Gender Differences in Intimate Partner Violence in Current and Prior Relationships

Adrenocortical deviations and adverse clinical outcomes in children and adolescents exposed to interparental intimate partner violence: A systematic review

Childhood exposure to interparental intimate partner violence (i-IPV) is a pervasive form of child maltreatment, posing major public health concerns and elevating risks for enduring adverse clinical and developmental consequences. However, assessing the full spectrum of clinical effects is challenging, potentially leading to inconsistent identification of children in need of early intervention. This systematic review aimed to identify hypothalamic-pituitary-adrenocortical axis dysfunction following i-IPV exposure, elucidating the underlying biopsychobehavioural mechanisms and predicting adverse outcomes. We searched Embase, MEDLINE, and PsycINFO for peer-reviewed studies from infancy through adolescence, screened reference lists and conducted forward searches. Analysis of 23 publications (N = 1848) revealed associations between i-IPV and altered adrenocortical function from early childhood, influenced by FKBP5 haplotype, parental caregiving and offspring emotional insecurity. Results showed that the adrenocortical stress response may predict internalising and externalising problems, childhood asthma, impaired executive function and poor academic performance. Nonetheless, inconsistencies in findings between studies suggest methodological heterogeneity and potential bias. Identifying biomarkers such as cortisol can enhance prediction and mechanism-based intervention efforts but long-term studies with a common theoretical and methodological framework are needed for comprehensive understanding. Integrating biological, emotional, and behavioural assessments could potentiate trauma services and research, ultimately improving outcomes for affected children.

Family poverty over the early life course and adult experiences of intimate partner violence: a cohort study

OBJECTIVES

This study aimed to determine whether family poverty over the early childhood, adolescent, and adult periods of the life course independently predicts experiences of intimate partner violence (IPV) in adulthood.

STUDY DESIGN

This was a birth cohort study in Brisbane, Australia, with pregnant women recruited at their first booking-in visit and their children, followed up to 30 and 40 years of age.

METHODS

Family income was obtained from the mother when the child was 6 months, 5 and 14 years of age. Offspring reported their own family income at 21, 30, and 40 years of age. The offspring completed the Composite Abuse Scale at 30 and 40 years. Adjusted logistic regression models are used to predict experiences of IPV at 30 (n = 2157) and 40 (n = 1438) years.

RESULTS

The findings at 30 and 40 years of age are consistent. Only poverty experienced concurrently with the assessment of IPV is strongly associated. At the 40-year follow-up, family poverty predicts higher ratios of all four forms of IPV; severe combined abuse (odds ratio [OR] = 2.24, 95% confidence interval [CI] = 1.24, 4.05), physical abuse (OR = 3.37, 95% CI = 1.95, 5.82), emotional abuse (OR = 2.09, 95% CI = 2.58, 8.57) and harassment (OR = 4.70, 95% CI = 2.58, 8.57).

CONCLUSION

Concurrent family poverty is strongly and consistently associated with patterns of IPV. These associations are for cross-sectionally collected data with the prospectively collected data not replicating these findings. Although it is not possible to identify a specific causal pathway, the findings suggest that the immediate consequences of poverty are strongly associated with IPV. Programmes that address poverty reduction provide the best prospect for reducing societal levels of IPV.

Barriers to and Facilitators of Help-Seeking Among Men Who are Victims of Domestic Violence: A Mixed-Studies Systematic Review

Domestic violence against men poses a significant threat to men's health and well-being and is increasingly being recognized as a public health issue. Unfortunately, men who are victims often struggle to disclose and report their abusive experiences. This review aims to examine and consolidate the evidence regarding the barriers to and facilitators of help-seeking behaviors of men who suffered from women-perpetrated domestic violence. A mixed-studies review was conducted using the Joanna Briggs Institute approach. Nine electronic databases were searched from each database's inception until January 2023. The 23 included studies were appraised using the Mixed Methods Appraisal Tool, and their findings were synthesized using the Joanna Briggs Institute convergent qualitative synthesis method. An overarching theme, "Stuck in a loop and finding ways to move on," which encapsulated the predicament of victimized men in abusive relationships, was identified along with three main themes. Overall, a gender-biased perspective of domestic violence, personal fears, and familial factors hindered victimized men from reporting violence and seeking help. A multi-faceted approach-consisting of public education campaigns, sensitizing, and training help professionals, engendering "safe" environments, developing men-specific assessments, and reforming social and legal-justice processes-is needed to effectively address the gender-specific challenges faced by men who are victims of domestic violence and break the cycle of abuse, and improve formal and informal help-seeking in men who are victims of domestic abuse.

Impact evaluation of invisible intimate partner violence on maternal healthcare utilization in Pakistan

INTRODUCTION

Existing research has shown that intimate partner violence (IPV) may hinder maternal access to healthcare services, thereby affecting maternal and child health. However, current studies have ignored whether emotional intimate partner violence (EV) could negatively affect maternal healthcare use. This study aims to evaluate the impact of invisible IPV on maternal healthcare utilization in Pakistan.

METHODS

We analyzed nationally representative data from the Pakistan Demographic and Health Survey database from 2012-2013 and 2017-2018. Exposure to physical intimate partner violence (PV) and EV was the primary predictor. Based on women's last birth records, outcomes included three binary variables indicating whether women had inadequate antenatal care (ANC) visits, non-institutional delivery, and lack of postnatal health check-ups. A logistic regression model was established on weighted samples.

RESULTS

Exposure to EV during pregnancy was significantly associated with having inadequate ANC visits (aOR = 2.16, 95% CI: 1.06 to 4.38, p = 0.033) and non-institutional delivery (aOR = 2.24, 95% CI: 1.41 to 3.57, p = 0.001). Lifetime exposure to EV was associated with increased risks of inadequate ANC visits (aOR = 1.48, 95% CI: 1.00 to 2.19, p = 0.049). Lifetime exposure to low-scale physical intimate partner violence (LSPV) (adjusted OR (aOR) = 1.73, 95% CI: 1.29 to 2.31, p < 0.001) was associated with increased risks of having no postnatal health check-ups.

CONCLUSIONS

Pregnant women who experienced EV and LSPV are at greater risk of missing maternal healthcare, even if the violence occurred before pregnancy. Therefore, in countries with high levels of IPV, early screening for invisible violence needs to be integrated into policy development, and healthcare providers need to be trained to identify EV and LSPV.

Factors associated with suicide/self-inflicted injuries among women aged 18-65 years in the United States: A 13-year retrospective analysis of the National Inpatient Sample database

BACKGROUND

Suicide is a significant cause of mortality in the United States, accounting for 14.5 deaths/100,000. Although there are data on gender disparity in suicide/self-inflicted injury rates in the United States, few studies have examined the factors associated with suicide/self-inflicted injury in females.

OBJECTIVE

To determine factors associated with suicide/self-inflicted injuries among women aged 18-65 years in the United States.

METHODS

Hospitalizations for suicide or self-inflicted injuries were identified using the National Inpatient Sample database from 2003-2015 using sample weights to generate national estimates. Independent predictors of suicide/self-inflicted injuries were identified using multivariable regression models. Interaction term analysis to identify the interaction between race/ethnicity and income were conducted.

RESULTS

There were 1,031,693 adult women hospitalizations in the U.S. with a primary diagnosis of suicide/self-inflicted injury in the study period. The highest suicide/self-inflicted injury risk was among women aged 31-45years (OR = 1.23, CI = 1.19-1.27, p < 0.05). Blacks in the highest income strata had a 20% increase in the odds of suicide/self-inflicted injury compared to Whites in the lowest socioeconomic strata (OR = 1.20, CI = 1.05-1.37, p <0.05). Intimate partner violence increased suicide/self-inflicted injury risk 6-fold (OR = 5.77, CI = 5.01-6.65, p < 0.05).

CONCLUSION

Suicide risk is among women aged 31-45 years, higher earning Black women, intimate partner violence victims, uninsured, and current smokers. Interventions and policies that reduce smoking, prevents intimate partner violence, addresses racial discrimination and bias, and provides universal health coverage are needed to prevent excess mortality from suicide deaths.

Global achievement of maternal health-related sustainable development goals targets among women exposed to intimate partner violence

Health-related Sustainable Development Goal (SDG 3) aims to ensure healthy lives. This study investigates the influence of Intimate Partner Violence (IPV) on achieving maternal health related SDG3 targets among exposed women globally.

METHODOLOGY

This study used secondary data analysis of Domestic Violence Modules from the latest Demographic and Health Surveys (DHS) of 40 countries. IPV was defined by women ever exposed to emotional, physical, severe, or sexual violence from the spouse. Achieving maternal health related SDG3 targets among women was measured by: Proportion of births attended by skilled health personnel; Antenatal care (women received antenatal care eight or more times from any provider); and the need for family planning satisfied with modern methods. The influence of IPV was estimated through adjusted OR after controlling for socioeconomic factors using logistic regression.

RESULTS

Exposure to IPV was among one-third of the women (37%) mainly physical (29%) and emotional (24%). Adjusted OR with 95%CI for the influence of IPV on women's utilization of skilled birth attendants was 0.81 (0.79-0.83)); having eight or more antenatal care visits 0.61 (0.59-0.63); and the needs for family planning with modern methods satisfied was 0.85 (0.83-0.87). Achievement of maternal health services was among 57% of the women. Women exposed to IPV were less to achieve maternal health services (50% VS 61%) with adjusted OR 0.71; 95%CI: 0.70-0.73 and it was not confounded by the positive effect of socioeconomic factors.

CONCLUSION & RECOMMENDATION

Exposure to IPV had a statistically significant negative influence on all the maternal health related SDG3 services among women. Programs working in facilitating the achievement of the SDGs related maternal health targets should include prevention of women's exposure to IPV and support for those who are exposed to it.

Parental Attachment, Self-Esteem, Social Problem-Solving, Intimate Partner Violence Victimization in Emerging Adulthood

Emerging adults can experience conflicts with their dating partner, leading to intimate partner violence (IPV). In order to understand the vulnerability factors involved in IPV victimization, the current study explored a serial multiple mediation model to determine the links between parental attachment (to the father and mother), self-esteem, and social problem solving (SPS) on the three forms of IPV (psychological, physical and sexual). Based on an online survey, 756 emerging adults (84.8% women, mean age = 23.52) completed self-report questionnaires related to parental attachment, self-esteem, SPS (avoidance and impulsive/carelessness style), and IPV during the past year. The study design was cross-sectional and data were analyzed through partial least structural equation modeling (PLS-SEM) technique. The findings did not support serial multiple mediation model, as the indirect effects of the two specific mediation models were not significant. However, the total indirect effects were significant, indicating a cascade effect chain of events between the variables; insecure parental attachment was related to lower self-esteem, which was associated with poor SPS skills (especially impulsive/carelessness style), which in turn was associated with both psychological and physical violence victimization. The implications of the findings for promoting the life skills of emerging adults, such as problem solving or self-esteem, to enable them to handle their relationship conflicts are discussed.

Evidence of Gender Asymmetry in Intimate Partner Violence Experience at the Population-Level

Claims of "gender symmetry" in intimate partner violence (IPV) prevalence are contested, with resolution of the issue complicated by methodological and measurement challenges. This study explores gendered differences in the distribution of IPV exposure at the population-level, considering multiple types of IPV exposure. The subjects comprised of 1,431 ever-partnered women and 1,355 ever-partnered men. Data from a nationally representative population-based cross-sectional survey were used to compare men and women's IPV experiences. Twenty-three IPV acts were assessed across IPV types (moderate physical, severe physical, sexual, psychological, controlling behaviors, economic). Proportions were presented by gender for the number of individual IPV acts experienced per IPV type, and the frequency of these acts (none, once, few times, or many times). A composite exposure score was developed to assess the number of acts and their frequency within types by comparing scores in tertiles and across types by correlations. Women reported greater overall prevalence of 20 of the 23 individual IPV acts assessed. Across all assessed acts, women comprised a substantially greater proportion of those who reported experiencing individual acts "many times." Women experienced more severe and more frequent IPV than men based on self-reported experience of IPV acts, and by the frequency with which acts were experienced. Significant differences between men and women's exposure scores were observed for all six assessed types, with greater proportions of women scoring in the upper tertiles. This study provides evidence of gender asymmetry in experiences of IPV at the population level. While men do experience IPV victimization, there remains need for directed and substantial resource allocation for intervention and therapeutic responses to women's exposure to IPV, and for primary prevention with men. Going forward, IPV measurement tools that consider frequency, severity, or co-occurring types of IPV are needed.

Dysfunctional Attitudes, Sociotropy-Autonomy, and Intimate Partner Violence Victimization in Emerging Adulthood

Understanding the dynamics and vulnerability factors involved in intimate partner violence (IPV) victimization among emerging adults is important in order to better prevent it from happening. The current study aimed to investigate the relationships among dysfunctional attitudes, sociotropy-autonomy, and types of IPV victimization (i.e., psychological, physical, and sexual) and severity (i.e., minor or severe) in emerging adulthood. Through an online survey, 929 emerging adults (84.6% women, mean age = 23.61) completed self-report questionnaires related to variables explored. When checking for childhood abuse, dysfunctional attitudes, sociotropy, and autonomy were related to IPV victimization for at least one type of violence and one scale of severity. The regression models show that independence from others and importance given to others are related to greater severe and minor physical violence, respectively. Attraction to loneliness seemed related to lesser minor psychological violence, whilst valorization of freedom of movement and action were related to greater minor sexual violence. The capacity to oppose others seemed related to greater severe sexual violence. These different cognitive and social characteristics may be associated with poorer social skills, thus making emerging adults more vulnerable to IPV victimization. The preventive and clinical implications are discussed.

Alcohol, gender, and violence: Factors influencing blame for partner aggression

Alcohol use has been associated with intimate partner violence (IPV) and reduced perpetrator blameworthiness, but this finding is not universal. Researchers examining alcohol and IPV-related blame often utilize vignettes depicting perpetrators who are sober and compare this to perpetrators depicted as more or less intoxicated. In this study, participants read one of three vignettes depicting male-to-female physical IPV. We compared participants' blame attributions across three conditions: perpetrator sober, perpetrator intoxicated-infrequent drinker, and perpetrator intoxicated-frequent drinker. Alcohol did not mitigate perpetrator blameworthiness for the assault; however, only the intoxicated-frequent drinker was rated as more blameworthy for his violence than the sober perpetrator. Participants also reported their own IPV perpetration, drinking behaviors, and gender role beliefs. Traditional gender role beliefs and a history of IPV perpetration were associated with shifting some of the blame onto the victim, and this was true for both men and women, especially when the perpetrator was described as a frequent drinker. Researchers should consider whether their alcohol vignettes might depict a behavior as reflecting the situation or the drinker's character, as this may impact their results. Furthermore, different observer characteristics may differentially predict blame attribution.

Self-Esteem, Social Problem Solving and Intimate Partner Violence Victimization in Emerging Adulthood

Although there are many studies examining the psychosocial vulnerability factors of intimate partner violence (IPV) victimization in emerging adulthood, little is known about the life skills that may be involved, such as social problem solving (SPS) and self-esteem. The aim of the current study is to explore the relationships between SPS, self-esteem, and types (i.e., psychological, physical and sexual) and severity of IPV victimization in emerging adulthood. Based on a French online survey, 929 emerging adults (84.6% of whom were women with a mean age of 23.6) completed self-report questionnaires related to SPS (problem orientations and problem-solving styles), self-esteem and IPV victimization. The results showed that positive SPS skills and higher self-esteem were associated with lower severity of IPV. Multivariate analyses showed that the most associated factors of severe forms of IPV were avoidant and impulsive/carelessness styles. Minor sexual violence was positively associated with lower self-esteem and rational problem-solving skills, while minor psychological victimization was related to avoidant style. Upon completion of this study, it can be said that conflicts which escalate into IPV may be associated with dysfunctional conflict resolution styles, highlighting the importance of interventions that promote the development of life skills in order to prevent IPV.

Gender Patterns in the Use of Physical Violence Against a Violent Partner: Results of a Cross-Sectional Population-Based Study in New Zealand

We examine gendered patterns in the use of violence in response to the partner's violence ("fighting back"). Within each gender, we examined if socio-demographic differences in prevalence were present, and if contextual factors influenced the use of violence against a violent partner. Data from a large, population-based sample of New Zealand adults was used to identify ever-partnered respondents who had experienced physical IPV (n = 407 women, and n = 391 men). Weighted percentages and 95% confidence intervals (95%CIs) were calculated for the use of violence against a violent partner, stratified by gender. Multivariable logistic regression was used to assess the association between each contextual risk factors and the use of violence against a violent partner. For both men and women, at the multivariable level, use of violence against a violent partner was associated with contextual factors related to the abuse. However, for almost all of these variables a higher proportion of women than men experienced the risk factor; for example, a higher proportion of women than men reported having experienced severe IPV (57.6% women; 43.7% men), injuries resulting from IPV (44.5% women, 15.0% men), and fear of a partner (22.7% women, 4.9% men). Women were also more likely to report experiencing other types of IPV (particularly sexual IPV) and were more likely to report that their children were present at the time of violence. These factors contributed to the higher proportion of women who reported fighting back at least once (53.4% of women and 22.3% of men). Health, social, and legal services need to conduct appropriate and thorough assessment of nature and context (current and historical) of the violence that individuals have been exposed to as part of service provision. Assessments need to be carried out with a gender-lens in order to provide comprehensive and appropriate responses.

Intimate partner violence and abuse experience and perpetration in UK military personnel compared to a general population cohort: A cross-sectional study

Background

Research exploring prevalence of, and factors associated with, increased risk of experiencing or perpetrating Intimate Partner Violence and Abuse (IPVA) in military communities is limited. This study aimed to describe IPVA prevalence in a military sample, explore the role of military-specific risk factors, and draw comparisons with a general population cohort.

Methods

We utilised data from a sample of military personnel participating in a cohort study of the health and wellbeing of UK military personnel who reported having an intimate relationship in the previous 12 months (n = 5557). To allow for comparison with civilian populations, participants from a general population cohort study in England (n = 6075) were matched on age and sex to the military cohort (n = 8093).

Findings

The 12-month prevalences of IPVA experience and perpetration in the military sample were 12.80% (95% CI 11.72-13.96%) and 9.40% (8.45-10.45%), respectively. Factors associated with both increased IPVA experience and perpetration included childhood adversity, relationship dissatisfaction, military trauma, and recent mental health and alcohol misuse problems. Compared to the civilian cohort, adjusted odds (95% CI) of IPVA experience and perpetration were higher in the military: 2.94 (2.15-4.01) and 3.41 (1.79-6.50), respectively.

Interpretation

This study found higher prevalences of IPVA experience and perpetration in the military compared to the general population cohort and highlighted both non-military and military factors associated with increased risk of both. Relationship dissatisfaction, military trauma and mental health difficulties mark key areas for IPVA prevention and management efforts to target.

Funding

Funded by the UK Ministry of Defence and National Institute of Health Research.

Gender differences in aggression: A multiplicative function of outward anger expression

Individuals with a higher (vs. lower) tendency to outwardly express anger (i.e., greater anger-out) generally exhibit greater aggression; men (vs. women) also tend to be more aggressive. Although the general aggression model posits that multiple person variables trigger aggression, the combined effects of multiple person variables are poorly understood. Thus, the aim of this study was to examine the nature of the relation between gender, anger-out, and reactive aggression. In particular, we were interested in whether the effects of anger-out and gender are additive or multiplicative. Specifically, we tested whether men exhibit higher levels of aggression than women at a consistent ratio across all levels of anger-out (i.e., the multiplicative model) or at a fixed amount depending on the level of anger-out (i.e., the additive interaction model). To this end, undergraduate participants (N = 203) completed a task in which they were falsely instructed that their objective was to respond more quickly than a same-sex opponent. They were told that whoever responded more quickly would administer a white noise burst to the opponent and choose its intensity, which served as our measure of aggression. Compared to an additive interaction model, the multiplicative model exhibited a better fit. Specifically, men displayed proportionately more aggression than women with the same level of anger-out. Research on and treatment for aggression should consider the multiplicative effects of factors related to aggression.

Intimate partner violence and subsequent depression and anxiety disorders

PURPOSE

The current longitudinal study examines the temporal association between different types of intimate partner violence (IPV) at early adulthood (21 years) and subsequent depression and anxiety disorders in young adulthood (30 years).

METHODS

Participants were from the Mater-University of Queensland Study of Pregnancy. A cohort of 1529 was available for analysis. IPV was measured using the Composite Abuse Scale at 21 years. At the 21 and 30-year follow-ups, major depression disorder and anxiety disorders were measured using the Composite International Diagnostic Interview.

RESULTS

We found a temporal relationship between almost all forms of IPV at 21 years and females' new cases of major depression disorder at 30 years. This association was not found for females who had previously been diagnosed with depression disorder. IPV did not predict the onset of new anxiety disorders, but it had a robust association with anxiety disorders in females with a previous anxiety diagnosis. We observed no significant link between IPV and males' subsequent major depression disorder. Interestingly, the experience of emotional abuse was a robust predictor of new cases of anxiety disorders but only for males.

CONCLUSION

Our results suggest the need for sex-specific and integrated interventions addressing both IPV and mental health problems simultaneously. IPV interventions should be informed by the extend to which pre-existing anxiety and depression may lead to different psychological responses to the IPV experience. Increased risk of anxiety disorders predicted by emotional abuse experienced by males challenges beliefs about invulnerability of men in the abusive relationships and demands further attention.

Maternal intimate partner violence victimization and child maltreatment

There is some limited evidence of an association between maternal intimate partner victimization (IPV) and children's experience of maltreatment. Using data from a longitudinal study, we examine whether this relationship is independent of range of potential confounders including socio-economic, familial and psychological factors. Data were taken from the 14 and 30-year follow-ups of the Mater-University of Queensland Study of Pregnancy (MUSP) in Australia. A subsample of 2064 mothers and children (59.0% female) whose data on maternal IPV and child maltreatment was available, were analysed. In families with maternal IPV, two in five children reported being maltreated, compared to one in five children maltreated in families without maternal IPV. Except for sexual maltreatment which was consistently higher in female offspring, there was no gender differences in experiencing different types of maltreatment in families manifesting maternal IPV. Although both males and females were at increased risk of child maltreatment in families where mothers were victimized by their male partners, male children were more likely to be emotionally maltreated. The main associations were substantially independent of measured confounders, except for father's history of mental health problems which attenuated the association of maternal IPV victimization and male offspring's physical abuse. Our findings confirm that there is a robust association between maternal IPV and child maltreatment. Both maternal IPV victimization and child maltreatment co-occur in a household characterized by conflict and violence. Consequences of IPV go beyond the incident and influence all family members. Efforts to reduce child maltreatment may need to address the greater level of IPV associated with the cycle of family violence.