A latent profile analysis of intimate partner victimization and aggression and examination of between-class differences in psychopathology symptoms and risky behaviors

Improvements in Safety Outcomes Following Brief Healthcare-Based Intimate Partner Violence Interventions among Women Who Screen Positive for Intimate Partner Violence-Related Traumatic Brain Injuries

Background: Traumatic brain injuries (TBIs) are a common consequence of experiencing intimate partner violence (IPV). IPV-related TBI contributes to adverse health outcomes among women, but it is unknown whether a history of IPV-related TBI negatively impacts safety outcomes following healthcare-based interventions for IPV. Methods: Using data from a larger randomized clinical trial, we explored the impact of IPV-related TBI status on safety-related outcomes in two healthcare-based IPV interventions. At baseline, 35% (n = 21) of the sample screened positive for IPV-related TBI history. We used repeated measures ANOVAs to examine differences in safety outcomes at post-treatment and 1-month follow-up based on treatment condition and IPV-related TBI status. Results: Significant interaction effects were found for safety outcomes, such that women with IPV-related TBI history experienced larger reductions in the frequency of physical IPV and similar reductions in sexual IPV across both treatment conditions compared to women without IPV-TBI (F(2, 102) = 10.88, p < 0.001; F(2, 98) = 3.93, p = 0.036). Conclusions: Findings suggest that brief healthcare-based IPV interventions may result in improvements in safety outcomes for women with a history of IPV-TBI. This highlights the continued need for implementation of promising IPV-focused interventions to promote safety and protect women from experiencing further IPV.

Concurrent Intimate Partner Violence: Survivors' Health and Help-Seeking

This study examined intimate partner violence patterns using the National Intimate Partner and Sexual Violence Survey, a nationally representative sample collected in 2010. The latent class analysis detected six distinctive patterns: Sexual Violence, Psychological Aggression, Multiple Violence, Coercive Control, Physical and Psychological Violence, and Stalking. Multiple Violence was the most common among males, while Coercive Control was the most common among females. Multiple Violence and Physical and Psychological Violence perpetrators inflicted more negative health consequences than the other types. Intervention and prevention approaches that consider perpetrator types as a part of survivor need assessments will improve services.

Mental health outcomes of physical, sexual, and psychological intimate partner violence among women in Turkey: A latent class study

Intimate partner violence (IPV) is a severe human right violation and a significant public health problem in Turkey. However, its complexity and stratified relationship with mental health problems are still uncovered in this under researched community, as violence is often approached as a uniform health and social problem. In this study, we collected data from 539 female adults in heterosexual relationships in Turkey using convenience and snowball sampling. The aim was to examine violence-related clusters and their association of these clusters with mental health outcomes, including depression, anxiety, and depression). We assessed whether participants experienced physical, sexual, and psychological violence in their intimate relationships and conducted a latent class analysis. We obtained five violence clusters: (1) no or low violence, (2) high psychological violence, (3) jealous control with physical violence, (4) moderate sexual and psychological violence, and (5) severe physical, sexual, and psychological violence. Analyses of variance showed that women who experienced multiple forms of IPV reported stronger depression, anxiety, and somatization compared with women in the no or low violence class. Additionally, they reported greater depression and anxiety compared with women who experienced only high psychological IPV. However, psychological violence amplified somatization as much as physical and sexual violence.

Patterns of Women's exposure to psychological violence: A global examination of low- and middle-income countries

Introduction

Under Sustainable Development Goal 5, prevalence of intimate partner violence (IPV) is a globally reportable indicator. There is a lack of consensus on how to measure and report psychological IPV, affecting prevalence estimates and cross-country comparability. We examine similarities and differences in the patterning of women's experiences of psychological abuse in low- and middle-income countries (LMICs) to inform common cut points.

Methods

Data include 13,452 ever-partnered women from six LMICs participating in the WHO multi-country study on women's health and domestic violence against women and 306,101 from 47 LMICs participating in the Demographic and Health Surveys. A confirmatory latent class analysis (LCA) approach was applied to identify the optimal class structure using the 3 DHS and 4 WHO psychological IPV items, assessed the impact of physical and sexual IPV on class structure, and tested class generalizability across countries. We validated the three-class solution by regressing the classes on physical IPV, sexual IPV, controlling behaviors, and injury due to domestic violence. We used item response theory (IRT) methods to assess item-level characteristics of the items.

Results

Analysis confirmed the three-class structure in most countries. Addition of physical and sexual IPV did not change overall class structure or improve discrimination or homogeneity of the items. The three-class structure was invariant within most WHO-classified regions. Operationalized classes informed by the LCA resulted in prevalences of roughly 90% low-to-no class, 7% moderate-intensity class, and 3% high-intensity class. Classes showed convergent validity with all outcomes tested. IRT analysis revealed good discriminations but substantial information overlaps over a narrow range of the latent psychological violence construct.

Conclusions

This study confirms the three-class pattern but suggests some differences across countries. and regions. We suggest cut points distinguishing violent from non-violent acts and demarcating levels of severity for future study. Findings offer evidence-based guidance to rectify challenges.

Intimate Partner Violence Polyvictimization and Health Outcomes

This study examines how gender interacts with polyvictimization patterns in survivors' health problems using 8,587 survivors of intimate partner violence from the National Intimate Partner and Sexual Violence Survey, a nationally representative sample collected in 2010. Polyvictimization included six categories that were created in our previous work: sexual violence, physical and psychological violence, coercive control, multiple violence, stalking, and psychological aggression. Multiple violence was associated with chronic pain, headache, difficulty sleeping, and poor health perception. Females experiencing coercive control were more likely to have chronic pain than males. The appropriate assessment of gendered patterns of polyvictimization, and relevant subsequent services and support will better address health problems among survivors.

Alcohol Misuse and Women's Use of Aggression in Intimate Relationships: The Mediating Role of Motivations for Using Aggression

The relationship between alcohol misuse and women's use of intimate partner violence (IPV) aggression has been well studied; however, there has been no research to date on women's self-reported motivations for use of IPV aggression (e.g., self-defense, control) as an underlying mechanism explaining this link. Accordingly, this study aims to examine whether the effects of alcohol misuse on IPV aggression vary as a function of women's motivations for using aggression. Participants were 412 ethnically diverse community women, between the ages of 18 and 65, in intimate relationships characterized by bidirectional IPV. The Motives and Reasons for IPV Scale was used to assess women's reasons for using IPV aggression. Results revealed that the tough guise motive (i.e., wanting to appear tough, intimidating, and willing to harm one's partner) explained the relationship between alcohol misuse and physical and sexual IPV aggression. Findings suggest the utility of incorporating the assessment of women's motivations for IPV aggression in an effort to provide better informed intervention addressing the underlying reasons women use IPV aggression.

Bidirectional Intimate Partner Violence Among Chinese Women: Patterns and Risk Factors

Bidirectional intimate partner violence (BIPV) refers to the co-occurrence of violence perpetration by both partners. BIPV has been analyzed using samples from different sociodemographic contexts but has yet to be fully explored in China. The present study employed a latent class approach to identify BIPV patterns, rates of prevalence, and associated risk factors among a sample of 1,301 heterosexual adult women in mainland China. Five distinct patterns of BIPV were identified, including (a) bidirectional psychological aggression, (b) bidirectional violence of all types, (c) multi-type victimization with psychological aggression, (d) minimal violence, and (e) bidirectional multi-types without physical violence. Marital status, education, employment status, acceptance of male dominance, and justification of intimate partner violence (IPV) were found to be predictive of different types of BIPV. Our findings suggest a need for a conceptual recognition of the heterogeneity and bidirectionality of IPV among Chinese women. Future research should extend to other diverse populations and sociocultural or clinical contexts in China. IPV assessments, research, and social programs ought to recognize the complexity of IPV and consider various IPV patterns specific to heterosexual women.

Intimate Partner Violence Stories of Appalachian Women

The purpose of this study was to explore past intimate partner violence as it occurred in Appalachian women residing in rural and non-urbanized areas. The methodology was qualitative description. Twelve former intimate partner violence female victims shared their experiences through the socioculturally appropriate tradition of story-telling. The meta-theme, Turning Points, reflecting the perceived non-linearity of intimate partner violence was supported by three themes: (1) The Process of Abuse: (2) Learn from my Story; Don't Let it be Your Story; and (3) Does Where I Live Make a Difference? All participants experienced patterns of abuse that cycled in frequency and severity, similar injuries and health problems, fear, helplessness, and, at times, hopelessness. Application of knowledge gained through naturalistic methods can advance our understanding of intimate partner violence as it occurs in vulnerable populations and the depth and breadth of sociocultural influences which may affect the public health threat of this type of violence.

Experiences of Elder Mistreatment: A Latent Profile Analysis

Using a polyvictimization framework, this study seeks to identify profiles of older adults who are mistreated by their family members. Data were drawn from a survey (n = 897) on the prevalence of elder mistreatment in rural India. This study involved 187 community-dwelling older adults (aged 61 years and above) with experiences of mistreatment in the year prior to the interview. Mistreatment was assessed through an adapted version of the Conflict Tactics Scale. Latent profile analysis was conducted to classify older adults into empirically derived clusters. The best fitting model yielded three distinct profiles: multiple mistreatment all (high frequency), multiple mistreatment (predominantly psychological), and multiple mistreatment (predominantly neglect). The three clusters differed in terms of individual, familial, and perpetrator characteristics. These findings highlight the heterogeneity of elder mistreatment experiences and the need for specific interventions that address the needs of mistreated older adults.

Social Reactions to IPV Disclosure and PTSD Symptom Severity: Assessing Avoidant Coping as a Mediator

Women's experiences of negative social reactions to disclosure of intimate partner violence (IPV) victimization have been linked to greater posttraumatic stress disorder (PTSD) symptom severity. However, research has not identified factors that may explain this association. The goal of the current study was to extend research in this area by elucidating the potential mediating role of avoidant coping in the relations among negative and positive social reactions to IPV disclosure and PTSD symptom severity. Participants were 173 community women currently experiencing IPV who disclosed their victimization to another individual (M age = 36.31, 65.9% African American). Findings revealed that IPV-victimized women who experienced greater negative social reactions to IPV endorsed higher levels of avoidant coping and greater PTSD symptom severity. Moreover, avoidant coping was found to mediate the negative social reactions-PTSD symptom severity association. Results highlight the relevance of avoidant coping to the link between negative social reactions to IPV disclosure and PTSD symptom severity, and suggest that prevention and intervention efforts targeting avoidant coping may be useful in reducing PTSD symptom severity among IPV-exposed women who experience negative social reactions to IPV disclosure.

Intimate partner violence in Nepal: Latent patterns and association with depressive symptoms

Existing data suggest that there are distinct patterns (or classes) of intimate partner violence (IPV) experience that depart from dichotomous categorizations used to monitor progress toward Sustainable Development Goal 5.2. Less is known about the patterning of IPV in non-Western settings. This study estimates distinct classes of IPV experience in Nepal and examines potential community-level variability in these classes and in the association between IPV class and depressive symptoms. This study used data collected in 2016 from a random sample of Nepalese married women of reproductive age (N = 1440) living in 72 communities in three districts (Nawalparasi, Chitwan, and Kapilvastu). We used fixed effects and random effects latent class models of 2 through 6 classes. We fit a negative binomial regression model adjusted for relevant confounders to examine the relationship of the latent IPV classes with depressive symptoms. A four-class model was the best fitting. It included a "low exposure" class (77.36% of the sample) characterized by a low probability of experiencing any form of IPV, a "sexual violence" class (9.03% of the sample) characterized by a high probability of experiencing a form of sexual violence, a "moderate violence" class (6.60% of the sample) characterized by modest probabilities of experiencing less severe emotional and physical IPV, and a "systematic violence" class (7.01% of the sample) characterized by a high probability of being exposed to all forms of IPV. Adding random effects did not improve model fit, suggesting no community-level variations in classes. Relative to membership in the low exposure class, membership in all other classes was associated with a higher count of depressive symptoms. Those in the systematic class had a mean weighted symptom count 2.29 times that of the low exposure group. Classes of IPV exposure must be identified to ensure that surveillance and programming are attuned to women's experiences of violence.

Typologies of PTSD clusters and reckless/self-destructive behaviors: A latent profile analysis

Posttraumatic stress disorder (PTSD) is comorbid with diverse reckless and self-destructive behaviors (RSDBs). We examined the nature and construct validity (covariates of age, gender, depression severity, number of trauma types, functional impairment) of the optimal class solution categorizing participants based on PTSD symptom and RSDB endorsement. The sample included 417 trauma-exposed individuals recruited through Amazon's MTurk platform who completed the Life Events Checklist for DSM-5, PTSD Checklist for DSM-5, the Posttrauma Risky Behaviors Questionnaire, and Patient Health Questionnaire-9. Latent profile analyses indicated an optimal three-class solution: the Low PTSD-RSDBs, High PTSD-Low RSDBs, and High PTSD-RSDBs classes. Multinomial logistic regression indicated that impairment and depression predicted the High PTSD-Low RSDBs vs. the Low PTSD-RSDBs classes. Impairment, age, being female, and depression predicted the High vs. Low PTSD-RSDBs classes. Number of trauma types, age, being female, and depression predicted the High PTSD-RSDBs vs. High PTSD-Low RSDBs classes. Results support the presence of a reckless behaviors subtype of PTSD (characterized by greater depression, greater impariment, greater number of trauma types, being male, and being younger), conducting comprehensive assessments of RSDBs for individuals reporting PTSD symptoms and of PTSD symptoms for individuals reporting RSDBs, and the need to tailor interventions to treat PTSD and RSDBs concurrently.

Avoidant Coping as a Moderator of the Association Between Childhood Abuse Types and HIV/Sexual Risk Behaviors

Women who experience intimate partner violence (IPV) report high rates of HIV/sexual risk behaviors. Childhood abuse has been linked to HIV/sexual risk behaviors among IPV-victimized women; however, limited research has examined factors that may influence this association. The current study tested the moderating role of avoidant coping in the relation between childhood abuse types (physical, emotional, and sexual) and HIV/sexual risk behaviors. Participants were 212 community women currently experiencing IPV (mean age = 36.63 years, 67.0% African American). Higher levels of avoidant coping were related to more severe childhood abuse types. Severity of childhood abuse types was associated with greater HIV/sexual risk behaviors. Avoidant coping moderated the relation between childhood sexual abuse severity and HIV/sexual risk behaviors, such that this association was significant for IPV-victimized women with high (but not low) levels of avoidant coping. Findings suggest the utility of targeting avoidant coping in interventions aimed at preventing or reducing HIV/sexual risk behaviors among IPV-victimized women with a history of childhood sexual abuse.

Trauma exposure and heavy drinking and drug use among college students: Identifying the roles of negative and positive affect lability in a daily diary study

Trauma exposure is linked to heavy drinking and drug use among college students. Extant research reveals positive associations between negative affect lability and both trauma exposure and alcohol use. This study aimed to extend past research by using daily diary methods to test whether (a) individuals with (versus without) trauma exposure experience greater negative and positive affect lability, (b) negative and positive affect lability are associated with heavy drinking and drug use, and (c) negative and positive affect lability mediate the relations between trauma exposure and heavy drinking and drug use. Participants were 1640 college students (M age=19.2, 54% female, 80% European American) who provided daily diary data for 30days via online surveys. Daily diaries assessed negative and positive affect and substance use (i.e., percent days of heavy drinking, percent days of drug use, total number of drugs used). Individuals with (versus without) a history of trauma exposure demonstrated higher levels of negative and positive affect lability. Negative, but not positive, affect lability was associated with percent days of heavy drinking, percent days of drug use, and total number of drugs used, and mediated the associations between trauma exposure and heavy drinking and drug use outcomes. Findings provide support for the underlying role of negative affect lability in the relations between trauma exposure and heavy drinking and drug use among college students, suggesting that treatments targeting negative affect lability may potentially serve to reduce heavy drinking and drug use among trauma-exposed college students.

Is Firearm Threat in Intimate Relationships Associated with Posttraumatic Stress Disorder Symptoms Among Women?

In the context of intimate partner violence (IPV), firearms may be used to threaten, coerce, and intimidate. Yet, what little research exists on firearms among IPV victims has focused almost exclusively on homicide or near homicide. Thus, the deleterious health consequences of firearms more broadly remain unknown. The goals of the current study were (1) to document the prevalence of firearm threat in a community sample of female IPV victims, and (2) to identify the extent to which threat with a firearm, independent of other forms of IPV, is related to women's posttraumatic stress disorder (PTSD) symptom severity. Participants were 298 women who had been a victim in a criminal domestic violence case with a male intimate partner (M_age = 36.39 years; 50.0% African American; 51.3% unemployed). Retrospective data on firearm threat, fear of firearm violence, other IPV victimization (i.e., physical, psychological, and sexual), and PTSD symptoms were collected during in-person individual interviews. Approximately one-quarter of the sample (24.2%) experienced threat with a firearm during the course of their relationship, and 12.5% were afraid that their partners would use a firearm against them in the 30 days prior to the study interview. Firearm threat and fear of firearm violence emerged as significant and unique predictors of PTSD symptom severity, controlling for age and physical, psychological, and sexual IPV victimization severity. The findings underscore firearm threat as a key factor for identifying and intervening with criminal justice involved women who experience IPV.