Normative misperceptions of abuse among perpetrators of intimate partner violence

How Does Denial, Minimization, Justifying, and Blaming Operate in Intimate Partner Abuse Committed by Men: A Systematic Review of the Literature

Intimate partner abuse (IPA) is widespread, and denial, minimization, justifying, and blaming (DMJB) are common among people who have committed IPA. Views on the function of DMJB in IPA are mixed, often based on the theoretical standpoint of the authors. This systematic review brings together the knowledge of how distorted accounts operate in IPA committed by men. A systematic review of primary research related to DMJB in heterosexual men who have committed to IPA was conducted. In all, 31 papers were found to meet the inclusion criteria (adult, male-to-female abuse, in western culture, peer reviewed and published in English) and were quality appraised. Data were extracted and analyzed using narrative synthesis. The findings indicate the way DMJB operates in this group is complex. It can represent facilitators of abusive behavior, a way to protect the individual's identity and self-esteem, and a tool men use instrumentally to achieve goals. Themes were present within and between studies highlighting the complex function of DMJB. A model representing the hypothesized intertwined function of DMJB for IPA is proposed. The limitations of the review are discussed and implications and recommendations for policy, practice, and future research are proposed.

Misperception of Norms About Intimate Partner Violence as a Driver of Personal IPV Attitudes and Perpetration: A Population-Based Study of Men in Rural Uganda

Intimate partner violence (IPV) against women is a global public health problem. Conceptual frameworks suggest misperceived norms around IPV might drive perpetration of violence against women in southern and eastern Africa. We conducted a cross-sectional, population-based survey of all men residing in a rural parish in southwest Uganda, eliciting their endorsement of IPV in five hypothetical scenarios and their reported frequency of perpetration of violence against their wife/main partner. They also reported their perceptions about the extent to which most other men in their villages endorsed and/or perpetrated IPV, which we compared against the population data to measure the primary explanatory variable of interest: whether individuals misperceived norms around IPV. We fitted multivariable Poisson regression models specifying personal IPV endorsement and IPV perpetration as the outcomes. Overall, 765 men participated in the study (90% response rate): 182 (24%) personally endorsed IPV, and 78 of 456 partnered men (17%) reported perpetrating one or more acts of IPV at least once per month. Although most men neither endorsed nor reported perpetrating IPV, 342 (45%) men mistakenly thought that most other men in their villages endorsed IPV and 365 (48%) men mistakenly thought that most other men perpetrate IPV at least monthly. In multivariable regression models, men who misperceived most men to endorse IPV were more likely to endorse IPV themselves (adjusted relative risk [aRR] = 2.44; 95% CI [1.66, 3.59]; p < .001). Among partnered men, those who misperceived IPV perpetration to be normative were more likely to perpetrate IPV themselves (aRR = 4.38; [2.53, 7.59]; p < .001). Interventions to correct misperceived norms about IPV may be a promising method for reducing violence against women in rural Uganda.

Risk factors for perpetrating sexual aggression among adolescents: Differences by gender and sexual orientation

Although anyone-regardless of gender or sexual orientation-can perpetrate sexual aggression, most studies examining risk factors for engaging in sexual aggression include samples of boys and men, and do not consider the sexual orientation of the respondent. The current study addresses this gap in the literature by examining how risk factors for sexual aggression vary as a function of gender and sexual orientation in a sample of 1782 high school youth. Participants completed surveys evaluating engagement in consent behaviors, rape myth acceptance, perception of peer rape myth acceptance, perceived peer engagement in violence, and perceived peer support for violence. A one-way MANOVA found that constructs varied as a function of gender and sexual orientation. Specifically, heterosexual boys reported lower engagement in consent behaviors, higher rape myth acceptance, and higher perceived peer support for violence compared to heterosexual girls and sexual minority girls. The results highlight the importance of considering gender and sexual orientation when designing sexual aggression prevention programs.

Measuring social norms of intimate partner violence to exert control over wife agency, sexuality, and reproductive autonomy: an item response modelling of the IPV-ASRA scale

BACKGROUND

The field of violence prevention research is unequivocal that interventions must target contextual factors, like social norms, to reduce gender-based violence. Limited research, however, on the social norms contributing to intimate partner violence or reproductive coercion exists. One of the driving factors is lack of measurement tools to accurately assess social norms.

METHODS

Using an item response modelling approach, this study psychometrically assesses the reliability and validity of a social norms measure of the acceptability of intimate partner violence to exert control over wife agency, sexuality, and reproductive autonomy with data from a population-based sample of married adolescent girls (ages 13-18) and their husbands in rural Niger (n = 559 husband-wife dyads) collected in 2019.

RESULTS

A two-dimensional Partial Credit Model for polytomous items was fit, showing evidence of reliability and validity. Higher scores on the "challenging husband authority" dimension were statistically associated with husband perpetration of intimate partner violence.

CONCLUSIONS

This brief scale is a short (5 items), practical measure with strong reliability and validity evidence. This scale can help identify populations with high-need for social norms-focused IPV prevention and to help measure the impact of such efforts.

The relationships between perceived mental illness prevalence, mental illness stigma, and attitudes toward help-seeking

Previous research suggests that, despite the commonality of mental illness in the United States, the majority of U.S. individuals with mental illness do not seek treatment. One important factor that contributes to this lack of treatment utilization is mental illness stigma. Such stigma may result, in part, from many individuals in the U.S. underestimating the prevalence of mental illness. To test whether this is the case, 638 adults from across the U.S. completed measures related to perceived prevalence of mental illness, private stigma, perceived public stigma, and help-seeking. Findings indicated participants significantly underestimated the given-year prevalence rate of mental illness. The perceived given-year prevalence rate was significantly correlated with lower private stigma and more positive attitudes towards help-seeking. Personal stigma significantly predicted attitudes towards help-seeking. Findings also suggested that individuals who have received mental health services have a higher perceived prevalence rate of mental illness, as well as lower levels of personal stigma and more positive attitudes towards help-seeking. These findings support the notion that helping the general public recognize the true prevalence rate of mental illness could reduce personal mental illness stigma and facilitate help-seeking behaviors. However, future experimental studies are needed to test this hypothesis.

Social Norms Sustaining Intimate Partner Violence: A Systematic Review of Methodologies for Proxy Measures

In light of the many robust quantitative data sets that include information on attitudes and behaviors related to intimate partner violence (IPV), and in an effort to expand the evidence base around social norms and IPV, many researchers construct proxy measures of norms within and across groups embedded in the data. While this strategy has become increasingly popular, there is no standardized approach for assessing and constructing these norm proxies, and no review of these approaches has been undertaken to date. This study presents the results of a systematic review of methods used to construct quantitative proxy measures for social norms related to IPV. PubMed, Embase, Popline, and Scopus, and PsycINFO were searched using Boolean search techniques. Inclusion criteria comprised studies published since 2000 in English that either (i) examined a norm proxy related to gender or IPV or (ii) analyzed the relationship between a norm proxy and perpetration of, experiences of, or attitudes toward IPV. Studies that employed qualitative methods or that elicited direct measures of descriptive or injunctive norms were not included. Twenty-six studies were eligible for review. Evidence from this review highlights inconsistencies in how proxies are constructed, how they are assessed to ensure valid representation of norms, and how researchers acknowledge their respective method's limitations. Key processes and reflections employed by some of the studies are identified and recommended for future research inquiries.

Perceptions of Contexts of Intimate Partner Violence Among Young, Partnered Gay, Bisexual and Other Men Who Have Sex With Men in the United States

There has been a growth in research illustrating that gay, bisexual, and other men who have sex with men (GBMSM) experience intimate partner violence (IPV) at rates that are comparable to those among heterosexual women. However, the majority of research on IPV among same-sex male couples has focused on adults, and research on the experience of IPV among younger men (those aged under 18), remains at a nascent stage, despite knowledge that IPV is often common among younger men. This article adds to the growing body of literature on IPV among young GBMSM (YGBMSM) through of an analysis of qualitative data from in-depth interviews (IDI) with GBMSM aged 15-19 (n = 30) in romantic relationships partnerships. The study sought to explore issues of relationship development, relationship contexts, and understandings of IPV. More than one-half of the sample reported experiencing some form of IPV in their current or past relationships. Participants described a range of experiences of IPV, including physical IPV, emotional IPV, sexual IPV, and controlling behaviors. Emotional IPV in the form of negative comments and controlling behaviors such as jealousy were the most commonly reported forms of violence behaviors. Although few participants reported experiencing physical or sexual IPV, several discussed concerns about giving, and partners' acknowledging, sexual consent. Antecedents to IPV included wanting or feeling pressured to participate in normative development milestones, short-lived relationships, and societal stigma. Interventions that develop content on IPV and that reflect the lived realities of YGBMSM who are experiencing their first relationships are urgently needed. Study findings also support the need for training teachers, health care providers, and parents to identify signs of IPV and provide them with the knowledge and skills to talk to YGBMSM about relationships and violence to reduce IPV.

The Challenges of Working With Men Who Perpetrate Partner Violence: Perspectives and Observations of Experts Who Work With Batterer Intervention Programs

Batterer intervention programs (BIPs) constitute the primary treatment for perpetrators of intimate partner violence (IPV). Systematic evaluations of BIPs, however, have yielded modest results in terms of these programs' ability to reduce perpetration. Descriptive studies, which can provide information on the contexts and process associated with BIPs, can provide insights into the underlying mechanisms that might promote change among BIP clients, and as such are important to improving efficacy measures for BIPs. To date, however, limited research exists on what challenges BIPs encounter in working with clients, and how those challenges present barriers to behavioral change among perpetrators at the intervention level. As part of a 2-year ethnographic study, we conducted 36 individual semistructured interviews with professionals working with BIPs. We identified six themes related to challenges to promoting behavioral change among men who perpetrate violence: (a) social acceptance of IPV, (b) hypermasculine attitudes, (c) emotional problems, (d) childhood exposure to violence, (e) co-morbid mental health issues, and (f) denial, minimization, and blame. Our results have implications for thinking about some of the contextual factors that may impede BIPs ability to produce desired outcomes and for identifying areas in which programs can be tailored to improve the overall client experience. Our results also point to the need for a more coordinated community response to IPV, and in particular to helping provide resources that support BIPs sustained, safe, and as effective as possible work.

College Students' Beliefs About Domestic Violence: A Replication and Extension

In recent decades, significant effort and money have been spent to change social and legal responses to domestic violence and affect public perceptions. A small body of research has examined individuals' opinions about what behaviors are considered domestic violence. Using a sample of college students, the present study examined a modified version of a somewhat popular instrument used to measure beliefs about domestic violence, extending previous work done by Carlson and Worden. Results indicated beliefs about domestic violence are multidimensional, depending on the nature of the behavior and, in part, the gender of the perpetrator. Opinions about the lawfulness of these behaviors fit the same factor structure as beliefs about domestic violence. Demographic characteristics, current relationship status, secondhand experiences with domestic violence, and perceived prevalence of domestic violence in the community are generally not related to beliefs about domestic violence or the lawfulness of these behaviors. However, attributions of blame on the victim are negatively related to domestic violence beliefs and lawfulness. Moreover, lawfulness is a key covariate for domestic violence beliefs. In addition, results also indicate that the gender of the perpetrator is an important variable affecting student's beliefs about sexual assault behaviors. Results from this study support the prevailing ideas behind the Battered Women's Movement that enacting policies and educational programs deeming domestic violence socially, morally, and legally wrong could shift long-standing sociocultural beliefs about men's use of violence against women. Implications of this study for research and policy specific to college students are discussed.

Adverse Childhood Experiences, Trauma Symptoms, Mindfulness, and Intimate Partner Violence: Therapeutic Implications for Marginalized Men

Adverse childhood experiences (ACEs) and trauma symptoms have been linked with intimate partner violence (IPV) perpetration and victimization among men, yet the field lacks depth in several key areas hampering progress toward violence intervention. Specifically, posttraumatic stress disorder (PTSD) dominates the field's scope of trauma symptoms under study, limiting understanding of other manifestations of trauma especially among men. Furthermore, most research focuses exclusively on men's physical IPV perpetration and rarely focuses on other types of IPV, severity of violence, or men's victimization. Also, few studies examine potential protective factors grounded in the ACE framework, such as mindfulness, among clinical populations. Finally, most research has not focused on men of color, despite some racial/ethnic minority groups disproportionate rates of IPV exposure. Therefore, the relationships between IPV frequency and severity (psychological, physical, injury) and ACEs, PTSD, trauma symptomology (separate from PTSD), and mindfulness self-efficacy were examined in a sample of 67 predominantly low-income men of color in a batterer intervention program. More than half of the sample (51.5%) reported exposure to four or more ACEs, and 31.1% met the clinical cutoff for a probable PTSD diagnosis. Higher ACE scores predicted increased rates for nearly all types of self-reported IPV perpetration and victimization. PTSD symptoms and complex trauma symptom severity together explained between 13% and 40% of IPV outcomes, and each was uniquely associated with certain types of self-reported IPV victimization and perpetration frequency and severity. Mindfulness self-efficacy was associated with decreased self-report psychological IPV perpetration and victimization frequency and severity. Clinical implications relevant to marginalized men are reviewed, including screening, training, and potential therapeutic interventions.

A Paradigm Shift in Batterer Intervention Programming: A Need to Address Unresolved Trauma

Intimate partner violence (IPV) is a significant public health problem affecting women, men, and children across the United States. Batterer intervention programs (BIPs) serve as the primary intervention for men who use violence, employing three primary modalities: psychoeducation, cognitive-behavioral therapy (CBT), and other forms of group therapy such as alcohol or drug treatment. However, research indicates that program effectiveness of the primary BIP modalities is limited, due, in part, to the theoretical underpinnings guiding intervention such as learned behavior (psychoeducation), patriarchy as the root cause (Duluth model), and "dysfunctional" thinking (CBT). Considering the mental, physical, and economic toll of IPV on families and the limited effectiveness of current intervention approaches, an assessment of the strengths and weaknesses of current modalities and an incorporation of the latest science addressing violence prevention and cessation are paramount. This article draws upon existing theories of trauma and the etiologies of violence perpetration and proposes an alternative model of care for men with IPV histories. Experiences of childhood adversity and trauma have well-established associations with a range of negative sequelae, including neurological, cognitive, behavioral, physical, and emotional outcomes. Childhood trauma is also associated with later violence and IPV perpetration. Thus, incorporating trauma-informed care principles and trauma interventions into programming for IPV perpetrators warrants further investigation. Practice and policy implications of a trauma interventions for men with IPV histories, as well as areas for future research, are discussed.

Alcohol Use, Hostile Sexism, and Religious Self-Regulation: Investigating Risk and Protective Factors of IPV Perpetration

Research suggests that the relationship between alcohol use and intimate partner violence (IPV) is moderated by a range of other factors. Therefore, we investigated the relationship between alcohol use, hostile sexism, and religious self-regulation with perpetration. Using a national sample of 255 men, we found that hostile sexism was associated with physical violence toward a partner and alcohol use was positively associated with psychological abuse toward a partner. With regard to religious self-regulation, we found that introjected religious self-regulation was positively associated with hostile sexism and positively associated with perpetrating physical IPV. Identified religious self-regulation was negatively associated with physical violence perpetration. We also found significant interactions among our independent measures on physical IPV perpetration. These analyses suggest that increased alcohol consumption elevates the risk for physical violence perpetration among men who are high in introjected religious self-regulation and low in hostile sexism, while reducing the risk for perpetration in men who are high in identified religious self-regulation and low in hostile sexism. Implications and limitations of the findings are discussed.

From campus to communities: evaluation of the first UK-based bystander programme for the prevention of domestic violence and abuse in general communities

BACKGROUND

Violence against women and girls is a public health epidemic. Campus-based research has found bystander programmes show promise as effective primary prevention of sexual violence. However, evidence regarding domestic violence and abuse bystander prevention specifically, and in community settings generally, is still in development. Further, research has predominantly emanated from the US. Examining proof of concept in differing cultural contexts is required. This study evaluates the feasibility and potential for effectiveness of a domestic violence and abuse bystander intervention within UK general communities-Active Bystander Communities.

METHODS

Participants recruited opportunistically attended a three-session programme facilitated by experts in the field. Programme feasibility was measured using participant attendance and feedback across nine learning objectives. Myth acceptance, bystander efficacy, behavioural intent and bystander behaviours were assessed using validated scales at baseline, post-intervention, and four-month follow-up. Results were examined for potential backlash. Analyses used a paired sample t-test and effect size was quantified with Cohen's d.

RESULTS

58/70 participants attended all programme sessions. Participant feedback consistently rated the programme highly and significant change (p ≤ 0·001) was observed in the desired direction across behavioural intent, bystander efficacy, and myth acceptance scores at post and follow-up. Effect size was generally large and, with the exception of Perception of Peer Myth Acceptance, improved at follow-up. Backlash was minimal.

CONCLUSIONS

To our knowledge this is the first UK-based study to examine the potential of bystander intervention as a community-level intervention for domestic violence and abuse. Findings are promising and indicate the translatability of the bystander approach to domestic violence and abuse prevention as well as community contexts. This is likely to be of great interest to policymakers and may help shape future community-based interventions. Further research is now needed using experimental designs engaging diverse community audiences.

Social Norms: Are Sexually Aggressive Men More Likely to Misperceive Other Men's Sexual Desires and Behavior?

Separate lines of research show that men overestimate the extent of male peers' sexual activity, and independently, that sexually aggressive men believe that other men approve of coercive behavior. This study examined the intersection of these lines of inquiry, testing whether the degree of male participants' misperception of other men's sexual behavior differs as a function of perpetrator status. In a national sample, we presented heterosexually active men (n=497) with sexual scenarios varying in sexual acts, partner types, and circumstances. Results showed that participants significantly overestimated the typicality of all types of sexual situations for other men. Participants also misjudged the desirability of scenarios consistent with a traditional masculinity sexual script to other men; these scenarios reflected an adversarial perspective on relationships and an impersonal approach to sexuality - a known risk factor for sexual aggression. Further, sexually aggressive men overestimated the desirability of these traditional masculinity scenarios to a greater extent than non-aggressive peers. Findings suggest that interventions that provide accurate knowledge about social norms, or "typical" sexual desires and behaviors among other men, may reduce pressure to live up to perceived but perhaps inaccurate masculine ideals, as well as reduce social norm-related risks for sexually aggressive behavior.

Attitudes Toward Violence and Gender as Predictors of Interpersonal Violence Interventions

The purpose of the research was to determine whether attitudes toward violence (ATV) and participant sex would influence notions about interpersonal violence (IPV) intervention by university students. It was anticipated those who held stronger cultural and reactive violence attitudes and males would be less in favor of intervention, but it was not certain whether gender or attitudes would be the stronger predictor for intervention approaches. An IPV intervention scale was developed to measure preferred approaches for intervention, which resulted in four approaches (affirmative intervention, no intervention, police intervention, and intervention threshold). A total of 420 university student volunteers completed the IPV intervention questionnaire followed by an ATV scale on an electronic data collection site. Results indicated ATV subtypes were stronger predictors of affirmative intervention than gender, but when considering cultural acceptability of violence, gender was the single predictor for a threshold of intervention. The findings have relevance for university and community intervention programs and public policy makers when attempting to alter the acceptability of violence to promote effective interventions.

Neighborhood violent crime and adolescent relationship aggression

Research has shown that neighborhoods play a role in the etiology of violence. However, few adolescent relationship aggression (ARA) studies have objective measures of violent neighborhoods. Drawing on a nationally representative sample of youth, this study examines the association between ARA and local levels of violent crime (measured using geocoded Uniform Crime Report data from each of the youths' residential neighborhoods). Study analyses are based on survey data from 723 youth (ages 10-18) in current or recent dating relationships (351 males and 372 females) in the Survey on Teen Relationships and Intimate Violence (STRiV), a national representative household panel survey exploring interpersonal violence and related aggression among adolescents. About 19% of the sample reported ARA victimization in their most recent dating relationship (ARA perpetration was 17%). Neighborhood violent crime in the study (males living in 86.9 and females 99.8) was slightly lower than the national average of 100. With a broad national sample, 40% non-Whites, hypotheses guided by theories of neighborhood influence were tested. The study did not find an association between neighborhood violent crime and ARA victimization and perpetration, controlling for key demographic factors. The results, for a broad range of high- and low-crime neighborhoods, suggest that neighborhood violence does not seem to affect individual rates of ARA. The results suggest the ARA victimization and perpetration are perhaps ubiquitous and found both in low and high violent crime neighborhoods, suggesting that addressing local violent crime rates alone does not seem to be a path to also reducing ARA.

Social norms, misperceptions, and mosquito net use: a population-based, cross-sectional study in rural Uganda

Background

Mosquito net use is an essential part of malaria prevention. Although previous research has shown that many people sleep under a mosquito net in endemic areas, it is unknown whether people underestimate how common it is to sleep under a net every night. Furthermore, perceived social norms about whether most others sleep under a mosquito net every night may contribute to personally sleeping under a net, given decades of research showing that people often mimic others’ behaviours.

Methods

Population-based data were collected from 1669 adults across eight villages in one rural parish in southwestern Uganda. Individuals’ perception about whether most adults in their community sleep under a mosquito net every night was compared with whether daily mosquito net use was the actual norm in their community to identify the extent of norm misperception. The association between whether an individual perceived daily mosquito net use to be the norm and personal mosquito net use was assessed while adjusting for the ratio of nets:people in the household and other factors.

Results

Although the majority (65%) of participants reported sleeping under a mosquito net every night (and 75% did so among the 86% of people with at least one net), one-quarter of participants thought that most adults in their community did not sleep under a mosquito net every night. Another 8% were unsure how many nights per week most adults in their community sleep under a mosquito net. Participants who perceived that daily mosquito net use was the norm were 2.94 times more likely to report personally sleeping under a mosquito net every night (95% CI 2.09–4.14, p < 0.001) compared to participants who thought doing so was not normative, adjusting for other factors.

Conclusions

Results suggest an opportunity for anti-malarial interventions to reduce misperceptions about mosquito net use norms and emphasize the commonness of daily mosquito net use in malaria-endemic regions. If people correctly perceive most others to sleep under a net every night, then they may personally do so when possible and support others to do so too.

A Critical Appraisal of the Social Norms Approach as an Interventional Strategy for Health-Related Behavior and Attitude Change

The Social Norms Approach is a widely used intervention strategy for promoting positive health-related behaviors. The Approach operates on the premise that individuals misperceive their peers' behaviors and attitudes, with evidence of under- and over-estimations of behaviors and peer approval for a range of positive and negative behaviors respectively. The greater these misperceptions, the more likely an individual is to engage in negative behaviors such as consuming heavier amounts of alcohol and other substances and reduce positive behaviors such as eating healthily and using sun protection. However, there are many complexities associated with the use of social norms feedback in interventions and empirical studies. Many social norms interventions do not attempt to change misperceptions of social norms or measure changes in normative perceptions pre- and post-intervention. This has led to a conflation of generic social norms interventions with those that are explicitly testing the Approach's assumptions that it is misperceptions of peer norms which drive behavior. The aim of the present review was to provide a critical appraisal of the use of the Social Norms Approach as an intervention strategy for health-related behaviors, identify the current issues with its evidence base, highlight key opportunities and challenges facing the approach, and make recommendations for good practice when using the approach. There are three core challenges and areas for improved practice when using the Social Norms Approach. Firstly, improvements in the methodological rigor and clarity of reporting of 'social norms' research, ensuring that studies are testing the approach's assumption of the role of misperceptions on behaviors are differentiated from studies investigating other forms of 'social norms.' Secondly, the need for a more explicit, unified and testable theoretical model outlining the development of normative misperceptions which can be translated into interventional studies. Finally, a need for a more robust evaluation of social norms interventions in addition to randomized controlled trials, such as the inclusion of process evaluations, qualitative studies of participant experiences of social norms feedback, and alternative study designs better suited for real-world public health settings. Such improvements are required to ensure that the Social Norms Approach is adequately tested and evaluated.

The Causal Influence of Perceived Social Norms on Intimate Partner Violence Perpetration: Converging Cross-Sectional, Longitudinal, and Experimental Support for a Social Disinhibition Model

Across three studies, we develop a model of the direct and indirect paths through which the perceived prevalence (perceived descriptive norms [PDN]) of intimate partner violence (IPV) among peers may influence individuals’ likelihood of engaging in IPV. Study 1 replicated and extended previous cross-sectional research by demonstrating a positive longitudinal association between PDN and subsequent IPV perpetration. Study 2 further showed the influence of PDN on IPV perpetration to be mediated through its relation to perceived peer acceptance of IPV (perceived injunctive norms [PIN]), which in turn predicted personal IPV acceptance. Study 3 built on this model using an experimental paradigm to show that increasing PDN leads to corresponding increases in PIN and, in turn, personal IPV acceptance, which both predicted IPV perpetration. Furthermore, the effects of PIN on personal IPV acceptance and IPV propensity were strongest for dominance-oriented individuals. Results bear important implications for social norms–based interventions for IPV.

Theory and practice of social norms interventions: eight common pitfalls

BACKGROUND

Recently, Global Health practitioners, scholars, and donors have expressed increased interest in "changing social norms" as a strategy to promote health and well-being in low and mid-income countries (LMIC). Despite this burgeoning interest, the ability of practitioners to use social norm theory to inform health interventions varies widely.

MAIN BODY

Here, we identify eight pitfalls that practitioners must avoid as they plan to integrate a social norms perspective in their interventions, as well as eight learnings. These learnings are: 1) Social norms and attitudes are different; 2) Social norms and attitudes can coincide; 3) Protective norms can offer important resources for achieving effective social improvement in people's health-related practices; 4) Harmful practices are sustained by a matrix of factors that need to be understood in their interactions; 5) The prevalence of a norm is not necessarily a sign of its strength; 6) Social norms can exert both direct and indirect influence; 7) Publicising the prevalence of a harmful practice can make things worse; 8) People-led social norm change is both the right and the smart thing to do.

CONCLUSIONS

As the understanding of how norms evolve in LMIC advances, practitioners will develop greater understanding of what works to help people lead change in harmful norms within their contexts. Awareness of these pitfalls has helped several of them increase the effectiveness of their interventions addressing social norms in the field. We are confident that others will benefit from these reflections as well.

Actual Versus Perceived HIV Testing Norms, and Personal HIV Testing Uptake: A Cross-Sectional, Population-Based Study in Rural Uganda

HIV testing is an essential part of treatment and prevention. Using population-based data from 1664 adults across eight villages in rural Uganda, we assessed individuals' perception of the norm for HIV testing uptake in their village and compared it to the actual uptake norm. In addition, we examined how perception of the norm was associated with personal testing while adjusting for other factors. Although the majority of people had been tested for HIV across all villages, slightly more than half of men and women erroneously thought that the majority in their village had never been tested. They underestimated the prevalence of HIV testing uptake by 42 percentage points (s.d. = 17 percentage points), on average. Among men, perceiving that HIV testing was not normative was associated with never testing for HIV (AOR = 2.6; 95% CI 1.7-4.0, p < 0.001). Results suggest an opportunity for interventions to emphasize the commonness of HIV testing uptake.

Social Norms for Intimate Partner Violence: A Replication With College Students

This study replicated prior research on college students' perceived descriptive norms (i.e., prevalence estimates) for intimate partner violence (IPV). In this study, male and female college students were instructed to estimate the prevalence of physical forms of IPV for "typical students" of their same gender on campus. Perpetrators of IPV-both male and female-made higher estimates than nonperpetrators. When compared to actual prevalence rates, both perpetrators and nonperpetrators overestimated the prevalence of IPV on campus. Findings have implications for prevention programs that address social norms.

Role of offender perception in treatment outcome

Purpose

The purpose of this paper is to address a possible interaction of cognitive distortions associated with substance dependency and intimate partner violence (IPV), and the effects on subsequent behavior. The primary focus was to investigate the relationship between offender perception (i.e. perception of family problems (FP) and perception of need for treatment for family problems (FPTx)) and treatment outcome (i.e. substance use and violence), among a unique sample of substance dependent male offenders of IPV. An additional investigation included the change in perception from baseline to the end of treatment.

Design/methodology/approach

In total, 63 participants were randomly assigned to one of two treatment conditions and assessed across 12 weeks of treatment.

Findings

Participants in the (FP+) (i.e. those who perceived family problems at baseline) and (FPTx+) (i.e. those who perceived a need for treatment for family problems at baseline) conditions reported a significantly greater change in the number of days of violence from baseline to the end of treatment, compared to participants in the (FP−) (i.e. those who did not perceive family problems at baseline) and (FPTx−) (i.e. participants who perceived no need for treatment at baseline) conditions. (FP+) and (FPTx+) participants had significant decreases in any violent behavior from pre- to post-treatment.

Originality/value

The results of this study highlight the importance of techniques aimed at improving clients’ ability to recognize and admit to problem behaviors, a critical component of cognitive-behavioral therapy, in an effort to increase their motivation for treatment, thus leading to greater treatment success.

Measuring personal beliefs and perceived norms about intimate partner violence: Population-based survey experiment in rural Uganda

BACKGROUND

Demographic and Health Surveys (DHS) conducted throughout sub-Saharan Africa indicate there is widespread acceptance of intimate partner violence, contributing to an adverse health risk environment for women. While qualitative studies suggest important limitations in the accuracy of the DHS methods used to elicit attitudes toward intimate partner violence, to date there has been little experimental evidence from sub-Saharan Africa that can be brought to bear on this issue.

METHODS AND FINDINGS

We embedded a randomized survey experiment in a population-based survey of 1,334 adult men and women living in Nyakabare Parish, Mbarara, Uganda. The primary outcomes were participants' personal beliefs about the acceptability of intimate partner violence and perceived norms about intimate partner violence in the community. To elicit participants' personal beliefs and perceived norms, we asked about the acceptability of intimate partner violence in five different vignettes. Study participants were randomly assigned to one of three survey instruments, each of which contained varying levels of detail about the extent to which the wife depicted in the vignette intentionally or unintentionally violated gendered standards of behavior. For the questions about personal beliefs, the mean (standard deviation) number of items where intimate partner violence was endorsed as acceptable was 1.26 (1.58) among participants assigned to the DHS-style survey variant (which contained little contextual detail about the wife's intentions), 2.74 (1.81) among participants assigned to the survey variant depicting the wife as intentionally violating gendered standards of behavior, and 0.77 (1.19) among participants assigned to the survey variant depicting the wife as unintentionally violating these standards. In a partial proportional odds regression model adjusting for sex and village of residence, with participants assigned to the DHS-style survey variant as the referent group, participants assigned the survey variant that depicted the wife as intentionally violating gendered standards of behavior were more likely to condone intimate partner violence in a greater number of vignettes (adjusted odds ratios [AORs] ranged from 3.87 to 5.74, with all p < 0.001), while participants assigned the survey variant that depicted the wife as unintentionally violating these standards were less likely to condone intimate partner violence (AORs ranged from 0.29 to 0.70, with p-values ranging from <0.001 to 0.07). The analysis of perceived norms displayed similar patterns, but the effects were slightly smaller in magnitude: participants assigned to the "intentional" survey variant were more likely to perceive intimate partner violence as normative (AORs ranged from 2.05 to 3.51, with all p < 0.001), while participants assigned to the "unintentional" survey variant were less likely to perceive intimate partner violence as normative (AORs ranged from 0.49 to 0.65, with p-values ranging from <0.001 to 0.14). The primary limitations of this study are that our assessments of personal beliefs and perceived norms could have been measured with error and that our findings may not generalize beyond rural Uganda.

CONCLUSIONS

Contextual information about the circumstances under which women in hypothetical vignettes were perceived to violate gendered standards of behavior had a significant influence on the extent to which study participants endorsed the acceptability of intimate partner violence. Researchers aiming to assess personal beliefs or perceived norms about intimate partner violence should attempt to eliminate, as much as possible, ambiguities in vignettes and questions administered to study participants.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02202824.

Beliefs about intimate partner violence: A survey of the Swedish general public

Public interventions are considered to be an important means of preventing intimate partner violence (IPV). What people believe about the nature of IPV is likely to determine their propensity to intervene, but little is known at present about IPV beliefs among the general public. In a survey of 650 Swedish citizens, beliefs about the prevalence and causes of IPV, and viable means of intervention were assessed. Respondents estimated, on average, that IPV occurs in almost one quarter of all intimate relationships in Sweden, and that IPV is particularly prevalent in low-income groups, among non-European immigrants, in suburban areas, and in couples under the age of 50 years. Physical violence was believed to be the most frequent form of abuse in male offender-female victim cases, whereas psychological violence was considered most frequent in other combinations of offender and victim gender. Female respondents estimated a higher prevalence of IPV, attributed less blame to IPV victims, and suggested more means of intervention, than did male respondents. The findings are discussed in relation to empirical prevalence estimates, and implications are proposed.

College Students' Perceptions of Depressed Mood: Exploring Accuracy and Associations

College is a time of high risk for depressed mood. Theories about depression (i.e. Cognitive Theory and Depressive Realism theory) are well researched, but suggest different venues of understanding the cognitive underpinnings of mood. In addition, much research is available about normative perceptions around substance use and how those perceptions relate to behaviors. However, there are no studies examining normative perceptions around depressed mood nor how these perceptions may relate to students' own well-being. Undergraduates (N=1577) ages 18-24 responded to an online survey as part of a larger study on drinking and depressed mood. The survey assessed symptoms of depression and feelings of sadness, depression and suicidal ideation experienced in the past 2 weeks, as well as students' perceptions of the prevalence of these feelings among other students. Rates of sadness and depression reported in the sample were relatively high; whereas rates of reported suicidal ideation were low. Most students under-estimated the prevalence of sadness and depression experienced by other students; a finding that was especially true for male students. Conversely, most students over-estimated the prevalence of suicidal ideation. Students who reported experiencing a given feeling in the past two weeks perceived greater rates of the feeling among other students. Depression symptoms were associated with both greater perceived prevalence of sadness, depression and suicidal ideation, as well as correct and over-estimates of the prevalence of sadness and depression. Implications for future directions in prevention and interventions efforts are discussed.

Perceived Social Norms for Intimate Partner Violence in Proximal and Distal Groups

This study investigated students' perceived descriptive social norms for intimate partner violence (IPV) among proximal and distal groups at college. Male and female college students estimated the prevalence rates for IPV among same-sex friends (proximal group) and same-sex "typical students" (distal group). In separate regression equations for men and women, perceived estimates of IPV rates for same-sex friends, but not estimates for same-sex typical students, were positively related with the participants' own IPV behaviors. Findings have important implications for IPV prevention and intervention programs for college students.

Indonesian Men’s Perceptions of Violence Against Women

This article explores male perceptions and attitudes toward violence against women in Indonesia. It analyzes interview data from Indonesian men collected as part of a large multimethod Australian government–funded project on masculinities and violence in two Asian countries. Reluctance to talk about violence against women was evident, and the accounts of those men who did respond referred to three justificatory discourses: denial, blaming the victim, and exonerating the male perpetrator. The findings support continuation of government and nongovernmental organization (NGO) projects aimed at both empowering women and reeducating men.

Motivational and Cognitive Predictors of the Propensity to Intervene Against Intimate Partner Violence

A survey using a community-based sample (N = 650) was conducted to identify motivational and cognitive predictors of individuals' propensity to intervene against intimate partner violence (IPV). A hierarchical regression analysis showed that motivational factors accounted for the greatest proportion of the variance in self-reported propensity. Specifically, personal norm (i.e., an individual's felt obligation to intervene) was the strongest individual predictor, followed by affective response (i.e., the extent to which an individual responds to IPV with negative emotions). Although cognitive factors explained only a small portion of the variance, the propensity to intervene was significantly higher for respondents who perceived IPV as a prevalent issue and who did not view the perpetrator as responsible for the solution of IPV. The findings suggest that attempts to facilitate public intervention should target specific, rather than general, aspects of public norms and beliefs about IPV.

A Self-Determination Model of Childhood Exposure, Perceived Prevalence, Justification, and Perpetration of Intimate Partner Violence

The present research was designed to evaluate self-determination theory as a framework for integrating factors associated with intimate partner violence (IPV) perpetration. The proposed model suggests that childhood exposure to parental violence may influence global motivational orientations which, in turn result in greater cognitive biases (overestimating the prevalence of IPV and justification of IPV) which, in turn, contribute to an individual's decision to use abusive behavior. Participants included 124 men who had engaged in abusive behavior toward an intimate partner. Results provided reasonable support for the proposed model and stronger support for a revised model suggesting that controlled orientation, rather than autonomy orientation, appears to play a stronger role in the association between childhood exposure to parental violence and cognitive biases associated with abusive behavior.

Social norms for intimate partner violence

This study investigated perceived descriptive norms (i.e., perceived prevalence) for intimate partner violence (IPV) among college students. Male and female college students were asked to estimate the prevalence of IPV for same-sex "typical students" on their campus. Perpetrators of IPV made higher estimates than nonperpetrators. Both perpetrators and nonperpetrators overestimated the prevalence of IPV when compared to actual prevalence rates. Findings lend support for using social-norms-based prevention programs on college campuses.

Social norms for intimate partner violence in situations involving victim infidelity

The present study investigated perceived descriptive norms (i.e., perceived prevalence) for male-to-female intimate partner violence (IPV) following victim infidelity (i.e., girlfriend had sex with another man). While watching a video-taped vignette of a young, dating couple in an argument that escalated to male-to-female violence, male participants were asked various questions to assess perceived descriptive norms at several time points during the escalating argument. Half of the participants were told that the victim in the video was unfaithful. Results suggested that while participants did believe that it was much more common for their male friends and for typical male students to aggress against unfaithful girlfriends compared to faithful girlfriends, these differences were less pronounced as the aggression intensified. When testing whether perceived norms for IPV were related to participants' purported risk of engaging in IPV, a clear pattern appeared: For the no-infidelity condition, IPV perceived norms for male friends and perceived norms for typical male students were each significantly related to participants' likelihood of engaging in IPV, such that the higher the estimated norm, the higher the participants' risk. However, for the infidelity condition, only perceived norms for male friends were related to the risk of engaging in IPV. Findings have important implications for social norms-based intervention and prevention programs for IPV on college campuses.

EXPOSURE TO DOMESTIC VIOLENCE AND CHILDHOOD EMOTIONAL ABUSE: Childhood Domestic Violence Exposure among a Community Sample of Adult Perpetrators: What Mediates the Connection?

The association between childhood exposure to domestic violence and later intimate partner violence (IPV) perpetration in adulthood has been well established in the literature. However, the literature examining the factors of exposure that contribute to perpetration in adulthood is fraught with mixed findings, with some studies finding a direct link between childhood domestic violence exposure and later IPV perpetration and others ruling out a link after controlling for other contextual barriers such as community violence and socioeconomic status. This study examined 124 non-treatment-seeking and unadjudicated adult male IPV perpetrators and found exposure to domestic violence in childhood contributes to the normalization of violence, which could predict future adult IPV perpetration. Practice implications are discussed, namely primary and secondary prevention of intimate partner violence.

Using social norms to reduce bullying

Bullying attitudes and behaviors and perceptions of peers were assessed in a case study experiment employing a social norms intervention in five diverse public middle schools in the State of New Jersey (Grades 6 to 8). Data were collected using an anonymous online survey (baseline n = 2,589; postintervention n = 3,024). In the baseline survey, students substantially misperceived peer norms regarding bullying perpetration and support for probullying attitudes. As predicted by social norms theory, they thought bullying perpetration, victimization, and probullying attitudes were far more frequent than was the case. Also as predicted, variation in perceptions of the peer norm for bullying was significantly associated with personal bullying perpetration and attitudes. Using print media posters as the primary communication strategy, an intervention displaying accurate norms from survey results was conducted at each of the five school sites. A pre-/postintervention comparison of results revealed significant reductions overall in perceptions of peer bullying and probullying attitudes while personal bullying of others and victimization were also reduced and support for reporting bullying to adults at school and in one’s family increased. The extent of reductions across school sites was associated with the prevalence and extent of recall of seeing poster messages reporting actual peer norms drawn from the initial survey data. Rates of change in bullying measures were highest (from around 17% to 35%) for the school with the highest message recall by students after a one-and-a-half-year intervention. Results suggest that a social norms intervention may be a promising strategy to help reduce bullying in secondary school populations.

Women's perceptions of their community's social norms towards assisting women who have experienced intimate partner violence

The role of social norms has played an often unrecognized role in the perception of and action to assist low-income urban women who are in violent relationships. Two forms of social norms will be assessed, including descriptive norms--what people typically do to assist women in a violent relationship--and injunctive norms--defined as what people should do to assist women. This study will present our initial findings into the development of measures to assess women's perception of their community's social norms toward assisting women who have experienced intimate partner violence (IPV) and how these norms are related to women's perception of the community, reasons for community assistance toward women experiencing IPV, and women's own experience of IPV. Systematic measurement development processes were applied to reliably and validly develop the social norms measures. A three-phase approach was used to develop eight paired items measuring descriptive and injunctive norms. A total of 176 low-income urban women were interviewed and the scale responses were compared to length of time at the residence, perceptions of their neighborhood, perceived reasons for community involvement and non-involvement in assisting women experiencing IPV, and IPV experienced as an adult. The two developed social norms scales were found to have high internal consistency alpha coefficients of 0.84 for descriptive norms and 0.93 for injunctive norms. Paired t tests were statistically significant, denoting higher injunctive than descriptive social norms. Lowered descriptive norms were found among younger women, women who reported that they did not think their neighborhood was a good place to live, women who had ever experienced intimate partner violence as an adult, and perceived lower reasons for neighbor involvement and higher reasons for neighbor non-involvement toward assisting women experiencing IPV. Higher levels of injunctive social norms were statistically associated with living in a good place and increased perceived reasons for neighbor involvement toward assisting women experiencing IPV. Significant differences between descriptive and injunctive norms suggest that women, especially those who are currently experiencing IPV, would prefer greater support from community neighbors than they are currently providing. The descriptive and injunctive social norms scales demonstrated a high level of internal reliability and significantly associated with other influencing factors thought to be associated with social norms. Overall, the performance of the injunctive and descriptive norms scales support their use as a tool to investigate social norms toward neighbors taking action to assist women experiencing IPV.

A Telephone Intervention for Substance-Using Adult Male Perpetrators of Intimate Partner Violence

OBJECTIVE: To preliminarily evaluate telephone-delivered motivational enhancement therapy (MET) in motivating unadjudicated and nontreatment seeking intimate partner violence (IPV) perpetrators, who also use substances, to self-refer into treatment. METHOD: 124 adult men were recruited via a multimedia marketing campaign and were randomly assigned to the intervention (MET) or comparison group following a baseline assessment. Participants in the MET condition received a personalized feedback report on their IPV and substance-use behaviors, consequences, and social norms beliefs. RESULTS: Results supported the likely effectiveness of MET in short-term reduction of IPV behavior, increasing motivation for treatment seeking, and changing perceived norms for IPV and substance abuse (SA). CONCLUSIONS: Applications for brief MET interventions to facilitate voluntary treatment entry among substance-using IPV perpetrators are discussed.