Witnessing Intimate Partner Violence as a Child Does Not Increase the Likelihood of Becoming an Adult Intimate Partner Violence Victim

Types of adolescent exposure to violence as predictors of adult intimate partner violence

Despite evidence that exposure to violence in adolescence may be more predictive of problem behavior outcomes than exposure to violence in earlier childhood, there is limited research on the relationship of adolescent exposure to violence on adult intimate partner violence (IPV) perpetration and victimization. This study examines the relationship of adolescent physical abuse victimization, witnessing parental violence, and adolescent exposure to violence in the community, to perpetration of and victimization by IPV in middle age. Respondents are drawn from a nationally representative longitudinal sample with data collected from 1976-77 to 2002-03, age 11-17 when first interviewed and 37-43 when last interviewed. Univariate descriptive statistics and bivariate correlations are presented, along with Heckman two-step models calculated separately for females and males. The use of the Heckman two-step model allows prediction not only of adult IPV, but also of selection out of intimate partner relationships (i.e., out of the at-risk population). For males, in the multivariate analysis, only physical abuse remains significant as a predictor. For females, adolescent exposure to violence is not predictive of adult IPV perpetration or victimization, but physical abuse is predictive of not being in the at-risk population (married or cohabiting). The combined index of adolescent exposure to violence is significant for both females and males in predicting selection into marriage or cohabitation, and at least marginally significant in predicting IPV.

Derivation and validation of a short emergency department screening tool for perpetrators of intimate partner violence: the PErpetrator RaPid Scale (PERPS)

BACKGROUND

There is no short screening tool for perpetrators of intimate partner violence (IPV), although one is needed.

OBJECTIVE

To retrospectively derive and prospectively validate a brief screening tool for perpetrators of IPV: the PErpetration RaPid Scale (PERPS).

METHODS

In the derivation phase of the study, we developed the PERPS based on historical data. The PERPS consists of three Yes/No questions about physical abuse of a partner. In the validation phase, we prospectively screened subjects during randomized 4-h shifts in a busy emergency department (ED). Subjects were asked to complete the newly derived three-question PERPS as well as the Physical Abuse of Partner Scale (PAPS), a 25-question Likert scale that is the gold standard for detection of physical abuse of a partner. The main outcome measures were sensitivity, specificity, predictive values, accuracy, and Cronbach alpha of the PERPS for internal consistency.

RESULTS

The PERP Scale derivation was based on a 207-subject historical database, and resulted in a three-question PERPS. Validation was completed on a new set of 214 patients presenting to the ED during 52 randomized 4-h shifts. The prevalence of IPV perpetration using the PERPS was 47/207 (22.7%; 95% confidence interval [CI] 16-27). For the PAPS, prevalence was 56/207 (27%; 95% CI 20-32). Compared with the PAPS, the sensitivity of the PERPS was 66%, specificity 93%, negative predictive value 87%, positive predictive value 78%, with an accuracy of 85%. Cronbach alpha of the PERPS was 0.68. Age, gender, and race were not predictive of positive results on either scale.

CONCLUSION

We successfully derived and validated a three-question perpetrator of IPV scale that can be used in a busy ED or office setting.

Brief intervention for perpetration of intimate partner violence (IPV): simulation versus instruction alone

OBJECTIVE

To compare two brief randomized computer-based interventions about perpetration of intimate partner violence (IPV).

METHODS

The study was a prospective cross-sectional cohort study of patients during randomized 4-hour shifts in an urban hospital-based emergency department setting with an emergency medicine residency. The site is a level 1 trauma center emergency department with an annual census of 60,000 adults. A touch-screen computer program was developed in Visual Basic 2005 Studio with consecutive data entry screens. A series of questions to evaluative IPV knowledge, attitude, and practices (KAP) was given before and after the brief intervention. The subjects were randomized to one of two intervention groups. Both groups were shown a set of PowerPoint slides addressing IPV prevention, which was followed by either a control group with nothing further (control) or a five-minute simulation video depicting IPV perpetration in adults (SIM). The main outcome was the net improvement in KAP scores defined as number who improved minus number who did worse. Perpetrators and victims were assessed separately. Demographics were also obtained. For demographics, descriptive statistics and percentages were used. Wilcoxon signed rank test was used for pre-post test paired data.

RESULTS

A total of 239 patients, presenting during 52 randomized four-hour shifts, completed the study; 118 were in the control group, 121 in SIM; 115 (48%) were male and 124 (51 %) female (9 unknown). Most participants were from 21 to 30 years old (38%); 77 (32%) were Hispanic and 100 (42%) were white. There was an overall improvement in responses to KAP questions with correct answers to all questions in 46% before vs 59% after the computer intervention (Diff 13% 95% confidence interval [CI] 4-22). The net improvement in KAP score in the control group was 8% and in the SIM group it was 22% (Diff = 15%, 95% CI = 6-24). Forty subjects (17%, 95% CI = 12-21) were perpetrators and 52 subjects (22%, 95% CI = 17-27) were victims. KAP scores were not significantly improved in the SIM group over the control for either perpetrators or victims.

CONCLUSION

An IPV simulation video resulted in a greater percent of subjects showing improvement in knowledge, attitudes, and practices about IPV perpetration. A brief IPV simulation video intervention can be performed in a busy emergency department setting.