Do violence dynamics matter?

Co-Occurrence of Violence on the Severity of Abuse in Intimate Relationships

Several empirical studies have shown that women who experience violence in intimate personal relationships (IPV) commonly experience more than one form of violence. While it is recognized that individual trajectories of IPV vary over time, little is known about the temporal dynamics of this co-occurrence or its consequences. This study describes the different forms of violence experienced by women and looks at whether it is possible to predict when severe violence (physical and sexual) is most likely to occur. Data in the study comes from interviews with 70 women who had been victims of intimate partner violence. The life history calendar method was used to facilitate identifying kinds and levels of violence and the month in which violence took place. Individual victimization trajectories were found to be heterogenous and likely to change in the short term. The women in our sample experienced more than one form of intimate partner violence and co-occurrence of different forms of violence was common in individual trajectories. The characteristics of the kind of violence experienced were important in understanding the temporal aspects of acts of severe violence. The increased knowledge about patterns of violence provided by these results should help to develop better ways to intervene to prevent such events.

Complex Relationship Between Daily Partner Violence and Alcohol Use Among Violent Heterosexual Men

Although alcohol use and partner violence are consistently associated, the nature of the alcohol-violence relationship is still unclear. The purpose of this pilot study was to use longitudinal daily assessments of male partners' alcohol use and violent events to identify the nature of the alcohol-violence relationship, employing both linear and nonlinear analyses. The participants were 20 adult heterosexual couples of whom the woman reported experiencing partner violence in the prior 30 days. Each partner provided a separate daily telephone report for 8 weeks via an automated interactive voice response (IVR), concerning the previous day's violence, alcohol use, stressors, emotional reactions, and concerns for children. Individual IVR databases were merged to form a combined couple's IVR time series. Time series were analyzed using graphic, linear, and nonlinear methods. Graphic analysis using state space grids found no consistent pattern across couples. Similarly, linear analysis using same-day cross-correlation and prior-day beta statistics found no significant group-level alcohol-violence relationship. Using cross-approximate entropy statistics and differential structural equation modeling, no nonlinear relationships between alcohol use and violence were noted either. Whether applying linear or nonlinear analytic methods, there is no group-level relationship between alcohol use by male perpetrators and their violent acts. The implications are significant. First, the alcohol-violence relationship may differ among subgroups. Second, couples need to be assessed thoroughly to determine their unique relationship with alcohol use, so that couple-specific interventions can be designed. Third, if perpetrators believe that their violence is facilitated by their alcohol use, then alcohol reduction should be encouraged despite any evidence suggesting a different alcohol-violence relationship. Finally, the accepted alcohol-causes-violence belief held by many providers needs to be reconsidered. Because the nature of the alcohol-violence relationship varies considerably across couples, clinicians should seek to understand their unique relationship applying across-the-board management approaches.

Violence towards women and their decisions to take action: A complex systems approach

Intimate partner violence (IPV) is a blight on society. Our traditional understanding suggests that interventions should be straightforward, leading to predictable positive results. However, these assumptions do not reflect the reality of IPV, which continues to frustrate physicians. While IPV research has thoroughly described the developmental risks and impacts of IPV, the violent incident itself remains largely unstudied and poorly understood. Although this lack of research may partially explain physician frustration and the limitations of our interventions, the greater problem may be our reliance upon the wrong paradigm in guiding our understanding. Complexity science says that systems are globally understandable, but not completely knowable. Our hypothesis is that IPV needs to be viewed as a complex adaptive system if we are to understand the phenomenon, identify expectations and appropriately intervene. When viewed through the lens of complexity science, IPV becomes less knowable and predictable, suggesting that interventionists should expect variable response. Research has indeed demonstrated that partner violence is a complex phenomenon with multiple, interdependent factors and a nonlinear trajectory. This nonlinearity/unpredictability can impact outcomes in IPV, often more so than the frequency or severity of the violence. Similarly, women's decision-making concerning the violence is also a nonlinear process dependent upon multiple factors and catastrophic influences. Once recognized, complexity science offers a novel approach to explain IPV's obfuscation and resistance to predictable change. Using the tempered expectations of a systems lens, the violent interdependencies can be clarified, the obscure causes of events can be visualized, and the temporal irregularities can be mapped. Not only can the disruptive tipping points, system feedforward propagations, powerful attractors and discontinuities compromise reasoned intervention, but these same factors, if understood, can be harnessed to foster and magnify circumstances that enable positive change.

Is Perceived Need for Action Among Women in Violent Relationships Nonlinear and, If So, Why?

Despite the prevalence and impact of partner violence, we understand little about women's action taking except that it seems an unpredictable, nonlinear process. This article determines the degree of nonlinearity in perceived need for help, legal action, or leaving among women in violent relationships. The participants included 143 women who experienced violence in the previous month, enrolled from six primary care clinics. Baseline surveys assessed background characteristics and factors which may affect perceived need for action. Multiple times series assessments of violence and need for action were collected daily for 8 weeks via telephone Interactive Voice Response. Measures of nonlinearity of violence, perceived need for help, legal action, and leaving were computed. Repeated measures ANOVA assessed differences across measures of nonlinearity. To identify factors contributing to nonlinearity, staged multiple regression assessed the relationship between nonlinearity measures and outcomes. Ninety-three women completed sufficient time series for nonlinearity assessment. Measures of nonlinearity were lower for need for legal action compared with needs for help and leaving. Regression analysis suggested that isolation, social networks, and lack of awareness contribute to nonlinearity. Women's perceived need for legal action and its level of nonlinearity were lowest compared with those of help seeking and leaving. Although its relative linearity suggests that the need for legal action may be the most predictable, its lower mean rating suggests that legal action is a low priority. Although need for help and leaving are of higher priorities, their nonlinearity suggests that intervention will not yield predictable results.

Does a history of childhood abuse moderate the association between symptoms of posttraumatic stress disorder and borderline personality disorder in survivors of intimate partner violence?

OBJECTIVE

This study examined whether a history of childhood abuse (CA) strengthened the association between borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) in the aftermath of intimate partner violence (IPV). This hypothesis arises from clinical literature but has not been examined empirically. We predicted that a history of CA would enhance associations between BPD features and PTSD symptoms.

METHOD

Dimensional assessment of both PTSD and BPD was made in a sample of 211 women who sought mental health services following IPV. Two analyses were conducted using clinician-assessed DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th ed.) PTSD symptoms: (a) total score and (b) symptom clusters.

RESULTS

Using path analysis, results indicated significant associations between BPD features and PTSD symptoms, but no significant interaction between BPD and CA in either analysis.

CONCLUSIONS

Results are discussed given current understanding of comorbidities involving PTSD, with particular attention to potential implications for clinical practice. Areas for future research are proposed.

"My Partner Will Change": Cognitive Distortion in Battered Women in Bolivia

This study examines the role of cognitive distortion in women's decision to stay with or leave their violent partner in a sample of Bolivian women. Our study is based on a consistency model: Cognitive distortion is assumed to play an important role in maintaining cognitive consistency under threatening conditions. Eighty victims of partner violence aged 18 to 62 years who sought help in a legal institution were longitudinally assessed three times over a time period of 6 months. Measures were taken from previous studies and culturally adapted through qualitative interviews. Nearly half of the participants decreased their intention to leave the violent partner in the time span of 1 month between the first and second interview. Women who had decreased their leaving intention had concurrently increased their cognitive distortion: They blamed their partner less, were more convinced that they could stop the violence themselves, and were more likely to believe that their partner would change. Cognitive distortion was not observed among women who remained stable in their intention to leave. Women whose intention of leaving decreased and who displayed more cognitive distortion after 1 month were more likely to live with the violent partner 6 months later than women whose leaving intention remained stable or increased. Socio-demographic variables were not related to cognitive distortion or stay-leave decisions in this study. We conclude that cognitive distortion plays a role for women's decision to stay, enhancing their risk of re-victimization.

Effects of religious and spiritual variables on outcomes in violent relationships

OBJECTIVE

Religious and spiritual factors in intimate partner violence have received increasing attention. But are such factors related to outcomes in violent relationships? The purpose of this study was to assess the relative impact of spiritual symptoms and religious coping on attitudinal/behavioral and clinical outcomes among women in violent relationships.

METHODS

Adult women with a recent history of husband-to-wife physical abuse were recruited from six primary care clinics. Once enrolled, 200 subjects completed a baseline interview and daily assessment of level of violence, using the Interactive Verbal Response for 12 weeks. At the completion of the study, contact with each participant was attempted to determine whether she had either sought professional help or left the relationship. Three religious/spiritual variables were assessed at baseline-number of visits to a religious/spiritual counselor, religious coping, and severity of spiritual symptoms. Stepped multiple linear regression was used to explain factor-analyzed outcomes (coping and appraisals, hope and support, symptomatology, functional status, readiness for change, and medical utilization), adjusting for demographic, marital, childhood, mental health, and violence variables.

RESULTS

After controlling for duration, severity and dynamics of violence, the use of spiritual resources, and the level of spiritual symptoms were associated with most attitudinal/behavioral and clinical outcomes, while religious coping was only associated with staying in the relationship.

CONCLUSIONS

Religious and spiritual factors were associated with most outcomes. Spiritual symptoms had a consistently negative effect on outcomes while use of spiritual resources had variable effects. Religious coping was only associated with refraining from leaving the relationship.