Intimate Partner Violence Among Hong Kong Young Adults: Prevalence, Risk Factors, and Associated Health Problems

The prevalence of intimate partner violence and risk factors for women and men in China during the Shanghai 2022 lockdown

AIMS

Intimate partner violence (IPV) is a global public health concern with negative effects on individuals and families. The present study investigated the prevalence, risk factors and gender disparities associated with IPV during the Shanghai 2022 Covid-19 lockdown - a public health emergency which may have exacerbated IPV.

METHODS

We estimated the total IPV prevalence and prevalence of physical, sexual and verbal IPV by using an adapted version of the Extended-Hurt, Insult, Threaten, Scream scale. This cross-sectional study was carried out using a population quota-based sampling of Shanghai residents across 16 districts during the 2022 Shanghai lockdown (N = 2026; 1058 men and 968 women).

RESULTS

We found a distinct gendered dynamic, where women reported a significantly higher prevalence of experienced IPV (27.1%, 95% confidence interval [CI]: 23.1-31.4) compared to men (19.8%, 95% CI: 16.1-24.0). Notably, the prevalence estimate mirrored the national lifetime IPV prevalence for women but was over twice as high for men. In multivariable logistic regression analyses, economic stress (income loss: adjusted OR [aOR] = 2.42, 95% CI: 1.28-4.56; job loss: aOR = 1.73, 95% CI: 1.02-2.92; financial worry much more than usual: aOR = 1.89, 95% CI: 1.00-3.57) and household burden (one child at home: aOR = 1.81, 95% CI: 1.12-2.92; not enough food: aOR = 1.67, 95% CI: 1.04-2.70) were associated with increased odds of overall IPV victimization among women but not men. With regard to more serious forms of IPV, job loss (aOR = 2.27, 95% CI: 1.09-4.69) and household burden (two or more children at home: aOR = 2.95, 95% CI: 1.33-7.69) were associated with increased odds of physical IPV against men. For women, a lack of household supplies was associated with increased odds of physical IPV (water: aOR = 3.33, 95% CI: 1.79-6.25; daily supplies: aOR = 2.27, 95% CI: 1.18-4.35). Lack of daily supplies (aOR = 2.17, 95% CI: 1.03-4.55) and job loss (aOR = 2.66, 95% CI: 1.16-6.12) were also associated with increased odds of sexual IPV.

CONCLUSIONS

Although a larger proportion of women reported IPV, men experienced greater IPV during the lockdown than previously estimated before the pandemic. Economic stressors, including job loss, and household burden were critical risk factors for serious forms of IPV. Improving gender equality that my account for disparities in IPV in China is critically needed. Policies that mitigate the impact of economic losses during crises can potentially reduce IPV.

Risk and Protective Factors Associated With Intimate Partner Violence Against Chinese Women: A Systematic Review

Intimate partner violence (IPV) is a global health challenge leading to various detrimental health outcomes. Chinese women are a vulnerable population often overlooked in IPV research. Guided by the social-ecological model, this systematic review aims to synthesize literature on the risk and protective factors for IPV among Chinese women. A comprehensive search was conducted in nine major English and Chinese databases for articles with data collected since 2006 on adult Chinese women, leading to 29 papers in the final analysis. Risk and protective factors associated with IPV identified in this review include factors at the individual level such as demographics (e.g., a younger age, unplanned pregnancy, abortion, having children, and migration), socioeconomic status (e.g., income and partners' education level), attitudinal factors (e.g., attitudes justifying IPV and traditional beliefs about gender roles), behavioral factors (e.g., alcohol use of women, partners' alcohol use and frequency, and partners' high frequency of gambling), adverse childhood experiences (e.g., witnessed violence in childhood), and other personal characteristics (e.g., chronic illness and good health status). Factors at the relationship level include conflicts, power in intimate relationships, and social capital (e.g., the size of social networks, network participation of women and their partners, and social control). Community-level factors related to geographic locations were also explored while no factors were identified at the societal level. None of the included studies examined the intersections of factors within the same level or across different levels. Recommendations for future research, practice, and policy are also discussed.

Subjective socioeconomic status: An indicator of intimate partner violence in middle-aged adults in Hong Kong

Intimate partner violence (IPV) has recently been recognised as a global public health issue that can cause various kinds of long-lasting physical, sexual and psychological health problems. Limited studies are available concerning the relationship between objective and subjective socioeconomic status (SES) and IPV, and the impact of experiencing IPV on health consequences. This is a cross-sectional study aiming to examine the association between objective and subjective SES as risk factors of IPV, and further investigate how they affect health status in adults who experienced IPV. A total of 400 participants were recruited from June to September 2016 among 18 districts in Hong Kong. Results from multiple linear regression showed that having a higher education (adjusted B [aB] = 0.22, 95% CI = 0.01, 0.45), having lower levels of subjective SES (aB = -0.08, 95% CI = -0.15, -0.01), experiencing childhood stress (aB = 0.58, 95% CI = 0.27, 0.89) and being married (aB = 0.60, 95% CI = 0.01, 1.19) were significantly associated with IPV. While employment and household income were not associated with IPV. Participants with higher levels of subjective SES were more likely to report somatic symptom (aB = -0.44, 95% CI = -0.87, -0.02), anxiety (aB = -0.38, 95% CI = -0.72, -0.04) and depressive symptom (aB = -0.52, 95% CI = -0.94, -0.10). Low subjective SES, instead of low objective SES, was found associated with IPV in Chinese adults. A priority for future studies is the confirmation and expansion of subjective SES and its function in clinical measures. Programmes instilling hope and optimism will be helpful to enhance subjective SES and boost physical and mental well-being in IPV survivors.

Beyond the Role of Interpersonal Violence in Predicting Negative Affective Conditions in Adults: An Examination of Hope Components in Chinese College Students

With the growth of positive psychology during the past two decades, increased research has been focused on identifying human virtues that not only foster well-being but also act as positive processes that mitigate the impact of life adversities. Thus, it is useful to examine how positive processes, such as hope, may impact individuals' psychological adjustment following adversities. This study investigated the relationships among interpersonal violence, hope, as a key human strength, and negative affect conditions in a large sample (N = 737) of Chinese male and female (N_female = 409) college students. Participants completed measures assessing prior exposure to interpersonal violence, levels of both hope components (i.e., agency and pathways), negative affect, depressive symptoms, and suicidal ideation. Results from correlational analyses showed that exposure to interpersonal violence was positively and hope was negatively correlated with negative affective conditions. However, hope agency was more strongly correlated with those outcomes than hope pathways. In addition, three separate hierarchical regression analyses indicated that after accounting for demographics (i.e., age and sex) and interpersonal violence, within hope components, only hope agency remained as strong concurrent predictors of negative affective conditions. The present findings in this Chinese sample are consistent with those obtained from Turkey and the United States samples, adding evidence to the more robust role of hope, and hope agency in particular, in predicting negative psychological adjustment associated with interpersonal violence. Efforts made to address the absence of hope agency may be particularly important in future attempts to mitigate negative affective conditions linked to interpersonal violence among Chinese college students.

Bidirectional Intimate Partner Violence Among Chinese Women: Patterns and Risk Factors

Bidirectional intimate partner violence (BIPV) refers to the co-occurrence of violence perpetration by both partners. BIPV has been analyzed using samples from different sociodemographic contexts but has yet to be fully explored in China. The present study employed a latent class approach to identify BIPV patterns, rates of prevalence, and associated risk factors among a sample of 1,301 heterosexual adult women in mainland China. Five distinct patterns of BIPV were identified, including (a) bidirectional psychological aggression, (b) bidirectional violence of all types, (c) multi-type victimization with psychological aggression, (d) minimal violence, and (e) bidirectional multi-types without physical violence. Marital status, education, employment status, acceptance of male dominance, and justification of intimate partner violence (IPV) were found to be predictive of different types of BIPV. Our findings suggest a need for a conceptual recognition of the heterogeneity and bidirectionality of IPV among Chinese women. Future research should extend to other diverse populations and sociocultural or clinical contexts in China. IPV assessments, research, and social programs ought to recognize the complexity of IPV and consider various IPV patterns specific to heterosexual women.

Intimate Partner Sexual Violence and Mental Health Indicators Among Chinese Emerging Adults

Intimate partner sexual violence (IPSV) among emerging adults, including heterosexuals and sexual minorities in the Chinese population, is poorly understood. Focusing on college students, the objectives of the present study were to estimate the prevalence of IPSV among Chinese emerging adults, examine the association between sexual orientation and IPSV, and evaluate the mental health and quality of life of survivors of IPSV. Data were collected from four university campuses in Hong Kong. A total of 1,015 participants were included in the data analysis. The prevalence of IPSV as identified by Conflict Tactics Scale (CTS)-2 was 12.1%. There was no gender difference in the prevalence of IPSV. Multiple logistic regression found that being older; having experienced childhood sexual abuse and having a smoking habit; and belonging to a sexual minority were factors associated with IPSV. Multiple linear regression found that IPSV survivors were more likely to have higher levels of anxiety and depression, more severe psychosomatic symptoms, and poorer quality of life in three domains: psychological, social relationships, and environment when compared with those without IPSV experience. The documented factors underscored the importance of awareness that men and sexual minorities might incur IPSV, which should receive more attention in IPSV prevention programs. Also, interventions for IPSV survivors should be targeted at improving their mental health and quality of life and sex education should place more emphasis on sexual consent and sexual health in dating relationships.

Do Negative Emotional States Play a Role in the Association Between Intimate Partner Violence and Poor Health-Related Quality of Life in Chinese Women From Low-Income Families?

A cross-sectional analysis of a dataset of 156 participants in a health assessment program explored whether negative emotional states mediated the association between intimate partner violence (IPV) and health-related quality of life (HRQoL). Compared with IPV screen-negative participants, those who screened positive had significantly lower HRQoL and significantly higher levels of depression, anxiety, and stress. The inverse associations between the presence of IPV and HRQoL were found to be mediated by depression, anxiety, and stress. Therefore, interventions to alleviate negative emotions in women suffering from IPV have the potential to be useful in improving their HRQoL.

Childhood Abuse and Current Intimate Partner Violence: A Population Study in Hong Kong

Previous studies have established that childhood violence victimization is associated with current experience of intimate partner violence (IPV). Existing literature, however, focused exclusively on female survivors and physical IPV and relied on non-representative samples. The present study examined the associations between life adversities and IPV using a representative sample of 1,239 men and women aged between 18 and 97. Participants provided information on their demographic characteristics, lifetime history of adverse life events, and past year IPV. Results show that IPV is common with 32.8% of the participants having reported past year psychological aggression, 4.5% reported physical abuse, and 1.1% reported injury. Various life adversities were also common with 21.7% having reported family disruption, 6% having experienced abuse or witnessing violence, and 2.1% life-threatening events. Logistic regression analyses revealed that experiencing abuse or witnessing violence in childhood is associated with a greater risk of past year psychological aggression, physical assault, and injury. Results were significant even after controlling for demographics and other life adversities. Family disruption in childhood was associated with increased risk of past year injury, but the association diminished after controlling for the rest of the variables. Experience of life-threatening events was not associated with any form of past year IPV. Altogether, our results point out that childhood victimization, especially physical abuse by parents, is associated with future long-term risk of IPV. This highlights the importance of early prevention and intervention for child abuse.

Intimate Partner Violence Perpetration and Victimization Among Chinese Young Adults: Profiles and Associated Health Problems

Intimate partner violence is an important public health issue affecting the well-being of the young adults. However, there is little epidemiological evidence on the incidence and associated mental health problems of both intimate partner violence perpetration and victimization in Chinese context. Using one representative community sample of 1,227 young adults aged 18-27 years in 2016, this study aimed to examine the prevalence, sociodemographic characteristics, and possible mental health consequences of intimate partner violence among young adults in Hong Kong. It is found that the prevalence of preceding 1-year intimate partner violence perpetration and victimization was 5.3% and 9.1% respectively. The perpetrators were worse educated, unemployed, and married, while the victims were also unemployed and cohabited. Compared with those without involving in any intimate partner violence, perpetrators of intimate partner violence were more likely to engage in frequent smoking and alcohol use, and victims of intimate partner violence reported lower life satisfaction, more self-harm behaviors, higher suicide ideation and attempt, and heavy alcohol use. Both perpetrators and victims were more likely to report the worst mental health problems and high risky behaviors.

Multiple Forms of Early Violent Socialization and the Acceptance of Interpersonal Violence Among Chinese College Students

Early violent socialization has consistently been associated with individuals' attitudes toward interpersonal violence in adulthood. However, how particular types of violent socialization during childhood differently influence individuals' acceptance of interpersonal violence remains unclear. The current study examined the effect of multiple types of violent socialization on acceptance of interpersonal violence among Chinese college students in Hong Kong (N = 794). The findings of hierarchical multiple regression analyses indicated that verbal advice regarding and witnessed experience with violence during childhood predict the acceptance of violence. In contrast, childhood experience of being a violence victim was not significantly associated with the acceptance of violence. In addition, gender moderates the relationship between verbal advice toward violence and acceptance of violence. Therefore, educational interventions related to the impact of multiple forms of violent socialization on attitudes toward violence that create a safe and stable environment for children may be beneficial for parents, teachers, and practitioners who work closely with children. The results may be also useful in informing colleges, universities, and professional practitioners as they make decisions about social awareness programs for college students to help change their attitudes toward violence.

Elements which precipitate conjugal violence: the discourse of men in criminal prosecution

OBJECTIVE

Unveiling the precipitating elements of conjugal violence based on the discourse of men undergoing criminal prosecution.

METHOD

This is a qualitative study developed in a Domestic Violence and Family Violence Campaign against Women from Salvador, Bahia, Brazil.

RESULTS

We interviewed 23 men. The following central ideas emerged: children and family interference; change in woman's behavior; feeling of ownership; discovery of extramarital affairs of women; absence of marital sexual intercourse; and use of alcohol and other drugs by men.

CONCLUSION

Several elements precipitate marital violence according to the mens' discourse. Knowing these elements can subsidize actions for preventing the phenomenon, especially from implementing peaceful conflict resolution strategies.

Maternal mental quality of life mediates the associations between intimate partner abuse against mothers and their children's behaviours and quality of life in low-income Chinese families

PURPOSE

To explore the association between maternal intimate partner abuse (IPA) and their children's health-related quality of life (HRQOL) and behavioural problem, and to establish a mediation model and investigate the mediating role of mothers' HRQOL on this association.

METHODS

A cross-sectional study was conducted on 197 mothers of 227 children (112 boys and 115 girls) from low-income Chinese families. The mothers were asked to complete the 5-item abuse assessment screen questionnaire for the presence of IPA, the Chinese (Hong Kong) version of 12-item Short-Form Health Survey (SF-12) for their HRQOL and a structured socio-demographics questionnaire. One of the parents completed the Child Health Questionnaire-Parent Form-50 (CHQ-PF50) and the strengths and difficulties questionnaire (SDQ) to report on their children's HRQOL and behavioural problems, respectively. The mediating effect of the maternal HRQOL on the relationship between maternal IPA status and their children's behavioural problems and HRQOL was tested using Baron and Kenney's multistage regression approach and bootstrapping method.

RESULTS

Thirty-five of the 197 mothers reported IPA (17.8%). Children whose mothers had experienced IPA had lower scores in the CHQ-PF50 mental health, parental impact-emotional, family activities and family cohesion subscales, and the psychosocial summary score compared to children of mothers who reported no IPA; they also had more emotional, conduct and hyperactivity/inattention problems and higher total difficulties scores measured by the SDQ. Maternal mental HRQOL was a mediator on the relationship between maternal IPA status and their children's behavioural problems and psychosocial HRQOL.

CONCLUSION

IPA experienced by mothers had significant negative impacts on their children's HRQOL and behaviours, which was mediated by maternal mental HRQOL.