Violence Increases Psychological Distress Among Women Trafficking Survivors in Ghana

Human trafficking is a crime that is often shaped by violence, particularly for women who are trafficked. Additionally, trafficking survivors often report severe psychological distress, though research on the causes of this psychological distress is lacking, as there is little longitudinal data available on trafficking survivors. Informed by past literature on the links between violence and mental health among other traumatized groups of women, we investigate how experiences of violence influence posttraumatic stress, depression, and suicide ideation among a unique longitudinal sample of 116 labor-trafficked women in Ghana. We find that experiencing sexual violence while being trafficked is associated with higher levels of both depression and posttraumatic stress years after the trafficking period ended. This indicates both the long-term effects of stress and the enduring nature of psychological distress among the women in this study. Our analytic account of how violent experiences while trafficked impact mental health over the period of reintegration contributes to the general literature on violence and mental health among women, as well as to literature on the health implications of human trafficking.

Reaching out to men in ending intimate partner violence: a qualitative study among male civil servants in Ibadan, Nigeria

PURPOSE

The aim of this study was to explore the perceptions of male civil servants in Ibadan, Nigeria about the perpetration of IPV and to document their suggested measures to prevent IPV in our communities in Nigeria.

METHODS

Four focus group discussions were conducted among 36 male civil servants selected from Oyo State Secretariat, Ibadan using purposive sampling technique. Data were transcribed and analysed using thematic approach.

RESULTS

Six major themes were identified; awareness of the forms of IPV, women and men as victims, causes, attitude, consequences as well as the suggested strategies for the prevention of IPV. Physical and psychological abuse were mentioned across the groups. The respondents pointed out that women experience IPV more than men, but that men also experience it. Some respondents stated that physical and psychological abuse against female intimate partners were acceptable in some circumstances according to the societal norms. The negative effects of IPV on physical, mental and social well-being of the individual, families and society were mentioned. Suggested ways of preventing IPV include tolerance and patience which will promote healthy, respectful and non-violent relationships among intimate partners.

CONCLUSION

Considering the perceptions and attitudes of these men to IPV, it is important to reach out to both genders for appropriate preventive and educational intervention in ending IPV among women and men.

Mental and Physical Health Changes Following an Abusive Intimate Relationship: A Systematic Review of Longitudinal Studies

Longitudinal studies are critical to understanding health changes following trauma. The present systematic review adopted a longitudinal perspective on intimate partner abuse (IPA) by examining characteristics and findings of studies that followed persons who recently left an abusive relationship or who were at a point where they might leave and reported on health over time. Web of Science, EBSCO, Published International Literature on Traumatic Stress, and PubMed databases were searched using combinations of terms reflecting IPA, longitudinal study design, and health outcomes. Quantitative studies that recruited adults or adolescents, had multiple time points, used a health indicator as an outcome, and where IPA was a predictor, independent variable, or inclusion criterion were included. These methods yielded 36 studies from 20 unique samples. The following domains were coded for each article: citation, demographics, risk of bias, sample setting, design, follow-up, relationship and IPA characteristics, outcomes, and analytic focus. Results showed that all samples were female, and most were help-seeking. Depression, post-traumatic stress, and physical symptoms decreased over time, while quality of life increased in most studies. Changes in anxiety symptoms over time were less consistent. Ongoing IPA and social support were the most consistent predictors of health changes over time, showing relations with indicators of poorer or better health, respectively. There was preliminary evidence that decreases in emotional and physical symptoms plateaued within 9 months of the baseline assessment. Sampling, study design, measurement, and analysis are considered, and recommendations for future research are provided.

Needs and Support Perceived by Women for Coping with the Experience of Intimate Partner Violence in Andalusia (Spain): A Qualitative Study

There is a need to improve psychological interventions in women experiencing intimate partner violence (IPV) and reduce its long-term sequelae. The objective of this qualitative study was to explore the needs of female IPV survivors, the support they receive, and their strategies for coping with this experience over the long term. During 2017, 53 female IPV survivors participated in the study, of whom 38 (71.7%) were recruited from women's associations against gender violence from three Andalusia provinces (Southern Spain). In a semi-structured interview, the women responded to four open-ended questions about the effects of IPV on their life and how they coped with this situation. Four main themes were identified: (1) changes after the experience, (2) support during recovery, (3) perceived needs and obstacles, and (4) current situation. The survivors considered formal and informal social support to be critical to their recovery and emotional well-being. They also highlighted the need for continuity in support programs and for specialist interventions to address long-term psychological sequelae. These findings reinforce the need for psychological programs more tailored to the needs of these women.

Intimate Partner Violence and Risk for Mortality and Incident Dementia in Older Women

The aim of this study was to assess the long-term risk for mortality and incident dementia associated with exposure to intimate partner violence (IPV) at any time over the life course. Data were taken from the Australian Longitudinal Study of Women's Health, a population-based cohort study initiated in 1996. Analysis is based on 12,085 community-dwelling women aged 70 to 75 years at baseline from all states and territories. Self-reported exposure to violence was separated into historical (any time before baseline), current (past 12 months), or both. Date of death was obtained from the National Death Index, and dementia status was self-reported or obtained from administrative data. We modeled mortality risk using Cox regression, and risk for incident dementia using Fine-Gray proportional hazards modeling with death as a competing risk. Follow up continued to December 2017. At baseline, 728 women (6.0%) reported historical IPV, 121 (1.0%) reported current violence, and 38 reported both (0.3%). Historical IPV increased 20-year mortality risk after controlling for demographic, socioeconomic, and lifestyle variables (hazard ratio 1.10, 95% confidence interval = [1.00, 1.20]). There was no relationship between current violence and mortality (hazard ratio 1.04, 95% confidence interval = [0.85, 1.29]). There was also no association between IPV and risk for incident dementia (hazard ratio 1.02, 95% confidence interval = [0.89, 1.17]). Older women who self-report exposure to IPV over the lifespan die significantly earlier than women who do not. Further research that considers the mediating role of psychological trauma is needed to examine the relationship between IPV and dementia.

Treatments for Female Victims of Intimate Partner Violence: Systematic Review and Meta-Analysis

Intimate partner violence (IPV) is an important problem that has significant detrimental effects on the wellbeing of female victims. The chronic physical and psychological effects of intimate partner violence (IPV) are complex, long-lasting, chronic, and require treatments focusing on improving mental health issues, safety, and support. Various psycho-social intervention programs are being implemented to improve survivor wellbeing. However, little is known about the effectiveness of different treatments on IPV survivors' wellbeing. For this purpose, we conducted a systematic review and meta-analysis to assess the effectiveness of interventions on improving outcomes that describe the wellbeing of adult female survivors of IPV. We searched PubMed, PsycINFO, and Cochrane Library. We explored the effectiveness of available interventions on multiple outcomes that are critical for the wellbeing of adult female victims of IPV. To provide a broad and comprehensive view of survivors' wellbeing, we considered outcomes including mental health, physical health, diminishing further violence, social support, safety, self-efficacy, and quality of life. We reviewed 2,770 citations. Among these 25 randomized-controlled-study with a total of 4,683 participants met inclusion criteria. Findings of meta-analyses on interventions indicated promising results in improving anxiety [standardized mean difference (SMD) -7.15, 95% confidence interval (CI) -8.39 to -5.92], depression (SMD -0.26, CI -0.56 to -0.05), safety (SMD = 0.43, CI 0.4 to -0.83), violence prevention (SMD = -0.92, CI -1.66 to -0.17), health (SMD = 0.39, CI 0.12 to 0.66), self-esteem (SMD = 1.33, CI -0.73 to 3.39), social support (SMD =0.40, CI 0.20 to 0.61), and stress management (SMD = -8.94, CI -10.48 to -7.40) at the post-test. We found that empowerment plays a vital role, especially when treating depression and Post-Traumatic Stress Disorder (PTSD), which are difficult to improve across interventions. We found mixed findings on self-efficacy and quality of life. The effects of IPV are long-lasting and require treatments targeting co-morbid issues including improving safety and mental health issues.

Empowerment, Stress, and Depressive Symptoms Among Female Survivors of Intimate Partner Violence Attending Personal Empowerment Programs

Intimate partner violence (IPV) affects one in three women and can have long-lasting psychological effects, with abuse survivors typically exhibiting elevated stress and depressive symptoms. However, women with greater personal empowerment resources (i.e., self-care, agency, self-efficacy) and who practice relaxation techniques generally exhibit lower stress and depressive symptoms. The present study investigated the effectiveness of Personal Empowerment Programs (PEP) and practicing relaxation techniques in promoting empowerment and lowering stress and depressive symptoms. Ninety women were recruited from PEP classes conducted at domestic violence agencies in Orange County, California. Salivary cortisol and affect were assessed before and after one PEP class. Perceived stress, depressive symptoms, empowerment, and relaxation techniques were also assessed. Practicing relaxation techniques correlated with more empowerment. For women without sexual abuse experiences only, having completed more classes (>5 classes) in the program was associated with greater empowerment, less stress, and fewer depressive symptoms. Implications extend to future studies and interventions for IPV survivors.

Nurturing Hope and Well-Being Among Survivors of Domestic Violence Within the Family Justice Center Model

Family Justice Centers (FJCs) represent a multi-disciplinary coordinated approach co-located to serve survivors of domestic violence. This study examined the change in hope and well-being among 130 survivors receiving domestic violence services through seven FJCs. Using a pretest, posttest design, Analyses of Variance results indicated that survivors exhibited robust increases in hope, emotional well-being, and flourishing. Correlational analyses showed that survivor defined goal success has important relationships with hope and well-being. Finally, hierarchical regression analyses revealed hope contributed unique variance of survivor flourishing over-and-above survivor defined success and emotional well-being. These findings are discussed in the context that hope may be an important coping resource for survivors of domestic violence and offers a common conceptual framework for FJCs.

Domestic Violence and Its Effects on Women, Children, and Families

Men and women experience severe domestic violence (DV) and intimate partner violence (IPV); however, women and children remain especially vulnerable. Violence along the DV/IPV continuum has been recognized as a type of child maltreatment and a child's awareness that a caregiver is being harmed or at risk of harm is sufficient to induce harmful sequelae. Consequences of these abusive behaviors are associated with mental and physical health consequences. Health care professionals can screen, identify, and manage this pathology in affected families while educating communities to these pernicious effects.

Modeling lifetime abuse and cardiovascular disease risk among women

BACKGROUND

Cardiovascular disease (CVD) is one of the most significant health challenges facing women today. Abuse is a serious gendered issue also affecting the health of women. Despite beginning evidence that abuse may increase the risk of CVD among women, causal pathways linking abuse to CVD have received little attention. Our purpose was to test Scott-Storey's conceptual model showing direct and indirect pathways through which lifetime abuse severity may affect women's CVD risk.

METHODS

Using data collected from a community sample of 227 Canadian women who had left an abusive partner, we conducted structural equation modeling with latent growth curve analysis using a phantom variable approach to test the direct effects of severity of lifetime abuse on CVD risk (indicated by measures of systolic and diastolic blood pressure) as well as its indirect effects through CVD risk behaviors and through women's initial level of depressive symptoms and the observed rate of change in their depressive symptoms over time.

RESULTS

Women in this sample had above average CVD risk factors (i.e., smoking, overweight/obesity, depressive symptoms, high blood pressure) in comparison to women in the general population. Further, CVD risk behaviors increased with severity of lifetime abuse and remained present long after leaving the abusive relationship. Results of the tested model provide preliminary evidence supporting many of the hypothesized pathways by which severity of lifetime abuse can increase CVD risk among women; the model fit the data reasonably well explaining 41% of the variance in CVD risk.

CONCLUSIONS

Findings support the growing recognition of the long-term effects of lifetime abuse on cardiovascular health, suggest important implications for clinicians working with women, and provide a novel approach for studying the concept of cumulative lifetime abuse through the use of a phantom variable.

Intimate partner violence and academic performance: the role of physical, mental, behavioral, and financial health

Undergraduate students of all gender identities are at risk of experiencing intimate partner violence (IPV) victimization. It is known that IPV negatively affects academic performance, yet little is known about the role of health. This study examined if past-year IPV victimization was associated with an increase in students' self-perception of health interfering with academic performance. Data were drawn from the 2011-2014 National College Health Assessment (N = 84,734). Structural equation modeling was used to examine the relationship between a latent variable of IPV and health impediments to academic performance. The model was a good fit for the data (RMSEA = .012, CFI = .994, TLI = .981). Undergraduate survivors of past-year IPV - and transgender students - were more likely to report impediments to their academic performance: physical assault (0.66, p < .001), sexual assault (0.57, p < .001), sexually transmitted infections (0.42, p < .001), pregnancy (0.38, p < .001), depression (0.38, p < .001), disordered eating (0.36, p < .001), financial problems (0.33, p < .001), anxiety (0.32, p < .001), sleep problems (0.32, p < .001), chronic health problems (0.29, p < .001), drug use (0.29, p < .001), injury (0.25, p < .001), and alcohol use (0.25, p < .001). This demonstrates that IPV has a spiral effect, such that IPV's impact on health is perceived by students as detrimental to their academics.

A Longitudinal Examination of Mothers' Depression and PTSD Symptoms as Impacted by Partner-Abusive Men's Harm to Their Children

Intimate partner violence (IPV) is a serious and widespread form of gender-based violence that disproportionately affects women. It is well established that IPV victimization contributes to depression and posttraumatic stress disorder (PTSD), and that many partner-abusive men continue to perpetuate abuse even after their relationship with the victim ends. In addition, when men harm their partners, they are more likely to harm their children, and evidence suggests that this harm continues post-separation. However, scant research has been conducted on men's harm to their children as an extension of IPV perpetration, with even less known about the mental health impact this form of abuse has on mothers. For this longitudinal cohort study, 40 partner-abused mothers who had separated, or were planning to separate, from an abusive partner with whom they shared children were recruited. Women were interviewed 4 times over 1 year. Results confirmed that, in addition to men's physical abuse perpetration relating to subsequent increases in mothers' depression and PTSD symptoms over time, their harm to the children predicted both mothers' depression and PTSD symptoms as well.

Mining for Posttraumatic Growth (PTG) in Sexual Minority Women Who Survive Intimate Partner Violence: A Conceptual Perspective

This theoretical paper explores the need to use posttraumatic growth (PTG) as a framework when studying sexual minority women (SMW) who are survivors of intimate partner violence (IPV) to examine the relationship between risk factors such as stress, anxiety and alcohol use and to understand the role of protective factors through mining for the presence of posttraumatic growth (PTG). Despite a call for continued research in this highly vulnerable population, representative studies of SMW and PTG remain extremely limited. Research that examines the relationship between IPV, behavioral health issues, and posttraumatic growth would provide the opportunity to develop tailored intervention models and opportunities for program development to decrease isolation and increase factors of posttraumatic growth. In particular, the impact of how interpersonal relationships as potential mediators and/or outcomes of posttraumatic growth (PTG) needs to be explored more thoroughly. PTG is a valuable framework for vulnerable populations such as sexual minority women because it focuses on how transformative change may result from traumatic experiences such as surviving IPV.

Understanding How Domestic Violence Support Services Promote Survivor Well-being: A Conceptual Model

Domestic violence (DV) victim service programs have been increasingly expected by legislators and funders to demonstrate that they are making a significant difference in the lives of those using their services. Alongside this expectation, they are being asked to describe the Theory of Change guiding how they believe their practices lead to positive results for survivors and their children. Having a widely accepted conceptual model is not just potentially useful to funders and policy makers as they help shape policy and practice -- it can also help programs continually reflect upon and improve their work. This paper describes the iterative and collaborative process undertaken to generate a conceptual model describing how DV victim services are expected to improve survivors' lives. The Social and Emotional Well-Being Framework guiding the model is an ideal structure to use to describe the goals and practices of DV programs because this framework: (1) accurately represents DV programs' goal of helping survivors and their children thrive; and (2) recognizes the importance of community, social, and societal context in influencing individuals' social and emotional well-being. The model was designed to guide practice and to generate new questions for research and evaluation that address individual, community, and systems factors that promote or hinder survivor safety and well-being.

The Consequences of Intimate Partner Violence on Health: A Further Disaggregation of Psychological Violence-Evidence From Spain

Using a nationally representative sample of 10,171 women, this study examines the association between current and previous intimate partner violence and current health status. Current physical or sexual violence was associated with the highest likelihood of reporting health outcomes, followed by current emotional or economic abuse. Current controlling behavior increased the odds of reporting poor health whereas previous controlling behavior has less effect on current health. Controlling behavior alone often is the first expression of mistreatment. If health professionals could identify violence at this early stage, long-term effects on women's health could be minimized. The implications for health of the cumulative effects of violence and of its timing are discussed.

Trajectories for women who disclose intimate partner violence in health care settings: the key role of abuse severity

OBJECTIVES

To examine the role of abuse severity in predicting women's trajectories in mental and physical health and psychological quality of life during the 18 months following abuse identification in a health care setting.

METHODS

The present analysis used growth curve modeling in a sample of 411 women positive for abuse on the Composite Abuse Scale.

RESULTS

A high proportion of women experienced severe combined abuse (SCA; 55 % at baseline and 29 % at 18 months). On average, there was an improvement in depressive symptoms and psychological quality of life over time. Controlling for sociodemographic characteristics, women scoring positive versus negative for SCA experienced increased depressive symptoms and decreased quality of life; however, exposure to severe abuse did not affect the rate of change over time in these outcomes. Severe abuse was not associated with physical health.

CONCLUSIONS

There is an important association between abuse severity and women's health and well-being over time. Understanding the role of different abuse experiences, risk and protective factors, and trajectories can assist in more accurate identification and appropriate care provision for women exposed to IPV.

The Lived Experience of Intimate Partner Violence in the Rural Setting

OBJECTIVE

To understand the lived experience of intimate partner violence (IPV) for women living in a rural setting to inform efforts to provide effective care, support, and resources.

DESIGN

Qualitative descriptive.

SETTING

Adirondack Mountain region of upstate New York.

PARTICIPANTS

Twelve women with recent experiences of IPV living in a rural area.

METHODS

In-depth interviews were conducted.

RESULTS

Key findings were the self-imposed isolation women engage in to manage stigma and the system-wide abuse by law enforcement and the legal system.

CONCLUSION

The results of this study illustrate the complex web of individual, social, cultural, economic, and political factors that create and perpetuate the problem of IPV. It is critical to eliminate IPV-related stigma, cut through isolation, and address the ongoing system-wide abuse and discrimination women face. Finally, many of the issues raised by the participants, such as discrimination, financial constraints, and problems with the legal system, originate outside the health care system. Therefore, nursing care must be provided as part of a comprehensive public health approach.

The Moderating Effect of Social Support From a Dating Partner on the Association Between Dating Violence Victimization and Adjustment

Dating violence victimization is associated with decreased relationship satisfaction and increased mental health symptomatology. Yet, violent dating relationships often remain intact across time, even when the aggression fails to cease. Thus, research is needed to determine the factors that reduce the negative impact of victimization. One factor may be that abusive dating partners are perceived as supportive by their partners, serving to reduce the negative impact of victimization. The current study sought to examine whether perceived support (i.e., perceptions of support) and capitalization support (i.e., perceptions of support for positive events) moderated and reduced the impact of dating violence victimization on decreased relationship satisfaction and increased depressive symptoms. Using a sample of females in dating relationships ( N = 253), results provided partial support for our hypotheses. Implications of these findings and directions for future research are discussed.

The process, outcomes, and challenges of feasibility studies conducted in partnership with stakeholders: a health intervention for women survivors of intimate partner violence

Feasibility studies play a crucial role in determining whether complex, community-based interventions should be subject to efficacy testing. Reports of such studies often focus on efficacy potential but less often examine other elements of feasibility, such as acceptance by clients and professionals, practicality, and system integration, which are critical to decisions for proceeding with controlled efficacy testing. Although stakeholder partnership in feasibility studies is widely suggested to facilitate the research process, strengthen relevance, and increase knowledge transfer, little is written about how this occurs or its consequences and outcomes. We began to address these gaps in knowledge in a feasibility study of a health intervention for women survivors of intimate partner violence (IPV) conducted in partnership with policy, community and practitioner stakeholders. We employed a mixed-method design, combining a single-group, pre-post intervention study with 52 survivors of IPV, of whom 42 completed data collection, with chart review data and interviews of 18 purposefully sampled participants and all 9 interventionists. We assessed intervention feasibility in terms of acceptability, demand, practicality, implementation, adaptation, integration, and efficacy potential. Our findings demonstrate the scope of knowledge attainable when diverse elements of feasibility are considered, as well as the benefits and challenges of partnership. The implications of diverse perspectives on knowledge transfer are discussed. Our findings show the importance of examining elements of feasibility for complex community-based health interventions as a basis for determining whether controlled intervention efficacy testing is justified and for refining both the intervention and the research design.

The process, outcomes, and challenges of feasibility studies conducted in partnership with stakeholders: a health intervention for women survivors of intimate partner violence

Feasibility studies play a crucial role in determining whether complex, community-based interventions should be subject to efficacy testing. Reports of such studies often focus on efficacy potential but less often examine other elements of feasibility, such as acceptance by clients and professionals, practicality, and system integration, which are critical to decisions for proceeding with controlled efficacy testing. Although stakeholder partnership in feasibility studies is widely suggested to facilitate the research process, strengthen relevance, and increase knowledge transfer, little is written about how this occurs or its consequences and outcomes. We began to address these gaps in knowledge in a feasibility study of a health intervention for women survivors of intimate partner violence (IPV) conducted in partnership with policy, community and practitioner stakeholders. We employed a mixed-method design, combining a single-group, pre-post intervention study with 52 survivors of IPV, of whom 42 completed data collection, with chart review data and interviews of 18 purposefully sampled participants and all 9 interventionists. We assessed intervention feasibility in terms of acceptability, demand, practicality, implementation, adaptation, integration, and efficacy potential. Our findings demonstrate the scope of knowledge attainable when diverse elements of feasibility are considered, as well as the benefits and challenges of partnership. The implications of diverse perspectives on knowledge transfer are discussed. Our findings show the importance of examining elements of feasibility for complex community-based health interventions as a basis for determining whether controlled intervention efficacy testing is justified and for refining both the intervention and the research design.

Symptoms of post-traumatic stress disorder among battered women in Lebanon: an exploratory study

Intimate partner violence against women is common in Lebanon and can lead to major health problems. However, the incidence of symptoms of post-traumatic stress disorder (PTSD) in battered women has not been extensively explored in the Lebanese cultural context. The objectives of this study were as follows: (a) to determine the prevalence of PTSD symptoms among women in Lebanon who have been physically abused by their partners, (b) to assess whether the rate of PTSD symptoms varied according to sociodemographic variables, and (c) to reveal other attributes that might be risk factors for developing symptoms of PTSD. Of the 95 physically abused women who met inclusion criteria, 85 completed a questionnaire including sociodemographic questions, the physical abuse subscale of the Composite Abuse Scale (CAS), and the PTSD Checklist-Civilian Version (PCL-C). Results showed a high prevalence of PTSD symptoms (97%), positively correlated with physical violence (r = .719). Lower education level and recent abuse were correlated with symptom severity, as were the number of problematic habitual behaviors in the abusive partner and the use of psychotherapy. Increased involvement of health care professionals in the detection of women at risk, with referral to appropriate resources, is suggested to improve prevention and management efforts.

The Association of Mental Health Conditions With Employment, Interpersonal, and Subjective Functioning After Intimate Partner Violence

This study explored the associations of posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), and depressive symptoms with employment, social support, and subjective functioning in 100 women who were seeking mental health assistance after intimate partner violence. Depressive disorders showed significant associations with low levels of social support, diminished self-esteem, reduced quality of life, and elevated negative social problem-solving orientation. PTSD severity was significantly associated with low self-esteem and elevated negative problem orientation, while severity of GAD was only associated with negative problem orientation. Results are discussed in light of current service models for women who have experienced intimate partner violence.

Impact of Intimate Partner Violence on Women's Mental Health

This study aimed to explore the mental health needs of women residing in domestic violence shelters; more specifically, we aimed to identify commonalities and differences among their mental health needs. For this purpose, qualitative and quantitative data was collected from 35 women from a Midwestern domestic violence shelter. Hierarchical clustering was applied to quantitative data, and the analysis indicated a three-cluster solution. Data from the qualitative analysis also supported the differentiation of women into three distinct groups, which were interpreted as: (A) ready to change, (B) focused on negative symptoms, and (C) focused on feelings of guilt and self-blame.

Coordinated Community Response Components for Victims of Intimate Partner Violence: A Review of the Literature

Intimate partner violence (IPV) against women is a serious problem throughout the world. Each year a substantial number of women experience psychological, physical, and sexual aggression from an intimate partner, with many women experiencing serious mental and physical health outcomes as a result of their victimization. A number of services are available to women who sustain IPV (e.g., shelters, advocacy, legal protection), and the combination of these services has been termed a Coordinated Community Response (CCR) to IPV. The purpose of the present manuscript is to review the individual components of CCRs for IPV victims, examine the extant literature on a number of the individual CCR components, and suggest directions for future research on CCRs for IPV victims. Our review demonstrates that there is a significant lack of research on various CCR components, that research on the integration of CCR services is limited, and that theoretical guidance for CCR programs is almost non-existent. Directions for improving research on CCR components are suggested.

Motivational interviewing at the intersections of depression and intimate partner violence among African American women

This article focuses on design, training, and delivery of a culturally tailored, multi-faceted intervention that used motivational interviewing (MI) and case management to reduce depression severity among African American survivors of intimate partner violence (IPV). We present the details of the intervention and discuss its implementation as a means of creating and providing culturally appropriate depression and violence services to African American women. We used a community-based participatory research approach to develop and evaluate the multi-faceted intervention. As part of the evaluation, we collected process measures about the use of MI, assessed MI fidelity, and interviewed participants about their experiences with the program.

Does job stability mediate the relationship between intimate partner violence and mental health among low-income women?

Intimate partner violence (IPV) has detrimental consequences for women's mental health. To effectively intervene, it is essential to understand the process through which IPV influences women's mental health. The current study used data from 5 waves of the Women's Employment Study, a prospective study of single mothers receiving Temporary Assistance for Needy Families (TANF), to empirically investigate the extent to which job stability mediates the relationship between IPV and adverse mental health outcomes. The findings indicate that IPV significantly negatively affects women's job stability and mental health. Further, job stability is at least partly responsible for the damaging mental health consequences of abuse, and the effects can last up to 3 years after the IPV ends. This study demonstrates the need for interventions that effectively address barriers to employment as a means of enhancing the mental health of low-income women with abusive partners.

Mental health consequences of intimate partner violence in Vhembe district, South Africa

OBJECTIVE

The aim of this study was to assess the contributions of different forms of intimate partner violence (physical violence, sexual violence, psychological abuse, and stalking) on symptoms of posttraumatic stress disorder (PTSD) and depression.

METHODS

In all 268 women (18 years and older) consecutively receiving a protection order in the Vhembe district in South Africa were assessed by an external interviewer. Hierarchical regressions tested the unique effects of different types of intimate partner violence on PTSD and depression.

RESULTS

In terms of PTSD symptom severity, more than half (51.9%) of the sample reported severe PTSD and 66.4% reported severe depression symptoms. Two types of intimate partner violence (physical and sexual) were significantly associated with PTSD symptoms, while only psychological violence was moderately correlated with depression symptoms. Physical abuse contributed to the prediction of PTSD and psychological abuse to depression.

CONCLUSIONS

A significant number of women with protection orders suffer from PTSD and depression. The results confirm a relationship between severity of intimate partner violence and mental health problems (PTSD and depression). Assessment of intimate partner violence should incorporate the multiple dimensions that have been identified as contributing to poor mental health.

A preliminary investigation of the influence of subjective norms and relationship commitment on stages of change in female intimate partner violence victims

Intimate partner violence (IPV) against women is a prevalent and serious problem throughout the world, causing devastating mental and physical health problems for victims. Recent research has begun to focus on factors that may influence women's decisions to stay or leave their abusive partners, as interventions for batterers has only resulted in minimal success in reducing IPV. Therefore, this study preliminarily examined the influence of women's perceptions of their social network members' subjective norms and their relationship commitment on stages of change to end an abusive relationship among a community sample of female IPV victims (N = 84). Results showed that subjective norms and women's relationship commitment were associated with women's stages of change. Relationship commitment did not mediate the relation between subjective norms and stages of change. These findings indicate that a number of factors contribute to women's stay/leave decision-making process, and close social network members could be included in interventions designed to keep women safe.

Assessment and psychotherapy with women experiencing intimate partner violence: integrating research and practice

Intimate partner violence (IPV) is a serious, pervasive problem; however, professional literature focused on psychotherapy for women experiencing IPV is limited. This article delineates reasons why there is a dearth of literature on this topic. It then provides guidelines for assessment and practice, focusing on issues and approaches unique to women experiencing IPV. For assessment, the therapist should gather information on the type of IPV the client experiences, the relationship dynamics involved, and the availability of the client's social support network. Discussion of the client's developmental history, including any history of child maltreatment and violence in early dating relationships is also relevant. Assessment of the client's current mental health functioning is essential and will include a consideration of common psychological sequelae that can result from IPV. Treatment should include safety planning as well as reducing minimization of the abuse. In addition, treatment should address potential IPV-related emotion dysregulation and splitting.

Depressive and posttraumatic symptoms among women seeking protection orders against intimate partners: relations to coping strategies and perceived responses to abuse disclosure

This investigation examined the relationship of abuse-specific coping strategies and perceived responses to abuse disclosure to symptoms of depression and posttraumatic stress among 131 women seeking a protection order against an intimate partner. Disengagement, denial, and self-blame coping strategies, as well as blaming of the participant by others, were associated with greater depressive and posttraumatic symptoms. None of the strategies of coping or responses to abuse disclosure were negatively related to depressive or posttraumatic stress symptoms. Findings suggest that mental health providers may find it useful to address these negative styles of coping while public education campaigns should target victim blaming.

The Prevalence of Mental Health Disorders in a Community Sample of Female Victims of Intimate Partner Violence

Intimate partner violence (IPV) is a serious, devastating, and prevalent problem. IPV places women at risk for negative health consequences, including increased mental health disorders. The majority of research to date has focused on mental health disorders among women in domestic violence shelters, and research is needed that examines mental health disorders among a broader range of women experiencing IPV. Therefore, the present study examined the prevalence of posttraumatic stress disorder (PTSD), depression, and substance abuse disorders in a community sample of IPV victims (N = 94) using diagnostic interviews. Results showed that the majority of women met diagnostic criteria for a mental health disorder, with PTSD being the most common mental health disorder. Furthermore, psychological abuse was a significant predictor of both PTSD and depression, whereas physical aggression did not predict these outcomes. Implications of these findings for treatment and intervention work with battered women are discussed.

The impact of neighborhood factors on the well-being of survivors of intimate partner violence over time

Intimate partner violence (IPV) is a pervasive social problem impacting the psychological well-being of millions of US women annually. The extant literature draws our attention to the devastating mental health effects of IPV, but largely overlooks how ecological factors may further explain survivors' well-being. This study examined how neighborhood disadvantage may contribute to survivors' compromised well-being, in addition to the abuse women experienced. Neighborhood disorder and fear of victimization significantly impacted survivors' well-being, over and above abuse. Although between-women effects of neighborhood disorder and fear were unrelated to change in women's depression or quality of life (QOL), significant within-woman effects were detected. Change in neighborhood disorder was negatively associated with change in QOL, and this relationship was fully mediated by fear. While no direct relationship between change in neighborhood disorder and depression was detected, an indirect effect through survivors' fear was revealed. Implications for future research and practice are discussed.

The Long Arc of Recovery: Characterizing Intimate Partner Violence and Its Psychosocial Effects Across 17 Years

Little is known about how intimate partner violence (IPV) affects women’s long-term mental health. Using 17 years of data from adolescent mothers, this study (a) empirically identified three subgroups based on patterns of IPV exposure during 4 years of their adolescence; (b) found that subgroup membership was a predictor of psychosocial outcomes in the subsequent 13 years, and (c) showed that the long-term effects of IPV exposure persisted even while controlling for the role of early poverty. By their 30s, women had recovered from IPV such that there were no significant differences between groups at the final time point.

Symptoms of PTSD and major depression in Latinas who have experienced intimate partner violence

The purpose of this study was to describe symptoms of PTSD and major depression in abused Latinas and to explore the relationships among intimate partner violence (IPV) experiences, these symptoms, and health related quality of life (HRQOL). The rate of PTSD was 69.7% and of major depressive disorder (MDD) was 57.6%. The comorbidity of PTSD and MDD was 54.5%. PTSD and MDD were not consistently correlated with IPV, although some significant relationships were found. PTSD and MDD symptoms were highly correlated with HRQOL. The impact of PTSD and MDD on psychological well-being and functioning in Latinas needs further investigation.

Mental health consequences of intimate partner abuse: a multidimensional assessment of four different forms of abuse

Battered women are exposed to multiple forms of intimate partner abuse. This article explores the independent contributions of physical violence, sexual coercion, psychological abuse, and stalking on symptoms of posttraumatic stress disorder (PTSD) and depression among a sample of 413 severely battered, help-seeking women. The authors test the unique effects of psychological abuse and stalking on mental health outcomes, after controlling for physical violence, injuries, and sexual coercion. Mean scores for the sample fall into the moderate to severe range for PTSD and within the moderate category for depression scores. Hierarchical regressions test the unique effects of stalking and psychological abuse, after controlling for physical violence, injuries, and sexual coercion. Psychological abuse and stalking contribute uniquely to the prediction of PTSD and depression symptoms, even after controlling for the effects of physical violence, injuries, and sexual coercion. Results highlight the importance of examining multiple dimensions of intimate partner abuse.

Heterogeneity among violence-exposed women: applying person-oriented research methods

Variability of experience and outcomes among violence-exposed people pose considerable challenges toward developing effective prevention and treatment protocols. To address these needs, the authors present an approach to research and a class of methodologies referred to as person oriented. Person-oriented tools support assessment of meaningful patterns among people that distinguish one group from another, subgroups for whom different interventions are indicated. The authors review the conceptual base of person-oriented methods, outline their distinction from more familiar variable-oriented methods, present descriptions of selected methods as well as empirical applications of person-oriented methods germane to violence exposure, and conclude with discussion of implications for future research and translation between research and practice. The authors focus on violence against women as a population, drawing on stress and coping theory as a theoretical framework. However, person-oriented methods hold utility for investigating diversity among violence-exposed people's experiences and needs across populations and theoretical foundations.

Rural and urban women's perceptions of barriers to health, mental health, and criminal justice services: implications for victim services

The purpose of this study was to examine rural and urban women's perceptions of barriers to health and mental health services as well as barriers to criminal justice system services. Eight focus groups were conducted, two in a selected urban county (n = 30 women) and two in each of three selected rural counties (n = 98 women). Results were classified into a barrier framework developed in the health service utilization literature which suggests there are four main dimensions of barriers: affordability, availability, accessibility, and acceptability. Results indicate that: (1) women face many barriers to service use including affordability, availability, accessibility, and acceptability barriers; (2) it takes an inordinate level of effort to obtain all kinds of services; however, women with victimization histories may face additional barriers over and above women without victimization histories; (3) barriers to health and mental health service utilization overlap with barriers to utilizing the criminal justice system; and (4) there are many similarities in barriers to service use among rural and urban women; however, there are some important differences suggesting barriers are contextual. Future research is needed to further clarify barriers to service use for women with victimization histories in general, and specifically for rural and urban women. In addition, future research is needed to better understand how women cope with victimization in the context of the specific barriers they face in their communities.