The continuum of violence against women: Gynecological violence within the Medical Model in Chile

OBJECTIVE

This study aims to investigate the presence of gynecological violence within the health system in Chile, quantify the magnitude of this problem, define its general contours, and shed light on a phenomenon that has long been silenced. Additionally, we are interested in detecting differences between public and private health services, as well as exploring the role played by variables such as sexual orientation, ethnicity, age, and educational level in contributing to the prevalence of gynecological violence.

METHODS

This study employed a cross-sectional and not probabilistic sampling approach. It included a sample of 1503 women from all regions of Chile, who were of legal age and who had attended gynecological services. A questionnaire was applied between January 2021 and April 2022 using the online platform SurveyMonkey®. Data were collected through the second national survey on obstetric and gynecological violence (GinObs 2021). The study adheres to activist research methodologies and was conducted in collaboration with activists and academic researchers.

RESULTS

57.9% of the women participants reported having experienced violence. Such violence appears to occur most frequently in the public health system, although not exclusively, and the victims are often people who belong to native ethnic groups, who identify as of African descent, whose sexual orientation is lesbian, who are elderly, and who have a lower level of education.

CONCLUSION

Gynecological violence is an integral part of the continuum of violence against women and is consistently reported in both public and private health services. This form of violence has serious consequences for women's health and constitutes a significant public health problem.

Self-esteem in the context of intimate partner violence: A concept analysis

AIM

To explore the meaning of self-esteem in the context of intimate partner violence (IPV).

BACKGROUND

IPV is a preventable public health issue. The dynamic of IPV diminishes women's self-esteem. Defining self-esteem will guide the development of IPV interventions in healthcare settings.

DESIGN

Walker and Avant's eight-step approach was used.

DATA SOURCE

The search was conducted from Oxford Dictionary of English online, CINAHL, APA PsycInfo, PubMed, Women's Studies International, and Google Scholar.

REVIEW METHODS

No limits on the year of publication were applied.

RESULTS

Defining attributes of self-esteem are self-concept, self-affirmation, and self-respect. Antecedents of self-esteem are exposure to IPV and victim-blaming attitudes by healthcare professionals. Consequences include depression, substance abuse, and posttraumatic stress disorder. Empirical referents include self-worth, self-competence, self-blame, self-evaluation, self-confidence, and self-determination.

CONCLUSIONS

Current literature is limited in its definition of self-esteem in the context of IPV. Women experiencing IPV with low self-esteem might not seek help for IPV from nurses. Nurses could develop culturally appropriate IPV screening tools that assess the changes in self-esteem among women from different sociodemographic and cultural backgrounds. The defining attributes could contribute to developing comprehensive IPV screening tools in healthcare settings.

Self-esteem and aggression in women: differences between female prisoners and women without criminal records

Contradictory findings have been reported regarding the association between self-esteem and aggression. Most studies have dealt with non-criminal populations. This study aimed to explore the relationship between self-esteem and aggression and investigate possible differences in self-esteem and aggression between female inmates and women without criminal records (non-criminals) in the prefecture of Attica, Greece. One hundred fifty-seven female inmates in the Attica's Korydallos Female Prison and 150 non-criminals from Attica's general population completed the Buss & Perry Aggression Questionnaire and Rosenberg's Self-esteem Scale between February 2012 and April 2014. Lower self-esteem was associated with higher aggression among women independent of criminality. Self-esteem was lower in inmates (Mean = 18.06, SD = 6.19) than in non-criminals (Mean = 21.65, SD = 4.90, p < .001). Female prisoners presented higher aggression than non-criminals (unadjusted Mean = 78.40, SD = 23.60 versus Mean = 68.82, SD = 14.95, p < .001). However, after adjusting for age, education and self-esteem, this difference was no longer statistically significant (p = .127). Further studies, especially in female offenders, should be conducted to broaden our understanding of female aggression with a view to developing and promoting focused therapeutic procedures.

Exploring Protective Strategies among Rural Women in an Abusive Relationship

The purpose of this study was to explore rural women's accounts of intimate partner violence and the strategies they used to protect themselves from such adversity. Convenience sampling included women currently in an abusive relationship (N = 22), who were receiving mental health services at a rural victim-service provider. Standardized measures indicated, on average, that study participants were symptomatic for depression, anxiety and posttraumatic stress disorder (PTSD), yet exhibited higher resilience than other PTSD populations. Participants used a variety of strategies to halt, escape, or resist violence in their lives. Informal and safety planning strategies were rated as most helpful, though resistance and placating strategies were most commonly used. Formal strategy use among participants was associated with higher levels of resilience and depressive symptoms; while participants' increased use of safety planning and resistance strategies were also related to greater resilience. Implications for rural victim service providers include addressing psychological distress and hardiness for women currently in an abusive relationship, while providing the necessary resources to secure their safety.

The Phenomenology of Meditation for Female Survivors of Intimate Partner Violence

An existential-phenomenological methodology was utilized to investigate the experience of meditation for female survivors of intimate partner violence. Six coresearchers were taught a form of concentrative meditation and were asked to meditate daily and to attend a weekly group meditation for 6 weeks. Semistructured interviews were utilized to gather the data. The essence of the experience that was revealed was the emergence of a centered awareness that is distinctly different from the usual mode of being in the world. Findings suggest the value of meditation as an intervention strategy with survivors and demonstrate the need for further research in this area.

Exploring the Relationship Between Positive Work Experiences and Women's Sense of Self in the Context of Partner Abuse

In this study we examined the relationships among partner abuse, work quality, and women's sense of self. In particular, we explored the potential for women's work to serve as an alternative source of feedback for the self in the context of partner abuse. The sample consisted of 100 working women who reported experiencing a range of partner abuse. Relationships among partner abuse, work quality, and three self constructs were tested using multivariate multiple regression. Work quality was significantly and positively associated with self at work and general self-esteem and approached significance for self at home. There were no significant associations between partner abuse and self at work. Partner abuse was negatively and significantly associated with self at home and approached significance for self-esteem. These varied results support the importance of assessing multiple aspects of the self and the potential of women's work to be a resource in the context of partner abuse.

Not good enough and on a tether: exploring how violent relationships impact women's sense of self

There is general agreement among researchers that partner violence and self-esteem are significantly inversely correlated. Several qualitative researchers have examined women's narratives within small samples for self statements and discovered references to lost or damaged sense of self. However, the process by which partner violence impacts women's sense of self and the extent of its influence on women's sense of self remains unclear. To further our understanding, the current study explored 100 women's sense of self in the context of their relationships. Women responded to open ended questions about how they describe themselves, influences on their sense of self, and perceived self changes. Participants in troubled relationships were recruited with fliers and advertisements. Over half of the women reported physically or psychologically abusive partners (n = 57) in the prior 12 months while 43 women reported no physical violence and little to no psychological abuse in the past year. All women made positive self references, but women with violent partners also included more numerous negative self descriptions. Women with violent partners also described more negative self-change (decreased assertiveness, confidence), loss of identity or a sense of themselves as different in different contexts; themes not commonly found in the comparison sample. For both groups, however, other influences, such as work and friends, appeared to provide opportunities for positive and affirming self-perceptions.

Assessment of the efficacy of a psychological treatment for women victims of violence by their intimate male partner

This study evaluates the long-term efficacy of a brief psychotherapeutic cognitive-behavioral program in group format for female victims of violence by their intimate partner. 53 battered women were randomized into one of two intervention programs: one including among others exposure technique (n = 28) and another one in which exposure procedures were substituted by communication skills training (n = 25). Additionally, both programs included: psycho-education, breath control, training to improve self-esteem, cognitive restructuring, problem-solving, planning pleasant activities, and relapse prevention. The treatment was carried out in 8 weekly sessions. Measures of posttraumatic symptoms, anxiety, depression, self-esteem and anger expression were analyzed at pre- and post-treatment, and at 1-, 3-, 6- and 12-months follow-ups. Results show a pronounced decrease of posttraumatic, depressive and anxiety symptoms, which maintained in the different measure moments, with scarce difference between the two programs. The results and their clinical implications are discussed.

Cognitive and coping mechanisms in the interplay between intimate partner violence and depression

This study examined the association between intimate partner violence, maladaptive cognitive schemas, coping, and depression in a sample of 298 battered women. The results indicated that maladaptive cognitive schemas were associated with less use of primary and secondary engagement coping, and higher use of disengagement coping. In particular, cognitive schemas reflecting disconnection and rejection accounted for the association between psychological abuse and percentage of disengagement coping. In addition, disengagement coping partially mediated between cognitive schemas and depressive symptoms. Finally, the role of cognitive schemas as personal constraints that affect the choice of coping and the implications for interventions with victims are discussed.

The role of appraisal distortion, contempt, and morality in couple conflict: a grounded theory

A common goal of couples' therapy is to help individuals modify their view of each other and the relationship. Distorted views and appraisals contribute to conflict, and these can be manifest by use of rationalization or denial. This study explored appraisal distortion as an evaluative and moral process that occurs during partner conflict, particularly when it becomes contemptuous and aggressive. Using a philosophical base that is grounded in the ethical relationship, a model of appraisal distortion and couple conflict was created using constructivist grounded theory methods. The theoretical concepts derived from the data show relationships between one's relational stance, appraisal distortion, and verbal and physical aggression. This model implies that helping individuals take responsibility for appraisals is important in treating conflict.

Intimate partner violence and depressive symptoms in women: Cognitive schemas as moderators and mediators

In this study the role of cognitive schemas as moderators and mediators between intimate partner violence and depressive symptoms was examined. The sample consisted of 312 women who had suffered an abusive relationship. Participants completed measures of physical, psychological and sexual abuse, maladaptive cognitive schemas (disconnection and rejection, autonomy, and other-directedness), and depression. The evidence for a moderation effect was low and mainly restricted to schemas of the impaired autonomy domain. In contrast, the results supported mediational models in which violence was associated to the cognitive schemas, and these in turn were associated to depressive symptoms. Mediation was partial, with the schemas of the disconnection and rejection domain explaining most of the association between violence and depression. Finally, several explanations for these findings are examined, and their implications for the concept and measure of the cognitive schemas are discussed.

Against the odds: the impact of woman abuse on maternal response to disclosure of child sexual abuse

Although the co-occurrence of woman abuse and child sexual abuse is high little research exists exploring the impact of woman abuse on maternal response to child sexual abuse (CSA). Findings from two qualitative studies indicate the form of woman abuse to have differential impact on maternal response. Mothers who were abused in non-physical ways, psychological, or emotional, displayed more ambivalent, less supportive responses. Mothers who were physically abused by their partners more often acted supportively to their children and displayed less ambivalence about separating from the perpetrator. Some survivors reported non-disclosure as children because of their fear of the perpetrator due to the woman abuse they were exposed to while being sexually abused. Practice and research implications are discussed.