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Nyseth Nzitatira H, Schmeer KK, Frizzell LC, Ndushabandi E. Assessing the well-being of partners of people found guilty of perpetrating genocide in Rwanda. J Health Psychol 2024:13591053241266595. [PMID: 39092489 DOI: 10.1177/13591053241266595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024] Open
Abstract
This article draws upon 89 in-person surveys with Rwandan women (ages 26-75) whose partners were incarcerated for genocide and examines how these women explain participation in the violence. We first engage in exploratory factor analysis of reasons cited for perpetrating genocide, which reveals (1) a factor comprised of internal reasons for participation, including greed and hatred; (2) a factor of external reasons, such as peer pressure or coercion, and (3) a factor driven by alcohol use. Next, we analyze how these factors are associated with the women's psychosocial wellbeing as measured by the World Health Organization's Self-Reporting Questionnaire. This quantitative analysis finds that, net of relevant control variables, accounts of participation in genocide that emphasize external reasons for participation are associated with better psychosocial wellbeing, while accounts of participation that emphasize internal reasons are associated with worse psychosocial wellbeing. We conclude by addressing the link between explanations for actions and wellbeing.
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Affiliation(s)
| | | | | | - Eric Ndushabandi
- Center for Research and Training on Human Rights and Democracy for Peace, Kigali, Rwanda
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2
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McKay T. No Escape: Mass Incarceration and the Social Ecology of Intimate Partner Violence Against Women. Violence Against Women 2024; 30:2461-2481. [PMID: 36916215 DOI: 10.1177/10778012231158110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Women in heavily policed and incarcerated communities face extremely high rates of intimate partner violence (IPV)-but how criminal legal system contact affects such violence remains poorly understood. This study explores the social ecology of IPV by fitting structural equation models to longitudinal, dyadic data from households in contact with the criminal legal system (N = 2,224) and their local communities. Results suggest that a complex of factors at multiple social-ecological levels-including adverse local conditions, dysfunctional couple conflict, and men's behavioral health and perceptions of their neighborhoods-may put women at heightened risk of IPV victimization in a time of mass incarceration.
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Affiliation(s)
- Tasseli McKay
- Department of Sociology, Duke University, Durham, NC, USA
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Bahati C, Nyiranteziryayo A, Izabayo J, Atete P, Sezibera V, Mutesa L. Mental health outcomes of offspring exposed to parental intimate partner violence in Rwanda. BMC Pediatr 2024; 24:419. [PMID: 38956491 PMCID: PMC11218358 DOI: 10.1186/s12887-024-04884-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 06/12/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Children who witness parental intimate partner violence (IPV) are more likely to develop mental health issues compared to those who do not witness such violence. OBJECTIVE The main objective of this study is to assess the association between parental intimate partner violence and child mental health outcomes. METHODOLOGY This cross-sectional study involved 548 participants divided into two groups: parents (N = 304) and offspring (N = 244). The participants were recruited from Mageragere Sector in the City of Kigali (urban), as well as Mbazi and Ruhashya sectors in Huye District (rural). To assess the difference about mental difficulties reported by the offspring, a Mann-Whitney U test was employed to compare the responses of parents and their children on mental health outcomes. Additionally, multiple linear regression analysis was conducted to explore the association between parental intimate partner violence (IPV) and the mental health outcomes of their offspring. RESULTS The results highlighted significant levels of mental and emotional challenges in children, as reported by both parents and the children themselves. Depression and youth conduct problems were more prevalent among the children compared to their parents, whereas anxiety and irritability were more commonly reported by parents than by their children. Intimate partner violence showed to be a predictor of irritability and anxiety symptoms in offspring. In terms of irritability, depression, and youth conduct problems they were identified as predictors of anxiety symptoms. Particularly, anxiety and irritability were revealed to predict youth conduct problems. CONCLUSION The study indicates that parental intimate partner violence (IPV) has an impact on the mental well-being of their offspring. Furthermore, it was observed that there is not only a correlation between IPV and poor mental health outcomes, but also a connection between different mental conditions, implying that children exposed to IPV are more prone to experiencing a range of mental issues. As a result, intervention programs should place emphasis on addressing the mental disorders of both parents and children.
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Affiliation(s)
- Claire Bahati
- Department of Clinical Psychology, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
| | - Amina Nyiranteziryayo
- Department of Clinical Psychology, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Josias Izabayo
- Centre for Mental Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Pauline Atete
- Centre for Mental Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Vincent Sezibera
- Centre for Mental Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Leon Mutesa
- Centre for Human Genetics, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
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Sadegh Mohammadi F, Spencer CM. Intimate Partner Violence and Attachment Styles as Factors Associated with Coping Stress Styles Among Iranian Women. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241249499. [PMID: 38742606 DOI: 10.1177/08862605241249499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
The current study sought to examine attachment styles as mediators between intimate partner violence (IPV) and stress coping styles among Iranian women. Data were collected from September to December 2020. The study population was composed of 102 women who were referred to Social Emergency Centers in Isfahan and affected by domestic violence. They were given self-report questionnaires to measure IPV (the Haj-Yahia Violence Questionnaire), Stress Coping Styles (CISS), and Attachment Styles (AAQ). Structural Equation Modeling was used to test the hypothesized relationships. Sexual IPV victimization was related to both avoidant attachment (β = .229, p = .015) and anxious attachment (β = .245, p = .008). Anxious attachment style was related to emotion-oriented coping (β = .437, p = .000). There was a negative relationship between avoidant attachment and anxious attachment (β = -.237, p = .032) with avoidance-oriented coping. Sexual IPV victimization and economic IPV victimization were associated with avoidance-oriented coping (β = -.225, t = 0.816, p = .015; β = .188, t = 0.816, p = .044). Women who had experienced IPV and had an insecure attachment style were more likely to utilize avoidance and emotional coping strategies. For women who had a secure attachment style, there was no association was found between IPV victimization and coping styles. Attachment styles may influence the relationship between IPV and coping strategies in Iranian women who have experienced violence.
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Johnson SL, Rasmussen JM, Mansoor M, Ibrahim H, Rono W, Goel P, Vissoci JRN, Von Isenburg M, Puffer ES. Correlates of Intimate Partner Violence Victimization and Perpetration in Adolescents and Young Adults in Sub-Saharan Africa: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:1168-1183. [PMID: 37226506 DOI: 10.1177/15248380231173428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Intimate partner violence (IPV) is a global public health crisis with long-term adverse consequences for both victims and perpetrators. Patterns of violence often begin during adolescence, yet most interventions target adult relationships. A systematic review was conducted to identify correlates of IPV victimization and perpetration among adolescents and young adults in sub-Saharan Africa (SSA). Eligible studies included participants 10 to 24 years old, took place in SSA, and tested a statistical association between a correlate and an IPV outcome. Correlates were defined as any condition or characteristic associated with statistically significant increased or decreased risk of IPV victimization or perpetration. PsycInfo, PubMed, Embase, and African Index Medicus were searched and included studies published between January 1, 2000 and February 4, 2022. The search resulted in 3,384 original studies, of which 55 met inclusion criteria and were analyzed. Correlates were first qualitatively synthesized by developmental period (e.g., early adolescence, older adolescence, and young adulthood) and then organized in a conceptual framework by correlate type (e.g., socio-demographic; health, behavior, and attitudes; relational; or contextual). Over two decades of literature reveals variability in evidence by developmental period but also substantial overlap in the correlates of victimization and perpetration. This review identifies multiple points for intervention and results suggest the urgent need for earlier, developmentally appropriate prevention efforts among younger adolescents as well as combined approaches that target both victimization and perpetration of IPV.
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Affiliation(s)
- Savannah L Johnson
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
| | - Justin M Rasmussen
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
| | | | - Hawo Ibrahim
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Wilter Rono
- Moi Teaching and Referral Hospital, Eldoret, Kenya
| | - Pari Goel
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - João R N Vissoci
- Duke Global Health Institute, Durham, NC, USA
- Department of Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Megan Von Isenburg
- Duke University Medical Center Library, Duke University Medical Center Archives, Durham, NC, USA
| | - Eve S Puffer
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
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Maposa I, Twabi HS, Matsena-Zingoni Z, Batidzirai JM, Singini G, Mohammed M, Bere A, Kgarosi K, Mchunu N, Nevhungoni P, Moyo-Chilufya M, Ojifinni O, Musekiwa A. Bayesian spatial modelling of intimate partner violence and associated factors among adult women and men: evidence from 2019/2020 Rwanda Demographic and Health Survey. BMC Public Health 2023; 23:2061. [PMID: 37864202 PMCID: PMC10589974 DOI: 10.1186/s12889-023-16988-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 10/13/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Intimate partner violence (IPV) remains a global public health concern for both men and women. Spatial mapping and clustering analysis can reveal subtle patterns in IPV occurrences but are yet to be explored in Rwanda, especially at a lower small-area scale. This study seeks to examine the spatial distribution, patterns, and associated factors of IPV among men and women in Rwanda. METHODS This was a secondary data analysis of the 2019/2020 Rwanda Demographic and Health Survey (RDHS) individual-level data set for 1947 women aged 15-49 years and 1371 men aged 15-59 years. A spatially structured additive logistic regression model was used to assess risk factors for IPV while adjusting for spatial effects. The district-level spatial model was adjusted for fixed covariate effects and was implemented using a fully Bayesian inference within the generalized additive mixed effects framework. RESULTS IPV prevalence amongst women was 45.9% (95% Confidence interval (CI): 43.4-48.5%) while that for men was 18.4% (95% CI: 16.2-20.9%). Using a bivariate choropleth, IPV perpetrated against women was higher in the North-Western districts of Rwanda whereas for men it was shown to be more prevalent in the Southern districts. A few districts presented high IPV for both men and women. The spatial structured additive logistic model revealed higher odds for IPV against women mainly in the North-western districts and the spatial effects were dominated by spatially structured effects contributing 64%. Higher odds of IPV were observed for men in the Southern districts of Rwanda and spatial effects were dominated by district heterogeneity accounting for 62%. There were no statistically significant district clusters for IPV in both men or women. Women with partners who consume alcohol, and with controlling partners were at significantly higher odds of IPV while those in rich households and making financial decisions together with partners were at lower odds of experiencing IPV. CONCLUSION Campaigns against IPV should be strengthened, especially in the North-Western and Southern parts of Rwanda. In addition, the promotion of girl-child education and empowerment of women can potentially reduce IPV against women and girls. Furthermore, couples should be trained on making financial decisions together. In conclusion, the implementation of policies and interventions that discourage alcohol consumption and control behaviour, especially among men, should be rolled out.
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Affiliation(s)
- Innocent Maposa
- Division of Epidemiology & Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Division of Epidemiology & Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Halima S Twabi
- Department of Mathematical Sciences, School of Natural and Applied Sciences, University of Malawi, Zomba, Malawi.
| | - Zvifadzo Matsena-Zingoni
- Division of Epidemiology & Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Center for Biomedical Modelling, Department of Psychiatry and Biobehavioural Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Jesca M Batidzirai
- School of Mathematics, Statistics, and Computer Science, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Geoffrey Singini
- Department of Mathematical Sciences, School of Natural and Applied Sciences, University of Malawi, Zomba, Malawi
| | - Mohanad Mohammed
- School of Mathematics, Statistics, and Computer Science, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Alphonce Bere
- Department of Mathematical and Computational Sciences, University of Venda, Thohoyandou, South Africa
| | - Kabelo Kgarosi
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Nobuhle Mchunu
- Biostatistics Research Unit, South African Medical Research Council, Durban, South Africa
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Statistics, Durban, South Africa
- Biostatistics Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - Portia Nevhungoni
- School of Mathematics, Statistics, and Computer Science, University of KwaZulu-Natal, Pietermaritzburg, South Africa
- Biostatistics Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - Maureen Moyo-Chilufya
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Oludoyinmola Ojifinni
- School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Alfred Musekiwa
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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McKay T. When State Violence Comes Home: From Criminal Legal System Exposure to Intimate Partner Violence in a Time of Mass Incarceration. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:2683-2715. [PMID: 35696614 DOI: 10.1177/08862605221106141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Exceptionally high rates of partner violence perpetration are evident among men returning from prison. Two bodies of scholarship, one on family stress and another on exposure to state violence, each suggest that criminal legal system exposure could promote partner violence perpetration via changes in men's behavioral health and interpersonal approach and in couples' conflict dynamics. Such relationships have not been tested in quantitative research. Structural equation models were fitted to longitudinal, couples-based survey data from the Multi-site Family Study on Incarceration, Parenting, and Partnering. Participants included men returning from a state prison term in five U.S. states (N = 1112) and their committed intimate or co-parenting partners (N = 1112). Models tested hypothesized pathways from three dimensions of criminal legal system exposure to later partner violence perpetration. In fitted models, men's childhood criminal legal system exposure predicts their post-prison partner violence perpetration via adult post-traumatic stress symptoms, reactivity, avoidance, and dysfunctional couple conflict dynamics. Men's cumulative criminal legal system exposure in adulthood predicts their post-prison partner violence perpetration via addiction and dysfunctional couple conflict. These initial results suggest that mass-scale incarceration could worsen partner violence via men's psychological and interpersonal adaptations to criminal legal system contact, particularly when such contact is sustained or occurs at a developmentally significant period in the life course.
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Affiliation(s)
- Tasseli McKay
- Department of Sociology, 3065Duke University, Durham, NC, USA
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8
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Bahati C, Rukundo G, Nyirahabimana N, Izabayo J, Niyonsenga J, Sezibera V. The prevalence of mental disorders among intimate partner violence exposed and non-exposed Rwandans: Findings from a national cross-sectional survey. Psychiatry Res 2022; 310:114465. [PMID: 35219265 DOI: 10.1016/j.psychres.2022.114465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 11/25/2022]
Abstract
Despite mounting evidence indicating an increased risk of long-term mental disorders in Rwanda's general population, little is still known about the national prevalence of mental disorders among victims of intimate partner violence (IPV) in a post-conflict setting. The aim of this study was to compare the prevalence of mental disorders among IPV exposed and non-exposed individuals in Rwanda. This was a cross-sectional study based on secondary data from the 2018 Rwanda Mental Health Survey. The sample consisted 20,381 participants selected nationwide, from 7,124 households (age range: 14-65 years), of which 3,759 Rwandans were exposed to IPV (18.4%) and 16,622 were non-exposed to IPV (81.6%). Participants were screened for IPV exposure and common mental disorders, and data was analyzed using the SPSS version 25 software. The results showed that the rate of any mental disorder was substantially higher in the group exposed to IPV than the non-exposed, at 32.4% and 11.7% respectively. These results highlight that among Rwandans diagnosed with severe mental disorders, participants with a history of IPV exposure present with increased odds of mental disorders prevalence and severity. Therefore, people seeking mental health care should also be screened for their IPV exposure and offered appropriate interventions.
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Affiliation(s)
- Claire Bahati
- Department of Clinical Psychology, College of Medicine and Health Sciences, University of Rwanda.
| | - Gilbert Rukundo
- Department of Clinical Psychology, College of Medicine and Health Sciences, University of Rwanda; Swiss Tropical and Public Health Institute
| | | | - Josias Izabayo
- Centre for Mental Health, College of Medicine and Health Sciences
| | - Japhet Niyonsenga
- Department of Clinical Psychology, College of Medicine and Health Sciences, University of Rwanda; Mental Health & Behaviour Research Group, College of Medicine and Health Sciences, University of Rwanda
| | - Vincent Sezibera
- Department of Clinical Psychology, College of Medicine and Health Sciences, University of Rwanda; Centre for Mental Health, College of Medicine and Health Sciences
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9
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Chatterji S, Heise L. Examining the bi-directional relationship between intimate partner violence and depression: Findings from a longitudinal study among women and men in rural Rwanda. SSM - MENTAL HEALTH 2021. [DOI: 10.1016/j.ssmmh.2021.100038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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10
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Stark L, Seff I, Weber AM, Cislaghi B, Meinhart M, Bermudez LG, Atuchukwu V, Onotu D, Darmstadt GL. Perpetration of intimate partner violence and mental health outcomes: sex- and gender-disaggregated associations among adolescents and young adults in Nigeria. J Glob Health 2020; 10:010708. [PMID: 32257165 PMCID: PMC7101086 DOI: 10.7189/jogh.10.010708] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background The association between intimate partner violence (IPV) victimisation and poor mental health outcomes is well established. Less is known about the correlation between IPV perpetration and mental health, particularly among adolescents and young adults. Using data from the nationally representative Violence Against Children Survey, this analysis examines the association between IPV perpetration and mental health for male and female adolescents and young adults in Nigeria. Methods Multivariate logistic regression models were used to examine associations between ever-perpetration of IPV and four self-reported mental health variables: severe sadness, feelings of worthlessness, suicide ideation, and alcohol use. Models were sex-disaggregated, controlled for age, marital status, and schooling, and tested with and without past exposure to violence. Standard errors were adjusted for sampling stratification and clustering. Observations were weighted to be representative of 13-24 year-olds in Nigeria. Results Males were nearly twice as likely as females to perpetrate IPV (9% v. 5%, respectively; P < 0.001), while odds of perpetration for both sexes were higher for those ever experiencing IPV (adjusted odds ratio (aOR) = 4.60 for males; aOR = 2.71 for females). Female perpetrators had 2.73 higher odds of reporting severe sadness (95% confidence interval CI = 1.44, 5.17; P = 0.002) and 2.72 times greater odds of reporting suicide ideation (1.28, 5.79; P = 0.010) than non-perpetrating females, even when controlling for past-year violence victimisation. In contrast, male perpetrators had 2.65 times greater odds of feeling worthless (1.09, 6.43; P = 0.031), and 2.36 times greater odds of reporting alcohol use in the last 30 days (1.50, 3.73; P < 0.001), as compared to non-perpetrating males. Conclusions Among adolescents and young adults in Nigeria, IPV perpetration and negative mental health outcomes are associated but differ for males and females. Mindful of the cross-sectional nature of the data, it is possible that socially determined gender norms may shape the ways in which distress from IPV perpetration is understood and expressed. Additional research is needed to clarify these associations and inform violence prevention efforts.
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Affiliation(s)
- Lindsay Stark
- George Warren Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Ilana Seff
- Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Ann M Weber
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Melissa Meinhart
- Columbia University School of Social Work, New York, New York, USA
| | | | | | - Dennis Onotu
- US Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Gary L Darmstadt
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
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Muwonge J, Umubyeyi A, Rugema L, Krantz G. Suicidal behaviour and clinical correlates in young adults in Rwanda: a population-based, cross-sectional study. JOURNAL OF GLOBAL HEALTH REPORTS 2019. [DOI: 10.29392/joghr.3.e2019080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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12
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Indashyikirwa Women’s Safe Spaces: Informal Response for Survivors of IPV within a Rwandan Prevention Programme. SOCIAL SCIENCES 2019. [DOI: 10.3390/socsci8030076] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Within intimate partner violence (IPV) prevention programmes that raise awareness of women’s rights and the forms and consequences of IPV, there is a need to ensure response mechanisms for IPV survivors. Indashyikirwa is a Rwandan IPV prevention programme, which established 14 women’s safe spaces, whereby men and women could access support for IPV, be referred or accompanied to other services. This paper draws on qualitative interviews with safe space facilitators, attendees, staff and observations of activities at various points across the programme. Thematic analysis was conducted to assess the process and impact of the spaces. Attendees generally preferred the women’s safe spaces over formal services for IPV disclosure and support, and the spaces also enhanced the quality of and linkage to formal IPV response services. The safe spaces further supported well-being and economic empowerment of attendees. Lessons learned from implementing this model are offered, including how to ensure safe, inclusive and integrated sources of support within broader IPV prevention efforts.
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13
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Santos AGD, Monteiro CFDS. Domains of common mental disorders in women reporting intimate partner violence. Rev Lat Am Enfermagem 2018; 26:e3099. [PMID: 30517584 PMCID: PMC6280180 DOI: 10.1590/1518-8345.2740.3099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 09/24/2018] [Indexed: 12/14/2022] Open
Abstract
Objective to verify associations between the types of intimate partner violence and
the domains of common mental disorders in women. Method cross-sectional study with 369 women. The information was obtained through
the instruments Self-Reporting Questionnaire and Conflict Tactic Scales. To
analyze the data, Pearson’s Chi-Square test, Fisher’s exact test and Odds
Ratio were used. Results women who reported physical abuse with and without sequela were respectively
2.58 and 3.7 times more likely to have symptoms of anxious depressed mood.
The chances of experiencing symptoms of decreased vital energy increased by
2.27 times with psychological aggression, 3.06 times with physical abuse
without sequelae and 3.13 times with physical abuse with sequelae. Somatic
symptoms did not show statistical association with the types of violence.
The propensity to develop symptoms of depressive thoughts increased 3.11
times with psychological aggression, 6.13 times with physical aggression
without sequelae, 2.47 times with sexual coercion and 7.3 times with
physical aggression with sequelae. Conclusion the types of intimate partner violence are strongly associated with the
domains of common mental disorders in women. This finding may contribute to
more accurate interventions by health professionals to women victims of
violence.
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Affiliation(s)
- Ariane Gomes Dos Santos
- Universidade Federal do Piauí, Departamento de Enfermagem, Teresina, PI, Brasil.,Instituto Federal de Educação, Ciência e Tecnologia do Piauí, Departamento de Saúde, Teresina, PI, Brasil
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14
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Umubyeyi A, Persson M, Mogren I, Krantz G. Gender Inequality Prevents Abused Women from Seeking Care Despite Protection Given in Gender-Based Violence Legislation: A Qualitative Study from Rwanda. PLoS One 2016; 11:e0154540. [PMID: 27152680 PMCID: PMC4859471 DOI: 10.1371/journal.pone.0154540] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 03/25/2016] [Indexed: 11/19/2022] Open
Abstract
Objective Despite its burden on a person’s life, Intimate Partner Violence (IPV) is known to be poorly recognised and managed in most countries and communities. This study aimed to explore health care professionals’ experiences of the health care seeking processes of women exposed to intimate partner violence in Rwanda. Methods Six focus group discussions were conducted in three district hospitals and three mental health units in Rwanda. A sample of 43 health care professionals with various professions and length of work experience, who regularly took care of patients subjected to IPV, was selected for focus group discussions. The analysis was performed using qualitative content analysis. Results The theme “Gendered norms and values defeat the violence legislation in women’s health care seeking when women are abused” expressed the health care professionals’ experiences of the double-faced situation which women exposed to IPV met in their help seeking process. Positive initiatives to protect women were identified, but the potential for abused women to seek help and support was reduced because of poverty, gender inequality with prevailing strong norms of male superiority, and the tendency to keep abuse as a private family matter. Conclusion Legislative measures have been instituted to protect women from abuse. Still many Rwandan women do not benefit from these efforts. The role of the health care services needs to be reinforced as an important and available resource for help and support for abused women but further legislative changes are also needed. Initiatives to further improve gender equality, and institutionalised collaboration between different sectors in society would contribute to protecting women from IPV.
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Affiliation(s)
- Aline Umubyeyi
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- * E-mail:
| | | | - Ingrid Mogren
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - Gunilla Krantz
- Department of Public Health and Community Medicine, Section of Epidemiology and Social Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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Psychometric Validation and Comparison of the Self-Reporting Questionnaire-20 and Self-Reporting Questionnaire-Suicidal Ideation and Behavior Among Congolese Refugee Women. J Nurs Meas 2016; 23:393-408. [PMID: 26673766 DOI: 10.1891/1061-3749.23.3.393] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The Self-Reporting Questionnaire (SRQ) has long been used among refugee populations to detect common mental health disorders. PURPOSE Our purpose was to compare findings from psychometric validation of the 20-item SRQ with a modified version, the SRQ-SIB (suicidal ideation and behavior). METHODS Factor analysis of both scales was performed in a sample of Congolese refugee women as well as predictive validity, contrast validity, and internal consistency. RESULTS Both scales exhibited a reliability of .911. The SRQ-SIB exhibited a three-factor solution; somatic, psychological, and SIB. The SIB was highly predictive for having experienced sexual violence. Analyses validate the use of both, but the SIB is useful for differentiating more severe cases of common mental disorder (CMD). CONCLUSIONS The SRQ-SIB may be an important tool for the nursing assessment of suicide among refugee women.
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Balogun MO, John-Akinola YO. A Qualitative Study of Intimate Partner Violence Among Women in Nigeria. JOURNAL OF INTERPERSONAL VIOLENCE 2015; 30:2410-2427. [PMID: 25392394 DOI: 10.1177/0886260514553112] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Negative health outcomes caused by intimate partner violence (IPV) have been recognized as a public health problem with extensive effects on the society. Cultural and traditional beliefs that reinforce IPV in Nigeria need to be understood to guide public health approaches aimed at preventing IPV. The purpose of this study was to determine women's attitudes and societal norms that support IPV, causes and consequences of IPV, and coping strategies, and to document suggested measures to prevent it. Six focus group discussions (FGDs) were conducted among 56 women aged 15 to 49 years purposively selected from rural and urban communities in Akinyele Local Government Area (LGA) of Oyo State, Nigeria. The FGDs were conducted in Yoruba language, translated to English, and analyzed using thematic approach. Findings were grouped into six major themes: triggers, societal norms, attitude, consequences, coping strategies, and preventive measures. Women reported experience of physical, psychological, and sexual violence and controlling behavior. Major causes of IPV reported by the women were having more money than partner, and building a house or having a business without partner's knowledge. Most participants reported that social norms dictate that a woman should have full regard for in-laws, and submit to and agree with all that the partner says and does. Most of the discussants in both the urban and rural areas reported that violence in any form is not justifiable or acceptable. Participants mentioned various ways through which IPV negatively impacted on women's health such as depression, hypertension, and damage to the reproductive system. They were however willing to endure suffering because of their children. Women who experienced IPV reported to close relatives but did not seek legal redress because these were unavailable. Ending IPV requires long-term commitment and strategies involving contributions from the government, community, and the family.
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Russell SG, Lim S, Kim P, Morse S. The legacy of gender-based violence and HIV/AIDS in the postgenocide era: Stories from women in Rwanda. Health Care Women Int 2015; 37:721-43. [PMID: 26291248 DOI: 10.1080/07399332.2015.1083026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Drawing on qualitative interviews with 22 Rwandan women, we describe the lived experiences of women survivors of gender-based violence (GBV) more than a decade and a half after the 1994 Genocide. We argue that the intersection between GBV and human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) has long-term implications: the majority of women interviewed continue to endure trauma, stigma, social isolation, and economic hardship in the postgenocide era and are in need of expanded economic and mental health support. Our findings have implications for the importance of providing integrated psychosocial support to survivors of GBV postconflict contexts.
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Affiliation(s)
| | - Sanaya Lim
- b CalOptima , Los Angeles , California , USA
| | - Paul Kim
- c Graduate School of Education, Stanford University , Stanford , California , USA
| | - Sophie Morse
- d Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University , Baltimore , Maryland , USA
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Rugema L, Mogren I, Ntaganira J, Krantz G. Traumatic episodes and mental health effects in young men and women in Rwanda, 17 years after the genocide. BMJ Open 2015; 5:e006778. [PMID: 26109109 PMCID: PMC4480039 DOI: 10.1136/bmjopen-2014-006778] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES To investigate mental health effects associated with exposure to trauma in Rwanda during the 1994 genocide period, and over the lifetime, in Rwandan men and women aged 20-35 years. SETTING This was a cross-sectional population-based study conducted in the southern province of Rwanda. Data was collected during December 2011 to January 2012. PARTICIPANTS A total population of 917 individuals were included, 440 (48%) men and 477 (52%) women aged 20-35 years. Number of households for inclusion in each village was selected proportional to the total number of households in each selected village. The response rate was 99.8%. Face-to-face interviewing was done by experienced and trained clinical psychologists, following a structured questionnaire. RESULTS Women were slightly less exposed during the genocide period (women 35.4% and men 37.5%; p=0.537), but more women than men were exposed to traumatic episodes over their lifetime (women 83.6%, n=399; men 73.4%, n=323; p<0.001). Current major depressive episodes (MDE) were twice as prevalent in women as in men. Traumatic episodes experienced in the genocide period severely affected men's current mental health status with relative risk (RR) 3.02 (95% CI 1.59 to 5.37) for MDE past and with RR 2.15 (95% CI 1.21 to 3.64) for suicidality. Women's mental health was also affected by trauma experienced in the genocide period but to an even higher extent, by similar trauma experienced in the lifetime with RR 1.91 (95% CI 1.03 to 3.22) for suicidality and RR 1.90 (95% CI 1.34 to 2.42) for generalised anxiety disorder, taking spousal physical/sexual violence into consideration. CONCLUSIONS Depression, post-traumatic stress disorder, anxiety and suicidal attempts are prevalent in Rwanda, with rates twice as high in women compared with men. For women, exposure to physical and sexual abuse was independently associated with all these disorders. Early detection of gender-based violence through homes and community interventions is important.
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Affiliation(s)
- Lawrence Rugema
- Department of Community Health, School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- Department of Public Health and Community Medicine, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Ingrid Mogren
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umea, Sweden
| | - Joseph Ntaganira
- Department of Community Health, School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Gunilla Krantz
- Department of Public Health and Community Medicine, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Bell SA, Lori J, Redman R, Seng J. Development of a brief screening tool for women's mental health assessment in refugee settings: A psychometric evaluation. Int J Nurs Stud 2015; 52:1202-8. [PMID: 25892280 DOI: 10.1016/j.ijnurstu.2015.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 03/25/2015] [Accepted: 04/03/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND PURPOSE The detection of common mental disorders in humanitarian crisis settings requires a screening tool that is feasible to use as well as sensitive and specific. The Self-Report Questionnaire, developed by the World Health Organization in 1994 to detect presence or absence of common mental health disorders, has frequently been used among conflict-affected and refugee populations. Our goal was to identify a highly predictive and reliable subset of items to serve as a screening tool that can be used in busy, over-crowded, and low-resource primary health care settings to identify women who need mental health attention. METHODS We analyzed the responses on a version of the Self-Report Questionnaire expanded to include two suicidality items from 810 displaced women living in refugee camps in Rwanda. Screening items were selected and evaluated for predictive ability using logistic regression in a cross-validation process, sensitivity and specificity using receiver operating characteristic curve analysis, and internal consistency analysis. RESULTS A five-item screening tool resulted. Those items are "Do you feel unhappy?", Do you feel easily nervous, tense, or worried?", "Have you lost interest in things?", "Do you have trouble thinking clearly?" and "Has the thought of ending your life been on your mind?". CONCLUSION The Self-Report Questionnaire-5 may be an important tool for identifying common mental disorders as well as suicide ideation and behaviors when assessing mental health among women in crisis situations. Further evaluation of this tool is warranted.
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Affiliation(s)
- Sue Anne Bell
- University of Michigan School of Nursing, United States.
| | - Jody Lori
- University of Michigan School of Nursing, United States
| | | | - Julia Seng
- University of Michigan School of Nursing, Department of Obstetrics and Gynecology and Institute for Research on Women and Gender, United States
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Umubyeyi A, Mogren I, Ntaganira J, Krantz G. Intimate partner violence and its contribution to mental disorders in men and women in the post genocide Rwanda: findings from a population based study. BMC Psychiatry 2014; 14:315. [PMID: 25406929 PMCID: PMC4245842 DOI: 10.1186/s12888-014-0315-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 10/24/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In low income countries, mental disorders are a neglected health problem. Mental disorders are influenced by a number of factors in people's everyday life of which intimate partner violence (IPV) commonly form an important part. The aim of this study was to investigate the prevalence of mental disorders in young men and women in Rwanda and their risk factors with main emphasis on IPV and its contribution to mental disorders, taking into account the genocide context. METHODS This population-based study included a representative sample of 917 men and women aged 20-35 years. The prevalence of mental disorders was investigated using of a diagnostic tool, the "MINI: Mini International Neuropsychiatric Interview". Risk factor patterns were analysed with bi- and multivariate logistic regression. To find the proportion of mental disorders attributed to IPV, the population attributable fraction was computed. RESULTS The prevalence rates of current depression, suicide risk and PTSD were more than two times higher in women than in men while for generalized anxiety disorder, the prevalence was about the same. Physical, sexual and psychological intimate partner violence exposure was highly associated with all forms of mental disorders for women. For physical violence, after adjusting for socio-demographic factors and exposure to traumatic episodes during the Rwandan genocide, the risk of current depression for women was elevated four times. Even though few men reported partner violence exposure, physical violence in the past year was found to be a statistically significant risk factor for current depression and for generalized anxiety disorder. However, having an experience of traumatic episodes during the genocide contributed to the risk of most of mental disorders investigated for men. CONCLUSION In Rwanda, IPV contributed considerably to mental disorders investigated. Thus, prevention of IPV should be considered as a public health priority, as its prevention would considerably reduce the prevalence of mental disorders.
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Affiliation(s)
- Aline Umubyeyi
- Department of Epidemiology and Biostatistics, School of Public health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda ,Department of Public Health and Community Medicine, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Ingrid Mogren
- Department of Clinical Sciences, Obstetrics and Gynecology, Umea University, Umea, Sweden
| | - Joseph Ntaganira
- Department of Epidemiology and Biostatistics, School of Public health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Gunilla Krantz
- Department of Public Health and Community Medicine, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
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Umubyeyi A, Mogren I, Ntaganira J, Krantz G. Women are considerably more exposed to intimate partner violence than men in Rwanda: results from a population-based, cross-sectional study. BMC WOMENS HEALTH 2014; 14:99. [PMID: 25155576 PMCID: PMC4148406 DOI: 10.1186/1472-6874-14-99] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Accepted: 08/15/2014] [Indexed: 11/22/2022]
Abstract
Background Intimate partner violence (IPV) against women is an important, yet often neglected public health issue. The existence of gender norms imbalance expressed by men’s and women’s attitudes in relation to power and decision-making in intimate relationships may influence the magnitude of IPV. The aim of this study was to investigate the prevalence and potential risk factors of physical, sexual and psychological IPV in young men and women in Rwanda. Methods This population-based, cross-sectional study included a representative sample of men and women from the Southern Province of Rwanda. Face-to-face interviews were performed using the World Health Organization (WHO) questionnaire for violence exposure to estimate past year and earlier in life IPV occurrence. Risk factor patterns were analyzed by use of bi- and multivariate logistic regression. Results Women were, to a considerably higher extent, exposed to physical, sexual and psychological IPV than men. Of the women, 18.8% (n = 78) reported physical abuse in the past year, compared to 4.3% (n = 18) of men. The corresponding figures for women and men for sexual abuse were 17.4% (n = 71) and 1.5% (n = 6), respectively, and for psychological abuse, the corresponding figures were 21.4% (n = 92) and 7.3% (n = 32). Findings illustrate that violence against women was recurrent, as the highest frequency (>3 times) dominated in women for the various acts of all forms of violence. Identified risk factors for women’s exposure to physical violence were being low educated, having poor social support, being poor and having many children. For men exposed to physical violence, no statistically significant risk factor was identified. Conclusions In this setting, IPV exposure was more common in women than men in the Southern Province of Rwanda. Promotion of gender equality at the individual level is needed to make a positive difference in a relatively short term perspective. Men’s lower reporting of IPV confirms women’s subordinate position, but men’s denial of incidents could also explain the gender role pattern.
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Affiliation(s)
- Aline Umubyeyi
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, University of Rwanda, P,O Box 5229, Kigali, Rwanda.
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