Physical and sexual intimate partner violence, women's health and children's behavioural functioning: entry analysis of a seven-year prospective study

"Your Skin Crawled Every Time He Touched You": A Secondary Qualitative Analysis Exploring Bagwell-Gray's Taxonomy of Intimate Partner Sexual Violence

Bagwell-Gray et al. developed a taxonomy of intimate partner sexual violence (IPSV) focusing on type of force (physical or nonphysical) and type of sexual activity (penetration or no penetration). The current secondary descriptive qualitative analysis of interviews with 89 Canadian women IPV victims assessed IPSV that fit Bagwell-Gray's taxonomy. About half (46 or 51.7%) described sexual violence, most commonly sexual abuse (26 or 29.2%), sexual assaults (17 or 19%), and sexual coercion (16 or 17.9%), with overlap across categories. Forced sexual activity was seldom mentioned (3 or 3.4%). Implications for service providers and researchers are provided.

Violent Partners or a Specific Class of Offenders? A Criminal Career Approach to Understanding Men Involved in Intimate Partner Sexual Violence

The current study investigates the criminal career of individuals involved in intimate partner sexual violence (IPSV). Specifically, the goal is to determine whether men who engage in IPSV can be distinguished from those who engage in intimate partner non sexual violence (IPNSV) only and whether criminal trajectories in the resulting subgroup are heterogeneous. The sample comes from a Canadian database including a total of 12,458 individuals involved in IPSV and 32,474 individuals involved in IPNSV). Bivariate and multivariate analyses are performed to examine the differences in the two groups while latent profile analysis allows examining the heterogeneity of characteristics of men who engaged in IPSV. Findings indicate that the criminal career of men who engage in IPSV follows a pattern that is clearly distinct from that of men who engage in IPNSV only and is more specialized in terms of sexual offenses. Results also show that the criminal trajectories followed by the men who engage in IPSV are heterogeneous. Four profiles of different trajectories were identified. Both theoretical and practical implications are discussed.

Intimate Partner Violence and Health Conditions Among U.S. Adults-National Intimate Partner Violence Survey, 2010-2012

INTRODUCTION

Few studies of intimate partner violence and health outcomes include multiple forms of intimate partner victimization, so this paper sought to examine health associations with intimate partner violence (IPV), including sexual, physical, stalking, and psychological forms, as well as polyvictimization.

METHODS

Data are from the 2010-2012 National Intimate Partner and Sexual Violence Survey, an on-going national random-digit-dial telephone survey of U.S. adults. There were 41,174 respondents. Logistic regression was used to compute prevalence ratios for any IPV, adjusted for demographics and non-IPV victimization. For individual forms of IPV, prevalence ratios were further adjusted for other forms of IPV. Tests for linear trend in poly-victimization were performed.

RESULTS

Any IPV was associated with all health conditions for both sexes with a few exceptions for males. Female penetrative sexual victimization and male stalking victimization were associated with the most health conditions. For each health condition, a significant linear trend indicated that as the number of forms of IPV experienced increased, prevalence of each health condition increased, with a few exceptions for males.

CONCLUSIONS

It is important for service providers to screen for multiple forms of IPV, including psychological aggression, because individual forms or polyvictimization may have unique and cumulative health effects.

Mothering in the context of intimate partner violence: A feminist intersectional critique of the nursing literature

AIMS

To describe how mothers and mothering in the context of IPV are conceptualized in the nursing research and practice literature with attention to underlying ideologies, biases and potential harms.

DESIGN

Feminist intersectionality was used as a theoretical and analytic lens.

DATA SOURCES

Articles published between 2000 and 2021 in the nursing literature, identified by searching Google Scholar, CINAHL, PubMed and Scopus databases, and conducting bibliographic reviews of published articles.

REVIEW METHODS

Search terms included: intimate partner violence, domestic violence, parenting, mother and nursing. Initial screening resulted in inclusion of 98 papers for analysis.

RESULTS

Four dominant ways of conceptualizing mothering in the context of IPV were identified: (1) IPV is conceptualized as a discrete acute event and/or crisis, (2) mothering is treated as a practice, (3) mothers are valued as vehicles for child health and well-being and (4) mothers are seen as vulnerable and 'at risk'. These narrow constructions are rooted in ideologies such as normative motherhood, deficit and grit/resilience and neoliberalism. Emerging shifts in the literature are providing an important counter-balance.

CONCLUSION

Biases in nursing knowledge about mothering in the context of IPV may limit nursing's capacity to support the health of these women and their children. The integration of emerging perspectives that emphasize strengths and equity is critical in strengthening nursing knowledge and practice and in beginning to redress existing limitations and potential harms.

IMPACT

This critique focused on higher-income countries of the Global North but raises fundamental questions that should be considered in other contexts. Applying broader conceptualizations of mothers, mothering and IPV to research and practice can help improve the quality of care available.

“The Average Counsellor Wouldn’t Know”: Exploring How General Health Practitioners Understand and Respond to Domestic Violence

Background

Individuals experiencing and perpetrating intimate partner violence (IPV) are frequently in contact with general health and mental health services. Health service providers, including nurses, thus have a key role in identifying and responding to initial indicators of IPV risk.

Purpose

The present study provides descriptive information about current assessment and intervention practices of health and mental health service providers when patients are presenting with concerns about IPV.

Methods

A secondary data analysis of interviews with general health practitioners (n = 17) were coded and dominant themes analyzed through thematic analysis.

Results

The present study uncovered ways in which IPV-related risks are, and are not, recognized and responded to. A metaphorical visual display in the form of a “domestic violence supply room” depicts the level of access and degree of competency described by practitioners in respective areas of practice. Within reach for all practitioners is the knowledge of factors that increase risk and vulnerability to IPV. Out of reach is a comprehensive understanding of the needs of children and perpetrators as well as the consistent ability to consider intersectionality and be reflexive when working with culturally and linguistically diverse populations. The step ladder to improved IPV response, including formal supports such as training and procedures, is frequently described as lacking.

Conclusions

A consistent and empirically supported approach to IPV assessment and response is rare to find across generalist service provision. Although service providers possess basic knowledge of risk factors, organizational direction is needed to allow providers to address IPV confidently and effectively.

Suffering in the Hands of a Loved One: The Endemic to Intimate Partner Violence and Consequences on Migrant Female Head-Load Carriers in Ghana

The study contributed to filling a knowledge gap in the area of intimate partner violence (IPV). Previous studies conducted in Ghana have investigated the causes and types of IPV, leaving a gap on the consequences the violence had on the victims. Using a population of local economic migrants (hereafter, head-load carriers), a qualitative design with emphasis on phenomenology was employed to investigate the effects of IPV on 20 head-load carriers in two major cities in Ghana (Kumasi and Accra). The analysis performed on the data, using interpretive phenomenological analysis, revealed that IPV affected the head-load carriers' health, employment, and human relationships. Each of the participants spoke of one or more health complications, which they attributed to IPV. Among the health-related effects reported by the head-load carriers were body pains, wounds, depression, suicide ideation, headache, and abdominal pains that resulted from the termination of an unwanted pregnancy. All the head-load carriers recounted the detrimental outcomes of IPV on their job and human relationships. After they had experienced IPV, some of the victims could not go to work due to fear of stigmatization and those who were able to could not work as they usually do due to severe pain. At their workplace, some of the IPV victims became aggressive toward customers and coworkers, whereas others remained isolated. These negatively impacted on their human relationship skills and earnings. Based on the findings, there is the need for policies that seek to address IPV to consider the effects on victims' employment, earning, and behavior.

Brief Report: Turkish Validity and Reliability of the HITS Intimate Partner Violence Screening Tool With Women

The current study examined the validity and reliability of the Turkish version of the HITS (Hurt-Insult-Threaten-Scream) tool which was developed to screen for intimate partner violence. 154 Turkish women participated and completed the Turkish version of the HITS (HITS-TR). The validity of the language and factor structure were evaluated. The internal consistency coefficient of the scale was.89. Confirmatory factor analysis (CFA), revealed a single factor structure consisting of four items that explained 76% of the total variance. A CFA was performed with a modified model upon a second sample indicating high compatibility for the revised model with χ²/df = 1.262, a root mean square error of approximation.036, goodness of fit index of.996, adjusted goodness of fit index.998, root mean square residual of.006 and standardized root mean square residual of.008. It is concluded that the HITS-TR can be used as a valid and reliable screening tool for intimate partner violence in Turkish women.

#MeToo on the Canadian Prairies: Raising Awareness of Sexual Assaults and Mental Health in Women Abused by Intimate Partners

Studies of intimate partner sexual assault (IPSA) and its effects on mental health are limited. This secondary data analysis examines IPSA, a history of child sexual abuse, depression, trauma, mental distress and quality of life in 665 Canadian women, 41% of whom had been sexually assaulted by intimate partners; 53% were sexually abused as children. Women who had experienced any IPSA had significantly higher scores on all Composite Abuse subscales (IPV), mental distress (SCL-10), and depression (CES-D-10). PTSD (PCL) was higher for women with both IPSA and CSA histories. Implications for advocates, clinicians, and researchers are presented.

The Associations of Constructive and Destructive Interparental Conflict to Child Well-Being Among Low-Income Families

Interparental conflict is a well-established precursor to child maladjustment. However, little is understood of the role of different interparental conflict in shaping the developmental outcomes of young children, especially those from socioeconomically disadvantaged backgrounds. This study uses data from a large and racially diverse sample of low-income, unmarried mothers with young children (n = 1,297) to examine the processes linking parental constructive conflict, destructive conflict, intimate partner violence (IPV) to child behavior problems, and child emotional insecurity as a mediator of these processes. Path analyses were conducted to estimate structural paths between (a) conflict constructs and child behavior problems, (b) conflict constructs and child emotional insecurity, and (c) child emotional insecurity and child behavior problems. Results demonstrated that constructive conflict was associated with decreased levels of both child emotional insecurity and child behavior problems, whereas destructive conflict was associated with increased levels of both child outcomes. IPV was associated with increased levels of child emotional insecurity only. Child emotional insecurity mediated the links between all three conflict constructs and child behavior problems. Such findings suggest the need for clinicians to help raise awareness regarding the consequences of children's exposure to different interparental conflict and educate parents about children's sense of emotional security in the family.

Symptoms within somatization after sexual abuse among women: A scoping review

INTRODUCTION

Somatization, defined as a number of medically unexplained physical symptoms for many years, is a resource-intensive condition with much suffering. Adult somatization has been linked to childhood trauma in both men and women. Among women, sexual trauma affects somatization level to a greater extent than nonsexual trauma. Early diagnosis of a somatization disorder would be of great help for both patients and society. The purpose of this scoping review is to map and summarize the literature on symptoms within somatization in women who have been sexually abused, and investigate if any specific symptom can be linked to previous sexual abuse.

MATERIAL AND METHODS

A scoping review methodology was used. The databases PubMed, PsycINFO, and the Cochrane Library were searched for original qualitative and quantitative research published between 2008 and 2019 that matched the objectives of the review.

RESULTS

The database search identified 195 articles, of which 43 were retrieved in full text. Seven articles were included, involving 2076 women. All studies were quantitative. The included studies were heterogeneous. Four studies showed inconsistent findings regarding a link between sexual abuse and chronic or acute pain. Two studies showed an association between sexual abuse and increased incidence of somatic symptoms. One study showed an association between sexual abuse and symptoms of irritable bowel syndrome. No specific somatic symptoms in somatization were identifiable within the scope of this study.

CONCLUSIONS

This is to our knowledge the first scoping review on sexual abuse and symptoms of somatization. The findings suggest a link between sexual abuse and somatic symptoms, but the identified association with pain and irritable bowel syndrome is inconsistent. No studies have clearly identified specific symptoms within somatization associated with sexual abuse. Qualitative research on the topic was identified as a knowledge gap.

Intimate Partner Sexual Violence: An Often Overlooked Problem

BACKGROUND

Intimate partner sexual violence (IPSV) is a common but often overlooked form of intimate partner violence (IPV) that may have unique consequences for those who experience it. We aimed to explore how outcomes associated with IPSV differ from outcomes associated with other forms of intimate partner and sexual violence.

METHODS

We conducted a narrative review of the English-language literature, including original research studies and reports that focused on outcomes associated with IPSV. We aimed to quantify the risk for health outcomes associated with exposure to IPSV in comparison with exposure to other forms of interpersonal violence or nonexposure to interpersonal violence.

RESULTS

Twenty-eight publications were reviewed, most were small observational studies focused on women exposed to IPSV. Reported outcomes were related to mental health (n = 20 studies), physical and sexual health (n = 19 studies), and health of children with a parent exposed to IPSV (n = 1 study). Compared with other forms of interpersonal violence, exposure to IPSV was associated with greater risk for posttraumatic stress disorder and depressive symptoms, problematic substance use, suicidality, pain and other somatic symptoms, adverse sexual health problems, specific physical injuries including strangulation, and death by homicide. Children with an exposed parent were at higher risk for internalizing symptoms such as depression, anxiety, and somatization.

CONCLUSIONS

Sexual violence in intimate partner relationships is common and has distinct consequences compared with other forms of interpersonal violence including elevated risks for suicidality and death by homicide. It should be given special consideration within the assessment and management of interpersonal violence.

Development of a practice framework for improving nurses' responses to intimate partner violence

AIMS AND OBJECTIVES

The aim of this article is to discuss critically the theoretical concepts of awareness, recognition and empowerment as manifested in intimate partner violence and to show how these can be translated into a practice framework for improving nurses' response.

BACKGROUND

Intimate partner violence is a universal problem and is considered a significant public health issue. Nurses are in an ideal position to recognise and respond to intimate partner violence, but many lack confidence in this area of practice. In our previous empirical work, we identified three concepts through which nurses' responses to intimate partner violence can be understood: awareness, recognition and empowerment. In this article, we advance nursing knowledge by showing how these concepts can form a practice framework to improve nurses' responses to intimate partner violence.

DESIGN

A discussion paper and development of a practice framework to improve nurses' responses to intimate partner violence.

DISCUSSION

The framework comprises three principal needs of women and three related key requirements for nurses to meet these needs. Arising from these are a range of practice outcomes: enhanced understanding of intimate partner violence, increased confidence in recognising intimate partner violence, establishment of trusting relationships, increased likelihood of disclosure and optimised safety.

CONCLUSIONS

Nurses sometimes lack confidence in recognising and responding to intimate partner violence. Awareness, recognition and empowerment are important concepts that can form the basis of a framework to support them. When nurses feel empowered to respond to intimate partner violence, they can work together with women to optimise their safety.

RELEVANCE TO CLINICAL PRACTICE

Access to adequate and timely intimate partner violence education and training is important in improving nurses' responses to intimate partner violence. Getting this right can lead to enhanced safety planning and better health outcomes for women who experience intimate partner violence. Although difficult to measure as an outcome, nurses' improved responses can contribute to higher rates of referral for help and reduction in intimate partner violence rates.

Children's exposure to intimate partner violence: Should sexual coercion be considered?

This study examined whether male-perpetrated sexual intimate partner violence (IPV) directed at a child's mother is associated with children's adjustment problems and if sexual IPV increases risk for children's adjustment problems over and above the risk associated with physical IPV alone. Participants were a community sample of 539 mothers and their children (age 7-10 years). Mothers and children reported on children's externalizing and internalizing problems. Mothers reported on recent male-perpetrated physical and sexual IPV and on their own psychological distress (depressive symptoms, relationship dissatisfaction). Four groups were formed on the basis of mothers' reports of IPV: nonviolent, physical only, sexual only, and sexual + physical. Children in the physical-only, sexual-only, and sexual + physical groups exhibited greater levels of externalizing problems than did children in the nonviolent group. Levels of externalizing problems among children in the physical-only and sexual-only groups did not differ. Including sexual IPV in the conceptualization of children's exposure to IPV may offer a more comprehensive understanding of how children are affected by IPV. (PsycINFO Database Record

Partner Abuse of Mothers Compromises Children's Behavioral Functioning Through Maternal Mental Health Dysfunction: Analysis of 300 Mother-Child Pairs

Partner violence is associated with numerous negative consequences for victims, especially poor mental health. Children who are exposed to partner violence are more likely to have behavior problems. Nevertheless, research on the relationship between severity of abuse, maternal mental health functioning following partner violence, and child behavior problems is limited. We explored the direct and indirect effects on the child's behavioral functioning of severity of maternal abuse and maternal mental health functioning following abuse. A sample of 300 mothers was recruited when they sought assistance for abuse for the first time at shelters for abused women or at the district attorney's office. Severity of abuse, mothers' mental health functioning, and child behavioral functioning were measured by maternal self-report at entry into the study and 4 months later. In SEM analysis, at both entry and 4 months, severity of abuse had a direct effect on maternal mental health functioning, which in turn had a direct effect on child behavioral functioning. The path from severity of abuse to child behavioral functioning also was significant but became non- significant once maternal mental health functioning was added to the equation, indicating that the path from severity of abuse to child behavioral functioning was indirect and occurred as a result of the mother's mental health functioning, which remained directly linked to child behavioral problems. Intergenerational interventions are needed to address both maternal mental health and child behavioral functioning when a mother reports partner violence and is experiencing mental health problems.

Modeling the intergenerational impact of partner abuse on maternal and child function at 24 months post outreach: Implications for practice and policy

OBJECTIVE

Many women are exposed to partner violence during their lifetime which affects mental health and child development. This study revalidates an intergenerational model connecting partner violence to poor functioning for mothers and children using structural equation techniques.

METHOD

A longitudinal design collected data on 300 mother-child pairs. Comparisons between the model, tested at study entry and again at 24 months, are reported. Maternal measures included childhood experiences of abuse, partner abuse, chronic pain, and mental health. The Child Behavior Checklist measured child function.

RESULTS

Comparison of both models revealed that maternal chronic pain, maternal mental health, and child witnessing of mother's abuse remain strong predictors of child dysfunction. Maternal social support and self-efficacy are significant predictors of more positive maternal mental health with a conduit effect on child behavior.

CONCLUSION

Intimate partner violence directly impacts the victim and also has a secondary impact on the children of abuse victims.

Problem-solving and mental health outcomes of women and children in the wake of intimate partner violence

The environmental stress of intimate partner violence is common and often results in mental health problems of depression, anxiety, and PTSD for women and behavioral dysfunctions for their children. Problem-solving skills can serve to mitigate or accentuate the environmental stress of violence and associated impact on mental health. To better understand the relationship between problem-solving skills and mental health of abused women with children, a cross-sectional predictive analysis of 285 abused women who used justice or shelter services was completed. The women were asked about social problem-solving, and mental health symptoms of depression, anxiety, and PTSD as well as behavioral functioning of their children. Higher negative problem-solving scores were associated with significantly (P < 0.001) greater odds of having clinically significant levels of PTSD, anxiety, depression, and somatization for the woman and significantly (P < 0.001) greater odds of her child having borderline or clinically significant levels of both internalizing and externalizing behaviors. A predominately negative problem-solving approach was strongly associated with poorer outcomes for both mothers and children in the aftermath of the environmental stress of abuse. Interventions addressing problem-solving ability may be beneficial in increasing abused women's abilities to navigate the daily stressors of life following abuse.