Suicide attempts and stressful life events among female victims of intimate partner violence living in poverty in Nicaragua

The role of effective factors on suicidal tendency of women in Turkey

Background/Aim

This study aims to identify the variables that influence the suicidal tendency of women who are married, have had a relationship or are currently in a relationship in Turkey.

Methods

This study uses cross-sectional data from the 2014 Hacettepe University Institute of Population Studies National Research on Domestic Violence Against Women in Turkey. Data from 6,458 women between the ages of 15 and 49 were analyzed in this dataset. Binary logistic regression was used to determine the factors influencing women's suicidal tendencies.

Results

Based on the analysis's findings, age, education level, health status, number of children, the sector in which the spouse/partner works, the drinking status of the spouse/partner, the situation where the spouse/partner fights with another man in a way that involves physical violence, the cheating status of the spouse/partner, the controlling behaviour of the spouse/partner, exposure to various types of violence by both the spouse/partner and someone other than the partner, and the household income level variables were found to be associated with the suicidal tendency of women.

Conclusion

Prioritizing women who are, in particular, between the ages of 15 and 24, live in the south of Turkey, have a high school education, are in poor health, are childless, have low household incomes, live with an unemployed spouse or partner, and are exposed to various forms of violence from their partner or other sources can be achieved more effective results in reducing and preventing women's suicidal behaviors.

Suicidal Behaviors and Risk Taking Among Homeless Individuals: A Systematic Review and Meta-Analysis

The present systematic review and meta-analysis study aimed to determine sociodemographic characteristics, risky behaviors, mental health disorders, and substance use disorders associated with suicide behaviors including suicidal ideation and suicide attempts among homeless individuals. PubMed, Scopus, Web of Science, and Cochrane Library databases were searched to identify the relevant studies published between January 1, 1995 and November 1, 2022. After initial evaluation of 9,094 papers, a total of 23 studies met the eligibility criteria. Results of the present study showed that chronic physical illnesses, violent behaviors, mood and psychotic disorders, and substance use disorders were significantly associated with both suicidal ideation and suicide attempts, while being older, having a history of physical abuse, and having mood and post-traumatic stress disorders were associated with suicide attempts only. The present study's findings suggest a crucial need for facilitating access to mental healthcare plans and promoting mental healthcare seeking among homeless individuals.

Characteristics of and Circumstances Associated With Female Intimate Partner Problem-Included Suicides: Analysis of Data From the National Violent Death Reporting System (2003-2019)

Intimate partner problems (IPP)-which include divorce, breakups, arguments, jealousy, conflict, discord, and violence-have been robust precipitating factors associated with an increased risk for suicidal thoughts and behaviors. Although research on suicide related to IPP is growing, efforts to explore the circumstances surrounding suicidality among female victims struggling with IPP remain insufficient. To address this gap, this exploratory study sought to understand the circumstances surrounding female IPP-related suicide in the United States. We conducted a secondary analysis of data from the U.S. National Violent Death Reporting System (NVDRS, 2003-2019) which includes 43 states, the District of Columbia, and Puerto Rico. Of the final analytical sample of 58,545 female suicide cases in the United States, we delineated IPP-included suicide cases (13,496, 23.1%) and non-IPP-included suicide cases (45,049, 76.9%). Two-sided Pearson chi-square tests and standardized difference (SD) tests identified significant differences in the surrounding circumstances between IPP-included suicide and non-IPP-included suicide. IPP-included female suicide was more common among younger women, those involved in an intimate relationship, and women who were pregnant or postpartum (p < .001; SD > .10). IPP-included suicide victims were more likely to have experienced depression, substance abuse, and previous interpersonal trauma than non-IPP-included suicide victims (p < .001; SD > .10). Compared to non-IPP-included suicide, IPP-included suicide was more likely to occur at the victim's house or apartment during evening and nighttime by firearm or hanging (p < .001; SD > .10). Our findings also showed that IPP-included suicide victims had previous suicidal thoughts and were more likely to have disclosed their suicidal ideation with others before committing suicide than non-IPP-included suicide victims (p < .001; SD > .10). Findings identified unique circumstances and characteristics possibly associated with IPP-included female suicide. Our understanding of suicide may be enhanced by exploring the causal pathway behind these relationships.

Stressful life events: Typology of aggression and mistreatment in male perpetrators of gender-based violence

The objective of this study was to analyze groups based on the stressful life events suffered and to know the relationship of these profiles with the type of abuse exercised against women in the couple. A sample of 118 heterosexual men who perpetrated gender-based violence was used, with a mean age of 40.46 years (SD = 11.14). The results show that those who suffered a greater number of adverse experiences abused their partners more frequently and with a more aggravated character. In addition, knowing typologies based on previous stressful life events could favor specific interventions in the elimination of the normalization of violence as a maladaptive relational strategy. It is necessary to continue investigating the characteristics of men who exercise gender-based violence, as well as to analyze previous exposure to violence in the family of origin due to the influence it exerts on subsequent abuse.

Suicidal Behaviour as an Emerging Factor in Female Victims of Gender-Based Violence within a Relationship: An Exploratory Study

Intimate partner violence (IPV), in addition to being an important public health problem, is a risk factor for suicidal behaviour (SB). The objective of this study was to explore the risk of suicidal behaviour associated with the different forms of abuse and the consequences derived from it. This exploratory study was conducted on a sample of women who experienced IPV (N = 70) in the Extremadura Region (Spain). Demographic factors, abuse experience, suicidal ideation (SI), suicidal communication (SC), and suicide attempts (SAs) were analysed according to the type of abuse. We found that a very high prevalence of psychological violence (IPVp) was accompanied, in most cases, by some other type of abuse (IPVp+). Additionally, a significant relationship was found between IPV and SB. Logistic regression revealed a greater risk of SI and SA in the IPVp+ group. The results of this study could be useful to healthcare service professionals in preventing suicidal behaviour.

Intimate partner violence, suicidality, and self-harm: a probability sample survey of the general population in England

BACKGROUND

Intimate partner violence (IPV) is a recognised risk factor for psychiatric disorders. There is little current evidence on IPV and self-harm and suicidality, and we therefore aimed to investigate the associations between experience of lifetime and past-year IPV with suicidal thoughts, suicide attempt, and self-harm in the past year.

METHODS

We analysed the 2014 Adult Psychiatric Morbidity Survey, a cross-sectional survey of 7058 adults (aged ≥16 years) in England, which used a multistage random probability sampling design and involved face-to-face interviews. Participants were asked about experience of physical violence and sexual, economic, and emotional abuse from a current or former partner, and about suicidal thoughts, suicide attempts, and self-harm. Other adversities were recorded through an adapted version of the List of Threatening Experiences. Multivariable logistic regression models quantified associations between different indicators of lifetime and past-year IPV, with past-year non-suicidal self-harm, suicidal thoughts, and suicide attempts. All analyses were weighted.

FINDINGS

Using weighted percentages, we found that a fifth (21·4%) of 7058 adults reported lifetime experience of IPV, and that 27·2% of women and 15·3% of men had experienced IPV. Among women, 19·6% had ever experienced emotional IPV, 18·7% physical IPV, 8·5% economic IPV, and 3·7% sexual IPV, which was higher than in men (8·6%, 9·3%, 3·6%, and 0·3%, respectively). Findings for ethnicity were unclear. Lifetime prevalence of IPV was higher in those living in rented accommodation or deprived neighbourhoods. Among people who had attempted suicide in the past year, 49·7% had ever experienced IPV and 23·1% had experienced IPV in the past year (including 34·8% of women and 9·4% of men). After adjusting for demographics, socioeconomics, and lifetime experience of adversities, the odds ratio of a past-year suicide attempt were 2·82 (95% CI 1·54-5·17) times higher in those who have ever experienced IPV, compared with those who had not. Fully adjusted odds ratios for past-year self-harm (2·20, 95% CI 1·37-3·53) and suicidal thoughts (1·85, 1·39-2·46) were also raised in those who had ever experienced IPV.

INTERPRETATION

IPV is common in England, especially among women, and is strongly associated with self-harm and suicidality. People presenting to services in suicidal distress or after self-harm should be asked about IPV. Interventions designed to reduce the prevalence and duration of IPV might protect and improve the lives of people at risk of self-harm and suicide.

FUNDING

UK Prevention Research Partnership.

The Serious Self-Harm Risk of "Mixed Presenters," People Who Presented to New Zealand Emergency Departments for Self-Harm and Other Reasons: A Cohort Study

The objective of this study was to investigate if "Mixed Presenters," people who present to emergency departments at least twice within 28 days, once for self-harm and once for another reason (any order), have an increased risk of subsequent serious self-harm compared to self-harm only repeat presenters. Self-harm coded emergency department data from the Multi-level Intervention for Suicide Prevention (MISP) study was utilized to identify people with at least two presentations to one of eight District Health Boards between 2010 and 2012. First eligible presentation pairs determined their "Mixed Presenter" or "Self-harm Only Presenter" status. The sample was linked to admission and mortality datasets. Survival analysis over the 30-month timeframe was used to determine which presenter group was at higher risk of serious self-harm. Mixed Presenters (n = 1,544), four times more common than Self-harm Only Presenters (n = 377), had an estimated 60% reduced risk of serious self-harm compared to Self-harm Only Presenters. Compared to men, women had a 3.5 times (HR 3.53, 95% CI 2.47-5.06) increased risk. Having an urgent triage code allocated at the index presentation and being admitted at that index presentation were associated with increased serious self-harm risk for Self-harm Only Presenters compared to Mixed Presenters. This study confirms that two presentations for self-harm within a short timeframe indicate high risk of serious self-harm in the future. As men often die following single attempts, and Mixed Presenters may transition to being Self-harm Only Presenters, each presentation for self-harm requires serious attention.

Differences in stressful life events between men and women experiencing homelessness

People experiencing homelessness are particularly vulnerable to experiencing stressful life events (SLEs) at some point in their lives; these SLEs are crucial for understanding the etiology and maintenance of homelessness. This study analyses the differences between men and women experiencing homelessness in the suffering of SLEs throughout their lives (childhood, adolescence, and adulthood). The sample consisted of a group of 293 people experiencing homelessness in Madrid (Spain): 156 men and 137 women. The results suggest that the number and type of SLEs experienced by men and women are different. In general, women experiencing homelessness suffer more SLEs than men in all periods of their lives. The differences in the level of sexual violence in childhood, sexual abuse in adulthood, and abuse by a spouse or partner are particularly striking. However, men experiencing homelessness score significantly higher than women for alcohol abuse, police complaints, arrest, and imprisonment throughout their lives. These findings have significant implications for the design of interventions and social policies that should be tailored to the specific needs of men and women who are homeless.

The Role of Perceived Social Support in the Association Between Stressful Life Events and Suicidal Behavior

Background: Suicide is a serious public health concern for which there have been well-established protective and risk factors reported in literature. There is a lack of evidence on the indirect effects of other variables on these factors. Specifically, the association between stressful life events and suicidal behavior may be affected by perceived social support, but its role in this association is largely uninvestigated. Objectives: Thus, this paper aims to explore the role of perceived social support in the association between stressful life events and suicidal behavior. Perceived social support will be explored as a mediator and as a moderator in this association. Methods: Data were obtained from the Determinants of Suicidal Behavior Conventional and Emergent Risk (DISCOVER), a study conducted to identify risk factors of suicidal behavior. The study participants are individuals with suicide attempts admitted to hospital. Participants (n = 343) were recruited from hospital setting. Suicidal behavior was measured using two outcomes (1) the occurrence of a suicide attempt (2) level of suicide intent as measured by the Pierce Suicide Intent Scale. Perceived social support was measured using the Sarason Social Support Questionnaire. Results: Stressful life events were significantly associated with suicide attempts (OR 1.440, 95% CI 1.440, 1.682, p < 0.001) and perceived social support (B -0.785, 95% CI -1.501, -0.068, p = 0.032). There was no significant mediation effect by perceived social support in the association between stressful life events and suicide attempts (Sobel's test statistic 1.64, p = 0.100). Perceived social support did not moderate the relationship between stressful life events and suicide attempts [(OR 1.007, 95% CI 0.987, 1.027, p = 0.514] or the relationship between stressful life events and level of suicidal intent (B -0.043, 95% CI -0.132, 0.046, p = 0.343). Conclusion: Stressful life events are associated with increased risk of suicide attempts. The study also identified an inverse relationship between stressful life events and perceived social support. These associations were independent of perceived social support. This study highlights the effects of stressful life events on suicide risk is not affected by perceived social support, requiring further investigation into measures to reduce the impact of social stressors on people with risk of suicide.

Health, disability, and consumption of psychoactive substances among people in a homeless situation in León (Nicaragua)

Nicaragua is one of the countries in Latin America with lowest levels of development. In Nicaragua, people in a homeless situation are one of the most socially excluded groups, and there is a lack of data regarding their characteristics, circumstances, and needs. This study examines the state of health, disability, and substance use among people living homeless (n = 68) in the city of León (Nicaragua). Sixty percent of the homeless people contacted responded to a questionnaire which was administered with the respondents by means of an interview. The findings showed that people living homeless in León had very negative states of health and disability, worse than those observed in other socially excluded groups in the same city and homeless people in more developed countries. The interviewees also presented a high level of substance abuse - mainly of alcohol and inhaled glue.

Influence of the history of abuse and suicidal attempts behavior among women victims of violence in Nicaragua

Suffering traumatic experiences linked to violence seems to be related to suicide attempts, especially, when the physical or sexual abuse has been experienced at an early age. This study examines the relationship between the history of abuse and suicide attempts among women victims of violence living in poverty in Nicaragua. This sample was subjected to a particularly serious range of stressful situations and experiences related to violence throughout their lives. The results show that women who experienced abuse during childhood were more likely to report a history of suicide attempts than women without a history of childhood abuse. Therefore, suicide attempts seem to be related more to those traumatic experiences during childhood than to violence suffered afterward. Identifying this type of abuse is particularly important because of its implications for the victims' health, as suicide attempts are maladaptive behaviors with which the women in the sample could have been addressing the trauma they experienced in their childhood. It is, therefore, necessary to highlight this problem in a developing country, which has been the focus of a limited number of studies, and where there are no support mechanisms for victims whose rights have been violated.

Stressful life events among homeless people in León (Nicaragua): Quantity, types, timing, and perceived causality

Nicaragua is one of Latin America's least developed countries and has a lack of data on homeless people, a stigmatized group living in extreme poverty. We conducted structured interviews with homeless people living in the city of León (Nicaragua; n = 41) to obtain data on the quantity, types, timing, and perceived causality of stressful life events (SLEs) experienced during their childhood and adolescence as well as throughout their adult lives. The findings showed that our participants had experienced a high number of extremely severe SLEs at very early ages and most of these SLEs occurred before they first became homeless. In terms of the perceived causal relationship between SLEs and homelessness, the interviewees mainly attributed being homeless to material, affective, or relationship factors, or an excessive consumption of alcohol and/or drugs. Suffering from multiple and serious SLEs, largely due to living in socioeconomically disadvantaged environments, appears to be an important vulnerability factor in both becoming homeless and chronic homelessness.

Retraction of Complaints Among Female Victims of Intimate Partner Violence Living in Poverty in Nicaragua

Retraction among female victims of intimate partner violence (IPV) who report their abuser is a major problem in all societies. This article describes a study of 136 female victims of physical IPV living in poverty in Nicaragua, one of the countries with the lowest levels of development in Central America. This article analyses the aspects that differentiate women living in poverty who retracted after reporting IPV from those who did not. The results show that retraction is widespread among female victims of IPV living in poverty in León (Nicaragua). Although it is difficult to predict the retraction behaviour of the respondents, some differences between the women who retracted their complaint and those who did not were observed. A combination of five variables (including personal circumstances and beliefs about the intimate partner relationship and family) was the best alternative for discriminating between women who had retracted and those who had not.

Types of non-psychotic mental disorders in adult women who suffered intimate partner violence: an integrative review

OBJECTIVE

Identifying the types of non-psychotic mental disorders in adult women who suffered intimate partner violence in the literature.

METHOD

An integrative review carried out in the MEDLINE, CINAHL, LILACS, Web of Science and SCOPUS databases.

RESULTS

We selected 19 articles published in international journals in English, with a predominance of cross-sectional study studies (78.9%). The most common types of non-psychotic mental disorders were: depression (73.7%) and post-traumatic stress disorder (52.6%). It was observed that 78.9% of the articles presented a 2C level of evidence.

CONCLUSION

Studies have shown that adult women who are victims of intimate partner violence mostly suffer from depression and post-traumatic stress disorder, as well as other morbidities; a fact that highlights how devastating violence by an intimate partner can impact on the mental health of those who experience it.

A systematic review of the psychometric properties of the cross-cultural translations and adaptations of the Multidimensional Perceived Social Support Scale (MSPSS)

BACKGROUND

Social support (SS) has been identified as an essential buffer to stressful life events. Consequently, there has been a surge in the evaluation of SS as a wellbeing indicator. The Multidimensional Perceived Social Support Scale (MSPSS) has evolved as one of the most extensively translated and validated social support outcome measures. Due to linguistic and cultural differences, there is need to test the psychometrics of the adapted versions. However, there is a paucity of systematic evidence of the psychometrics of adapted and translated versions of the MSPSS across settings.

OBJECTIVES

To understand the psychometric properties of the MSPSS for non-English speaking populations by conducting a systematic review of studies that examine the psychometric properties of non-English versions of the MSPSS.

METHODS

We searched Africa-Wide Information, CINAHL, Medline and PsycINFO, for articles published in English on the translation and or validation of the MSPSS. Methodological quality and quality of psychometric properties of the retrieved translations were assessed using the COSMIN checklist and a validated quality assessment criterion, respectively. The two assessments were combined to produce the best level of evidence per language/translation.

RESULTS

Seventy articles evaluating the MSPSS in 22 languages were retrieved. Most translations [16/22] were not rigorously translated (only solitary backward-forward translations were performed, reconciliation was poorly described, or were not pretested). There was poor evidence for structural validity, as confirmatory factor analysis was performed in only nine studies. Internal consistency was reported in all studies. Most attained a Cronbach's alpha of at least 0.70 against a backdrop of fair methodological quality. There was poor evidence for construct validity.

CONCLUSION

There is limited evidence supporting the psychometric robustness of the translated versions of the MSPSS, and given the variability, the individual psychometrics of a translation must be considered prior to use. Responsiveness, measurement error and cut-off values should also be assessed to increase the clinical utility and psychometric robustness of the translated versions of the MSPSS.

TRIAL REGISTRATION

PROSPERO - CRD42016052394.

Relationship of Physical Intimate Partner Violence with Mental Health Diagnoses in the Nationwide Emergency Department Sample

OBJECTIVES

We examined associations of physical intimate partner violence (PIPV) with selected mental health disorders using a nationally representative sample of emergency department (ED) discharges corresponding to men and women (18-64 years) from the 2010 Nationwide Emergency Department Sample.

METHODS

PIPV was determined using International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) external cause of injury code E967.3 (battering by spouse or partner). ICD-9-CM clinical classification of discharge diagnoses was used to identify mental health disorders. Multivariable logistic regression models were constructed to estimate adjusted odds ratios (OR_adj) and their 95% confidence intervals (CIs).

RESULTS

PIPV prevalence was estimated at 0.36 per 1000 ED discharges. The strongest correlates of PIPV were alcohol-related (OR_adj = 3.02, 95% CI: 2.62-3.50), adjustment (OR_adj = 2.37, 95% CI: 1.56-3.58), intentional self-harm (OR_adj = 1.41, 95% CI: 1.05-1.89), anxiety (OR_adj = 1.23, 95% CI: 1.07-1.40), drug-related (OR_adj = 1.22, 95% CI: 1.01-1.47), and mood (OR_adj = 1.16, 95% CI: 1.04-1.31) disorders. PIPV's association with alcohol-related disorders was stronger among women (OR_adj = 3.22, 95% CI: 2.79-3.72) versus men (OR_adj = 1.98, 95% CI: 1.42-2.77). Similarly, drug-related disorders were stronger correlates of PIPV among women (OR_adj = 1.32, 95% CI: 1.09-1.60) versus men (OR_adj = 0.59, 95% CI: 0.31-1.16).

CONCLUSIONS

In EDs, PIPV was linked to several mental health disorders, with women experiencing comorbid PIPV and substance use more frequently than men.

Violence, stigma and mental health among female sex workers in China: A structural equation modeling

Intimate partner violence is prevalent among female sex workers (FSWs) in China, and it is significantly associated with mental health problems among FSWs. However, limited studies have explored the mechanisms/process by which violence affects mental health. The purpose of this study was to explore the relationships among partner violence, internalized stigma, and mental health problems among FSWs. Data were collected using a self-administered cross-sectional survey administered to 1,022 FSWs in the Guangxi Zhuang Autonomous Region (Guangxi), China during 2008-2009. We used structural equation modeling to test the hypothesized relationships. Results indicated that violence perpetrated by either stable sexual partners or clients was directly and positively associated with mental health problems. Violence also had an indirect relation to mental health problems through stigma. Results highlight the need for interventions on counseling and care for FSWs who have experienced violence and for interventions to increase FSWs' coping skills and empowerment strategies.