contributed uniquely to antisocial behavior. Exploratory analyses indicated that experiencing both cyber victimization and psychological IPV was necessary for increased depressive symptoms and antisocial behavior. This study is the first to establish a unique relation between cyber victimization and mental health problems, after accounting for psychological IPV. The findings also suggest a need to consider multiple forms of victimization when considering relations between specific types of victimization and mental health problems.

Associations between intimate partner violence and termination of pregnancy: a systematic review and meta-analysis

BACKGROUND

Intimate partner violence (IPV) and termination of pregnancy (TOP) are global health concerns, but their interaction is undetermined. The aim of this study was to determine whether there is an association between IPV and TOP.

METHODS AND FINDINGS

A systematic review based on a search of Medline, Embase, PsycINFO, and Ovid Maternity and Infant Care from each database's inception to 21 September 2013 for peer-reviewed articles of any design and language found 74 studies regarding women who had undergone TOP and had experienced at least one domain (physical, sexual, or emotional) of IPV. Prevalence of IPV and association between IPV and TOP were meta-analysed. Sample sizes ranged from eight to 33,385 participants. Worldwide, rates of IPV in the preceding year in women undergoing TOP ranged from 2.5% to 30%. Lifetime prevalence by meta-analysis was shown to be 24.9% (95% CI 19.9% to 30.6%); heterogeneity was high (I (2)>90%), and variation was not explained by study design, quality, or size, or country gross national income per capita. IPV, including history of rape, sexual assault, contraceptive sabotage, and coerced decision-making, was associated with TOP, and with repeat TOPs. By meta-analysis, partner not knowing about the TOP was shown to be significantly associated with IPV (pooled odds ratio 2.97, 95% CI 2.39 to 3.69). Women in violent relationships were more likely to have concealed the TOP from their partner than those who were not. Demographic factors including age, ethnicity, education, marital status, income, employment, and drug and alcohol use showed no strong or consistent mediating effect. Few long-term outcomes were studied. Women welcomed the opportunity to disclose IPV and be offered help. Limitations include study heterogeneity, potential underreporting of both IPV and TOP in primary data sources, and inherent difficulties in validation.

CONCLUSIONS

IPV is associated with TOP. Novel public health approaches are required to prevent IPV. TOP services provide an opportune health-based setting to design and test interventions.

"My situation wasn't that unique": The experience of teens in abusive relationships

College freshman and sophomores with histories of high school dating violence were invited to participate in a study about that experience. The shared experience described by ten participants was that of being controlled. Control is established by creating a sense of responsibility and is maintained by angry outburst, threats to self, and guilt. Participants described an expectation of constant contact that included techno vigilance. In their stories, young women miss good and better times, hope for "the ideal romance," and continue to care and have concern for their abuser who is described as "troubled."