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Gilchrist G, Dheensa S, Johnson A, Henderson J, Radcliffe P, Dwyer G, Turner R, Thomson K, Papastavrou Brooks C, Love B, Zenasni Z, Berbary C, Carter B, Parrott S, Li J, Easton C, Bergman C, Feder G, Gilchrist E. Adapting the ADVANCE group program for digitally-supported delivery to reduce intimate partner violence by men in substance use treatment: a feasibility study. Front Psychiatry 2024; 14:1253126. [PMID: 38328518 PMCID: PMC10847362 DOI: 10.3389/fpsyt.2023.1253126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/27/2023] [Indexed: 02/09/2024] Open
Abstract
Introduction COVID-19 restrictions created barriers to "business as usual" in healthcare but also opened the door to innovation driven by necessity. This manuscript (1) describes how ADVANCE, an in-person group perpetrator program to reduce intimate partner violence (IPV) against female (ex)partners by men in substance use treatment, was adapted for digitally-supported delivery (ADVANCE-D), and (2) explores the feasibility and acceptability of delivering ADVANCE-D to men receiving substance use treatment. Methods Firstly, the person-based approach and mHealth development framework were used to iteratively adapt ADVANCE for digitally-supported delivery including conceptualization, formative research, and pre-testing. Then, a non-randomized feasibility study was conducted to assess male participants' eligibility, recruitment, and attendance rates and uptake of support offered to their (ex)partners. Exploratory analyses on reductions in IPV perpetration (assessed using the Abusive Behavior Inventory; ABI) and victimization (using the revised ABI; ABI-R) at the end of the program were performed. Longitudinal qualitative interviews with participants, their (ex)partners, and staff provided an understanding of the program's implementation, acceptability, and outcomes. Results The adapted ADVANCE-D program includes one goal-setting session, seven online groups, 12 self-directed website sessions, and 12 coaching calls. ADVANCE-D includes enhanced risk management and support for (ex)partners. Forty-five participants who had perpetrated IPV in the past 12 months were recruited, forty of whom were offered ADVANCE-D, attending 11.4 (SD 9.1) sessions on average. Twenty-one (ex)partners were recruited, 13 of whom accepted specialist support. Reductions in some IPV perpetration and victimization outcome measures were reported by the 25 participants and 11 (ex)partners interviewed pre and post-program, respectively. Twenty-two participants, 11 (ex)partners, 12 facilitators, and 7 integrated support service workers were interviewed at least once about their experiences of participation. Overall, the program content was well-received. Some participants and facilitators believed digital sessions offered increased accessibility. Conclusion The digitally-supported delivery of ADVANCE-D was feasible and acceptable. Remote delivery has applicability post-pandemic, providing greater flexibility and access. Given the small sample size and study design, we do not know if reductions in IPV were due to ADVANCE-D, time, participant factors, or chance. More research is needed before conclusions can be made about the efficacy of ADVANCE-D.
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Affiliation(s)
- Gail Gilchrist
- National Addiction Center, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Sandi Dheensa
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Amy Johnson
- School of Health in Social Science, Department of Clinical Psychology, Center for Psychological Therapies, University of Edinburgh, Edinburgh, United Kingdom
| | - Juliet Henderson
- National Addiction Center, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Polly Radcliffe
- National Addiction Center, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Georges Dwyer
- National Addiction Center, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Richard Turner
- National Addiction Center, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Kate Thomson
- School of Health in Social Science, Department of Clinical Psychology, Center for Psychological Therapies, University of Edinburgh, Edinburgh, United Kingdom
| | - Cat Papastavrou Brooks
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Beverly Love
- National Addiction Center, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Zohra Zenasni
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Cassandra Berbary
- College of Health Sciences and Technology, Rochester Institute of Technology, Rochester, NY, United States
| | - Ben Carter
- National Addiction Center, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Steve Parrott
- Department of Health Sciences, University of York, York, United Kingdom
| | - Jinshuo Li
- Department of Health Sciences, University of York, York, United Kingdom
| | - Caroline Easton
- College of Health Sciences and Technology, Rochester Institute of Technology, Rochester, NY, United States
| | | | - Gene Feder
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Elizabeth Gilchrist
- School of Health in Social Science, Department of Clinical Psychology, Center for Psychological Therapies, University of Edinburgh, Edinburgh, United Kingdom
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Porsch LM, Xu M, Veldhuis CB, Bochicchio LA, Zollweg SS, Hughes TL. Intimate Partner Violence Among Sexual Minority Women: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:3014-3036. [PMID: 36154756 PMCID: PMC10039964 DOI: 10.1177/15248380221122815] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Intimate partner violence (IPV) is prevalent among sexual minority women (SMW). However, compared to IPV research with heterosexual women and other LGBTQ+ population groups, SMW are understudied. We conducted a scoping review to examine the current state of knowledge about IPV among SMW, and to identify gaps and directions for future research. A search of Medline, Embase, CINAHL, and PsycINFO databases returned 1,807 papers published between January 2000 and December 2021. After independent reviewers screened these papers for relevance, 99 were included in the final review. Papers were included if they used quantitative methods and reported IPV data on adult SMW separately from other groups. Findings confirmed high rates of IPV among SMW and highlighted groups with particular vulnerabilities, including non-monosexual women and SMW of color. Risk factors for IPV in this population include prior trauma and victimization, psychological and emotional concerns, substance use, and minority stressors. Outcomes include poor mental and physical health. Findings related to the effects of minority stressors on IPV and comparisons across sexual minority groups were inconsistent. Future research should focus on IPV perpetration; mechanisms underlying risk for IPV, including structural-level risk factors; and understanding differences among SMW subgroups.
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Affiliation(s)
| | - Mariah Xu
- Columbia University, New York, NY, USA
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Brown LA, Webster JL, Tran JT, Wolfe JR, Golinkoff J, Patel E, Arcomano AC, Ben Nathan J, Azat O'Connor A, Zhu Y, Oquendo M, Brown GK, Mandell D, Mowery D, Bauermeister JA. A Suicide Prevention Intervention for Emerging Adult Sexual and Gender Minority Groups: Protocol for a Pilot Hybrid Effectiveness Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e48177. [PMID: 37773618 PMCID: PMC10576233 DOI: 10.2196/48177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/08/2023] [Accepted: 07/28/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Suicide attempts and suicide death disproportionately affect sexual and gender minority emerging adults (age 18-24 years). However, suicide prevention strategies tailored for emerging adult sexual and gender minority (EA-SGM) groups are not widely available. The Safety Planning Intervention (SPI) has strong evidence for reducing the risk for suicide in the general population, but it is unclear how best to support EA-SGM groups in their use of a safety plan. Our intervention (Supporting Transitions to Adulthood and Reducing Suicide [STARS]) builds on content from an existing life skills mobile app for adolescent men who have sex with men (iREACH) and seeks to target core risk factors for suicide among EA-SGM groups, namely, positive affect, discrimination, and social disconnection. The mobile app is delivered to participants randomized to STARS alongside 6 peer mentoring sessions to support the use of the safety plan and other life skills from the app to ultimately reduce suicide risk. OBJECTIVE We will pilot-test the combination of peer mentoring alongside an app-based intervention (STARS) designed to reduce suicidal ideation and behaviors. STARS will include suicide prevention content and will target positive affect, discrimination, and social support. After an in-person SPI with a clinician, STARS users can access content and activities to increase their intention to use SPI and overcome obstacles to its use. EA-SGM groups will be randomized to receive either SPI alone or STARS and will be assessed for 6 months. METHODS Guided by the RE-AIM (reach, efficacy, adoption, implementation, and maintenance) framework, we will recruit and enroll a racially and ethnically diverse sample of 60 EA-SGM individuals reporting past-month suicidal ideation. Using a type-1 effectiveness-implementation hybrid design, participants will be randomized to receive SPI (control arm) or to receive SPI alongside STARS (intervention arm). We will follow the participants for 6 months, with evaluations at 2, 4, and 6 months. Preliminary effectiveness outcomes (suicidal ideation and behavior) and hypothesized mechanisms of change (positive affect, coping with discrimination, and social support) will serve as our primary outcomes. Secondary outcomes include key implementation indicators, including participants' willingness and adoption of SPI and STARS and staff's experiences with delivering the program. RESULTS Study activities began in September 2021 and are ongoing. The study was approved by the institutional review board of the University of Pennsylvania (protocol number 849500). Study recruitment began on October 14, 2022. CONCLUSIONS This project will be among the first tailored, mobile-based interventions for EA-SGM groups at risk for suicide. This project is responsive to the documented gaps for this population: approaches that address chosen family, focus on a life-course perspective, web approaches, and focus on health equity and provision of additional services relevant to sexual and gender minority youth. TRIAL REGISTRATION ClinicalTrials.gov NCT05018143; https://classic.clinicaltrials.gov/ct2/show/NCT05018143. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/48177.
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Affiliation(s)
- Lily A Brown
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Jessica L Webster
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Jennifer T Tran
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - James R Wolfe
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Jesse Golinkoff
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Esha Patel
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Amanda C Arcomano
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Jennifer Ben Nathan
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Alexander Azat O'Connor
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Yiqin Zhu
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Maria Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Gregory K Brown
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - David Mandell
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Danielle Mowery
- Institute for Biomedical Informatics, University of Pennsylvania, Philadelphia, PA, United States
| | - José A Bauermeister
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
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Tubman JG, Moore C, Lee J, Shapiro AJ. Multivariate Patterns of Substance Use, Minority Stress and Environmental Violence Associated with Sexual Revictimization of Lesbian and Bisexual Emerging Adult Women. JOURNAL OF LESBIAN STUDIES 2023:1-21. [PMID: 37500604 DOI: 10.1080/10894160.2023.2240552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
This study documented between-group differences in factors associated with sexual revictimization histories in a sample of young sexual minority women. Diverse samples of lesbian (N = 204, ageM = 23.55 years) and bisexual (N = 249, ageM = 23.35 years) women from the United States were recruited using the CloudResearch platform to assess factors associated with recent experiences of intimate partner violence (IPV). Participants were categorized into four groups based on self-reports of sexual victimization (a) during childhood and (b) during adulthood in intimate relationships. Multivariate Analysis of Variance (MANOVA) was used to model between-group differences in three variable domains: Past-year substance use involvement, minority stress, and violence in relationship and community settings. Lesbian women reporting sexual revictimization in adulthood reported significantly higher scores for measures of past-year substance use involvement and negative consequences, daily discrimination experiences, relational victimization, and criminal victimization, compared to their counterparts with no history of sexual victimization. Among bisexual women, sexual revictimization was associated with a similar pattern of between-group differences. The sexual revictimization experiences of sexual minority women appear to occur in the context of multivariate patterns of harmful substance use, minority stress, and violence in both relationship and community settings. Our findings have implications for how intervention services are provided to emerging adult sexual minority women who experience multiple episodes of sexual abuse during their lifespans. Recommendations include specialized training for counseling or intervention service providers, integrated trauma-informed services that address both substance use and sexual assault issues, and affirmative services for sexual minority women.
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Affiliation(s)
| | - Candace Moore
- Department of Psychology, American University, Washington, DC, USA
| | - Jacquie Lee
- Department of Psychology, American University, Washington, DC, USA
| | - Avital J Shapiro
- Department of Psychology, American University, Washington, DC, USA
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Expósito-Álvarez C, Santirso FA, Gilchrist G, Gracia E, Lila M. Participants in Court-mandated Intervention Programs for Intimate Partner Violence Perpetrators with Substance Use Problems: A Systematic Review of Specific Risk Factors. INTERVENCION PSICOSOCIAL 2023; 32:89-108. [PMID: 37383646 PMCID: PMC10294470 DOI: 10.5093/pi2023a7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 03/30/2023] [Indexed: 06/30/2023]
Abstract
Men with alcohol and/or other drug use problems (ADUPs) court-mandated to attend intervention programs for intimate partner violence (IPV) perpetrators have been identified as a high-risk, highly resistant group of IPV perpetrators, as they present lower treatment adherence and higher dropout and recidivism rates. Previous research suggests that IPV perpetrators with ADUPs may require tailored interventions to address their specific risk factors. The present systematic review was conducted using PRISMA guidelines to identify the specific risk factors in men with and without ADUPs on entry to court-mandated perpetrator programs. The following databases were searched from inception to November 2021: Web of Science, PsycINFO, and Scopus. There was a screening of 3,995 records, and 29 quantitative studies were included in the review. Risk factors present in males court-mandated to perpetrator programs were grouped into four categories: sociodemographic risk factors, personality disorders and psychological adjustment, social-relational risk factors, and risk factors related to attitudes towards women. Results indicated that the main risk factors in IPV perpetrators with ADUPs, compared to those without, were higher clinical symptomatology (e.g., anger and impulsivity), personality disorders, poorer executive functions, having experienced more stressful life events, higher exposure to childhood trauma, lower intimate social support, and higher responsibility attributed to the offenders' personal context. These results contribute to a deeper understanding of the complex phenomenon of IPV and ADUPs, and could help to inform key targets for perpetrator programs that may improve the well-being of their (ex)partners and increase the effectiveness of intervention programs for IPV perpetrators.
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Affiliation(s)
- Cristina Expósito-Álvarez
- University of ValenciaDepartment of Social PsychologyValenciaSpainDepartment of Social Psychology, University of Valencia, Spain
| | - Faraj A. Santirso
- University of ValenciaDepartment of Social PsychologyValenciaSpainDepartment of Social Psychology, University of Valencia, Spain
| | - Gail Gilchrist
- National Addiction CentreInstitute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUKNational Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Enrique Gracia
- University of ValenciaDepartment of Social PsychologyValenciaSpainDepartment of Social Psychology, University of Valencia, Spain
| | - Marisol Lila
- University of ValenciaDepartment of Social PsychologyValenciaSpainDepartment of Social Psychology, University of Valencia, Spain
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Lila M, Gilchrist G. Treatment Resistant Perpetrators of Intimate Partner Violence: Research Advances. INTERVENCION PSICOSOCIAL 2023; 32:55-58. [PMID: 37383643 PMCID: PMC10294455 DOI: 10.5093/pi2023a10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Affiliation(s)
- Marisol Lila
- University of ValenciaDepartment of Social PsychologyValenciaSpainDepartment of Social Psychology, University of Valencia, Spain;
| | - Gail Gilchrist
- National Addiction CentreInstitute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUKNational Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
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Gilchrist G, Potts LC, Connolly DJ, Winstock A, Barratt MJ, Ferris J, Gilchrist E, Davies E. Experience and perpetration of intimate partner violence and abuse by gender of respondent and their current partner before and during COVID-19 restrictions in 2020: a cross-sectional study in 13 countries. BMC Public Health 2023; 23:316. [PMID: 36782157 PMCID: PMC9924203 DOI: 10.1186/s12889-022-14635-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 11/15/2022] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Intimate partner violence and abuse (IPVA) includes controlling behaviours, psychological, physical, sexual and financial abuse. Globally, surveys and emergency services have recorded an increase in IPVA since restrictions were imposed to limit COVID-19 transmission. Most studies have only included heterosexual women. METHODS Data from the Global Drug Survey (an annual, anonymous, online survey collecting data on drug use) Special Edition were analysed to explore the impact of COVID-19 on people's lives, including their intimate relationships. Five relationship groupings were created using respondents' lived gender identity: women partnered with men (46.9%), women partnered with women (2.1%), men partnered with men (2.9%), men partnered with women (47.2%), and partnerships where one or both partners were non-binary (1%). Self-reported experience and perpetration of IPVA in the past 30 days before (February) and during COVID-19 restrictions (May or June) in 2020 (N = 35,854) was described and compared for different relationship groupings using Fishers Exact Tests. Changes in IPVA during restrictions were assessed using multivariable logistic regression. RESULTS During restrictions, 17.8 and 16.6% of respondents had experienced or perpetrated IPVA respectively; 38.2% of survivors and 37.6% of perpetrators reported this had increased during restrictions. Greater proportions of non-binary respondents or respondents with a non-binary partner reported experiencing or perpetrating IPVA (p < .001) than other relationship groupings. 22.0% of respondents who were non-binary or had a non-binary partner, 19.5% of men partnered with men, 18.9% of men partnered with women, 17.1% of women partnered with women and 16.6% of women partnered with men reported experiencing IPVA. Respondents with higher psychological distress, poor coping with pandemic-related changes, relationship tension and changes (increases or increases and decreases) in alcohol consumption reported increased experience of IPVA during restrictions. CONCLUSIONS This study confirmed that IPVA can occur in all intimate relationships, regardless of gender of the perpetrator or survivor. Non-binary respondents or respondents with non-binary partners reported the highest use and experience of IPVA. Most IPVA victim support services have been designed for heterosexual, cisgender women. IPVA support services and perpetrator programmes must be tailored to support all perpetrators and survivors during the pandemic and beyond, regardless of their sexual or gender identity.
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Affiliation(s)
- Gail Gilchrist
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Laura C. Potts
- grid.13097.3c0000 0001 2322 6764Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Dean J. Connolly
- grid.13097.3c0000 0001 2322 6764National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,grid.439471.c0000 0000 9151 4584Barts Health NHS Trust, Whipps Cross University Hospital, London, UK
| | - Adam Winstock
- grid.83440.3b0000000121901201Institute of Epidemiology and Health Care, University College London, London, UK ,Global Drug Survey, London, UK
| | - Monica J. Barratt
- grid.1017.70000 0001 2163 3550Social and Global Studies Centre and Digital Ethnography Research Centre, RMIT University, Melbourne, Australia ,grid.1005.40000 0004 4902 0432National Drug and Alcohol Research Centre, UNSW Sydney, Randwick, Australia
| | - Jason Ferris
- grid.1003.20000 0000 9320 7537Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Elizabeth Gilchrist
- grid.4305.20000 0004 1936 7988School of Health in Social Sciences, University of Edinburgh, Edinburgh, UK
| | - Emma Davies
- grid.7628.b0000 0001 0726 8331Centre for Psychological Research, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
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Kar A, Das N, Broadway-Horner M, Kumar P. Intimate Partner Violence in Same-Sex Relationships: Are We Aware of the Implications? JOURNAL OF PSYCHOSEXUAL HEALTH 2022. [DOI: 10.1177/26318318221134268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Intimate partner violence (IPV) has been a significant public health problem in same-sex relationships. However, health policies across the globe do not address IPV causing a massive gap in health and economic burden. In the last decade, crucial missing links have been established, and researchers tried to connect the dots of this severe health disparity. This intersectionality has found the impact of race, gender, class, physical ability, and legal framework of IPV in lesbian, gay, and bisexual (LGB) relationships. However, preventive strategies, training programs, and dialogues in the clinical field about IPV are from heteronormative lenses. This particular bias can perpetuate the issue and will remain one of the leading causes of health burden in the LGB population. This article reviews the lacunae in health policies regarding same-sex IPV, highlights its impact on minority mental health, and calls for attention to train health-care professionals regarding the same.
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Affiliation(s)
- Anindya Kar
- Advanced Neuropsychiatry Institute, Kolkata, West Bengal, India
- Gloucestershire Health and Care NHS Foundation Trust, Gloucester, United Kingdom
| | - Nabagata Das
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Matt Broadway-Horner
- Department of Health and Social Care, University of Chester, Chester, United Kingdom
| | - Praveen Kumar
- Department of Psychiatry, New Craig’s Hospital, NHS Highland, United Kingdom
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Yakubovich AR, Heron J, Metheny N, Gesink D, O’Campo P. Measuring the Burden of Intimate Partner Violence by Sex and Sexual Identity: Results From a Random Sample in Toronto, Canada. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP18690-NP18712. [PMID: 34376084 PMCID: PMC9554278 DOI: 10.1177/08862605211037433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Debates on how sex, gender, and sexual identity relate to intimate partner violence (IPV) are longstanding. Yet the role that measurement plays in how we understand the distribution of IPV has been understudied. We investigated whether people respond differently to IPV items by sex and sexual identity and the implications this has for understanding differences in IPV burdens. Our sample was 2,412 randomly selected residents of Toronto, Canada, from the Neighborhood Effects on Health and Well-being (NEHW) study. IPV was measured using short forms of the Physical and Nonphysical Partner Abuse Scales (20 items). We evaluated the psychometric properties of this measure by sex and sexual identity. We examined whether experiences of IPV differed by sex and sexual identity (accounting for age and neighborhood clustering) and the impacts of accounting for latent structure and measurement variance. We identified differential item functioning by sex for six items, mostly related to nonphysical IPV (e.g., partner jealousy). Males had higher probabilities of reporting five of the six items compared to females with the same latent IPV scores. Being female and identifying as lesbian, gay, or bisexual were positively associated with experiencing IPV. However, the association between female sex and IPV was underestimated when response bias was not accounted for and outcomes were dichotomized as "any IPV." Common practices of assuming measurement invariance and dichotomizing IPV can underestimate the association between sex or gender and IPV. Researchers should continue to attend to gender-based and intersectional differences in IPV but test for measurement invariance prior to comparing groups and analyze scale (as opposed to binary) measures to account for chronicity or intensity.
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Affiliation(s)
| | | | | | | | - Patricia O’Campo
- Unity Health Toronto, ON, Canada
- University of Toronto, ON,
Canada
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Trombetta T, Rollè L. Intimate Partner Violence Perpetration Among Sexual Minority People and Associated Factors: A Systematic Review of Quantitative Studies. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2022; 20:1-50. [PMID: 36097504 PMCID: PMC9452866 DOI: 10.1007/s13178-022-00761-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/25/2022] [Indexed: 05/31/2023]
Abstract
Introduction Intimate partner violence (IPV) among sexual minority people has been underestimated since few decades ago despite its spreading. The current systematic review aims to review and systematize studies on factors associated with IPV perpetration within this population. Methods Data search was conducted on EBSCO and PubMed considering articles published until July 2022, and 78 papers were included. Results Although methodological limitations can affect the results found, the data demonstrated an association between IPV perpetration and psychological, relational, family of origin-related and sexual minority-specific factors, substance use, and sexual behaviors. Conclusion The findings emerged highlight the importance of a multidimensional approach to tackle IPV perpetration among sexual minority people and limit relapses, while increasing individual and relational wellbeing. Policy Implications The empirical evidence emerged can contribute to the development of policies and services tailored for sexual minority people victims of IPV, to date still scarce and often ineffective.
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Affiliation(s)
- Tommaso Trombetta
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Torino, TO Italy
| | - Luca Rollè
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Torino, TO Italy
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Trombetta T, Rollè L. Intimate Partner Violence Perpetration Among Sexual Minority People and Associated Factors: A Systematic Review of Quantitative Studies. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2022; 20:1-50. [PMID: 36097504 DOI: 10.1007/s13178-021-00629-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/25/2022] [Indexed: 05/20/2023]
Abstract
INTRODUCTION Intimate partner violence (IPV) among sexual minority people has been underestimated since few decades ago despite its spreading. The current systematic review aims to review and systematize studies on factors associated with IPV perpetration within this population. METHODS Data search was conducted on EBSCO and PubMed considering articles published until July 2022, and 78 papers were included. RESULTS Although methodological limitations can affect the results found, the data demonstrated an association between IPV perpetration and psychological, relational, family of origin-related and sexual minority-specific factors, substance use, and sexual behaviors. CONCLUSION The findings emerged highlight the importance of a multidimensional approach to tackle IPV perpetration among sexual minority people and limit relapses, while increasing individual and relational wellbeing. POLICY IMPLICATIONS The empirical evidence emerged can contribute to the development of policies and services tailored for sexual minority people victims of IPV, to date still scarce and often ineffective.
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Affiliation(s)
- Tommaso Trombetta
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Torino, TO Italy
| | - Luca Rollè
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Torino, TO Italy
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Blosnich JR. Interpersonal and self-directed violence among sexual and gender minority populations: Moving research from prevalence to prevention. CURR EPIDEMIOL REP 2022; 9:142-160. [PMID: 36845319 PMCID: PMC9957556 DOI: 10.1007/s40471-022-00299-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 11/03/2022]
Abstract
Purpose of review This scoping review of reviews aimed to detail the breadth of violence research about sexual and gender minorities (SGM) in terms of the three generations of health disparities research (i.e., documenting, understanding, and reducing disparities). Recent findings Seventy-three reviews met inclusion criteria. Nearly 70% of the reviews for interpersonal violence and for self-directed violence were classified as first-generation studies. Critical third-generation studies were considerably scant (7% for interpersonal violence and 6% for self-directed violence). Summary Third-generation research to reduce or prevent violence against SGM populations must account for larger scale social environmental dynamics. Sexual orientation and gender identity (SOGI) data collection has increased in population-based health surveys, but administrative datasets (e.g., health care, social services, coroner and medical examiner offices, law enforcement) must begin including SOGI to meet the needs of scaled public health interventions to curb violence among SGM communities.
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Affiliation(s)
- John R. Blosnich
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W 34 St., Los Angeles, CA 90089, USA
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania 15240, USA
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13
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Powers RA, Kaukinen CE. Gender Differences in the Relationship Between Sexual Activity and Dating Violence: The Role of Satisfaction, Jealousy, and Self-control. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP9420-NP9445. [PMID: 33349124 DOI: 10.1177/0886260520983274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
While research has shown that sexual intercourse within a relationship is positively associated with physical intimate partner violence (IPV) perpetration, particularly among young adults, whether well-known correlates of IPV moderate this relationship and whether these effects are gendered is less known. We draw on data from the International Dating Violence Study (2001-2006; n = 5,502) to more thoroughly explore sexual activity in a relationship on the risk for dating violence perpetration among college students in heterosexual relationships. First, the relationship between sexual activity and physical IPV is examined. Second, this study examines the role of sexual satisfaction/disagreement on IPV among sexually active participants as a potential mechanism by which sexual activity impacts IPV. Third, this study examines whether jealousy and self-control, two well-known correlates of IPV, moderate the relationship between sexual activity and IPV. For all analyses, gendered effects were examined. We found that sexual activity was positively related to overall and severe (i.e., potentially injurious) IPV perpetration and the effects were comparable between men and women. Likewise, although there was gender symmetry in the main effects of jealousy, results demonstrate that the interaction between intimacy and jealousy was gendered. Conversely, self-control was related to IPV comparably for men and women but did not moderate the effects of intimacy. Sexual satisfaction was unrelated to IPV perpetration for men and women, but women who report disagreement over frequency of intercourse reported higher offending. The theoretical implications of the current study are discussed as well as avenues for prevention and intervention programming, including collaborative, campus-based approaches to both violence prevention, healthy relationships, and sexual decision-making.
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Lin K, Hu R, Wang X, Xue J. Female Same-Sex Bidirectional Intimate Partner Violence in China. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP6881-NP6902. [PMID: 33092433 DOI: 10.1177/0886260520959624] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Although there exists a growing body of research on female same-sex intimate partner violence (FSSIPV) as well as bidirectional intimate partner violence (BIPV) among lesbian women, much of this literature focuses on the IPV experience of women living in Western societies such as the United States. The current study represents the very first to explore BIPV among lesbian women in China. In this study, we analyze a survey sample of 225 self-identified lesbian women in China to examine FSSBIPV patterns, pattern-specific rates, and risk factors of FSSBIPV. Using the Latent Class Analysis technique, we discover three main patterns of partner abuse, including bidirectional psychological violence (60%), bidirectional violence multiple types with physical abuse (79.1%), and minimal violence (20.9%). Logistic regressions show that there is no significant demographic, socioeconomic, or attitudinal difference between the bidirectional psychological violence group and the minimal violence group while being younger, cohabitating, and holding pro-IPV attitudes significantly predicted higher odds of experiencing multiple types of bidirectional violence. Contributions to the literature, as well as policy implications, are also discussed.
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Affiliation(s)
- Kai Lin
- California State University, Sacramento, CA, USA
| | - Ran Hu
- University of Toronto, Ontario, Canada
| | - Xiying Wang
- Beijing Normal University, Beijing, People's Republic China
| | - Jia Xue
- University of Toronto, Ontario, Canada
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Tognasso G, Trombetta T, Gorla L, Ramon S, Santona A, Rollè L. Romantic Attachment, Internalized Homonegativity, and Same-Sex Intimate Partner Violence Perpetration Among Lesbian Women in Italy. Front Psychol 2022; 13:870921. [PMID: 35465549 PMCID: PMC9021864 DOI: 10.3389/fpsyg.2022.870921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 02/25/2022] [Indexed: 11/13/2022] Open
Abstract
Same-Sex Intimate Partner Violence (SSIPV) among lesbian women has been underestimated until few decades ago. While the association between romantic attachment and SSIPV has been widely demonstrated, mechanisms that mediate this association and the complex relationships between romantic attachment, SSIPV, and SSIPV-specific risk factors have not been adequately investigated to date. The current study assessed the influence of romantic attachment on SSIPV perpetration among lesbian women, exploring the mediating role of internalized homonegativity within this association. Three hundred and twenty-five Italian lesbian women with a mean age of 30 years were recruited and completed the following self-report measures: the Experiences in Close Relationships-Revised (ECR-R), the Measure of Internalized Sexual Stigma, and the Revised Conflict Tactics Scale Short Form. The results showed a positive association between attachment anxiety, and general and psychological SSIPV perpetration. Similarly, attachment avoidance was positively related with general, psychological, and physical SSIPV perpetration. The association between romantic attachment, and general and psychological SSIPV was partially mediated by internalized homonegativity. These findings have theoretical implications and provide valuable information to implement services and interventions tailored for SSIPV, to date scarce and not effective.
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Affiliation(s)
- Giacomo Tognasso
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | | | - Laura Gorla
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Shulamit Ramon
- Department of Allied Health, Midwifery and Social Work, University of Hertfordshire, Hatfield, United Kingdom
| | | | - Luca Rollè
- Department of Psychology, University of Torino, Turin, Italy
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Swann G, Dyar C, Newcomb ME, Whitton SW. Longitudinal Transitions in Intimate Partner Violence among Female Assigned at Birth Sexual and Gender Minority Youth. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP4578-NP4603. [PMID: 32954911 PMCID: PMC7981285 DOI: 10.1177/0886260520959647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Female-assigned at birth sexual and gender minorities (FAB SGM) are at elevated risk of experiencing intimate partner violence (IPV), yet little longitudinal research has been conducted with this population. In the current study, we attempted to understand how patterns of IPV victimization and perpetration, measured across a wide range of IPV behaviors (psychological, physical, sexual, cyber, and SGM-specific), changed over time for FAB SGM youth. Participants came from a longitudinal cohort study of FAB SGM late adolescents and young adults (FAB400; N = 488) and included anyone who reported a romantic partner at one of the first three waves (six months apart; N = 433). Latent class analysis (LCA) was run at each wave to determine the best-fitting class structure across IPV experiences. These were followed up with latent transition analyses (LTAs) to determine patterns of movement between classes over the course of the three waves. Lastly, we looked at the effects of staying with the same romantic partner on transitions. We found that the same three-class structure replicated across all three waves of the study. That class structure identified no/low, psychological, and high IPV classes at each wave. In the LTA, when transitions occurred for FAB SGM, they were much more likely to transition to a class defined by lower likelihoods of experiencing IPV (i.e., psychological to no/low) than they were to a class defined by higher likelihoods of IPV (i.e., psychological to high). However, we found that FAB SGM youth were less likely to transition to a less severe IPV class if they maintained the same serious romantic partner across waves. This finding, in particular, suggests that IPV is often relationship specific for FAB SGM and that efforts to reduce IPV in SGM communities must consider intervening at the relationship level to effect meaningful change.
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Affiliation(s)
- Gregory Swann
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA
| | - Christina Dyar
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA
| | - Michael E. Newcomb
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA
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Kim C, Schmuhl M. Assessment of Research on Intimate Partner Violence (IPV) Among Sexual Minorities in the United States. TRAUMA, VIOLENCE & ABUSE 2021; 22:766-776. [PMID: 31630642 DOI: 10.1177/1524838019881732] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Although sexual minority couples experience intimate partner violence (IPV) similar to or higher than heterosexual couples, not much attention has been given to LGBTQ couples. Using content analysis, this integrative review seeks to examine the state of scholarly literature regarding IPV among LGBTQ+ communities in the United States. For studies to be eligible for inclusion in this review, studies were required to focus on LGBTQ+ populations within the United States, published in English, involved violence between intimate partners, were the result of peer-reviewed, original research, and were published between years 2008 and 2018. Using SocIndex as the search database, a total of 46 peer-reviewed journal articles met the inclusion criteria. This study found that most studies employed quantitative research designs aiming to examine the statistical relationship between IPV and other variables by using surveys. Demographic information of the participants was mostly used as predictors of IPV, whereas health-related risky behaviors were mostly used as outcomes variables that were associated with IPV. Theoretical frameworks, methodology, and policy suggestions used in each study were examined in depth. A discussion of future studies and policy implications follows the findings of this study.
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Affiliation(s)
- Chunrye Kim
- Sociology and Criminal Justice Department, 124477Saint Joseph's University, Philadelphia, PA, USA
| | - Margaret Schmuhl
- Public Justice Department, 14828State University of New York at Oswego, NY, USA
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18
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Prevalence of Intimate Partner Violence Among Men Who Have Sex With Men: An Updated Systematic Review and Meta-Analysis. Sex Med 2021; 9:100433. [PMID: 34571326 PMCID: PMC8766270 DOI: 10.1016/j.esxm.2021.100433] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/03/2021] [Accepted: 08/10/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction Intimate partner violence (IPV) among men who have sex with men (MSM) has become a serious and widespread public health issue, which might result in low quality of life and increase the global burden of diseases. Aim To quantitatively estimate the pooled prevalence of IPV and its specific forms (physical violence, sexual violence and emotional violence) among MSM. Methods Databases of PubMed, Cochrane Library, CINAHL, MEDLINE, PsycINFO, CNKI, WANFANG Data, and Weipu (CQVIP) Data were searched for identified studies published between January 1990 and August 2020. Random effect meta-analyses were used to synthesize the pooled prevalence and 95% CIs of IPV. Main Outcome Measures The pooled prevalence of IPV in victimization and in perpetration among MSM. Results A total of 52 studies with 32,048 participants were included for final analysis. The pooled prevalence of IPV was 33% (6,342 of 19,873; 95%CI, 28–39%) in victimization and 29% (1,491 of 5,983; 95%CI, 17 –40%) in perpetration across all recall periods among MSM population. Furthermore, the pooled prevalence of physical violence was 17% (3,979 of 22,928; 95%CI, 14 –20%) and 12% (942 of 9,236; 95%CI, 10 –15%), of sexual violence was 9% (1,527 of 19,511; 95%CI, 8 –11%) and 4% (324 of 8,044; 95%CI, 3 –5%), of emotional violence was 33% (5,147 of 17,994; 95%CI, 25 –40%) and 41% (1,317 of 3,811; 95%CI, 17 –65%) in victimization and perpetration, respectively. Out of all the IPV identified, emotional violence was estimated at the highest level. Conclusion This study demonstrated a high prevalence of IPV both in victimization and perpetration among MSM, and emotional violence was estimated at the highest level out of all IPV forms. Efforts are needed to develop corresponding prevention programs for victims with an intent to increase the accessible availability of health services, and ultimately improve their life quality. Liu M., Cai X., Hao G. et al., Prevalence of Intimate Partner Violence Among Men Who Have Sex With Men: An Updated Systematic Review and Meta-Analysis. Sex Med 2021;9:100433.
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19
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Risk and Protective Factors for Adolescent Relationship Abuse across Different Sexual and Gender Identities. J Youth Adolesc 2021; 50:1521-1536. [PMID: 34128143 PMCID: PMC10177626 DOI: 10.1007/s10964-021-01461-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 05/29/2021] [Indexed: 10/21/2022]
Abstract
Little is known about the characteristics and context of adolescent relationship abuse victimization across youth of different sexual and gender minority identities. This study sought to examine this in a national sample of 14-15-year-old youth. The sample comprised 3296 youth who reported having been in a relationship, of which 36% (n = 1197) were exclusively cisgender heterosexual; 41% (n = 1, 349) cisgender sexual minority; and 23% (n = 750) gender minority, the majority of whom were also sexual minority. More than half of all youth who had been in a relationship, dated or hooked up with someone had experienced some form of adolescent relationship abuse victimization. Gender minority youth, in particular transgender boys and non-binary youth assigned female at birth, were more likely to be victims of multiple types of adolescent relationship abuse compared to cisgender youth. Perpetrator gender varied for sexual and gender minorities and was more homogenous for cisgender heterosexual youth. Several factors were associated with adolescent relationship abuse for all youth, although alcohol use, and parental trust and communication emerged as particularly important for sexual and gender minority youth. Overall, findings address multiple gaps in the literature and contribute to the understanding of adolescent relationship abuse across different sexual and gender identities.
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20
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Islam S. Perceptions of Psychological Intimate Partner Violence: The Influence of Sexual Minority Stigma and Childhood Exposure to Domestic Violence among Bisexual and Lesbian Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5356. [PMID: 34069849 PMCID: PMC8157349 DOI: 10.3390/ijerph18105356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/11/2021] [Accepted: 05/14/2021] [Indexed: 12/02/2022]
Abstract
Sexual minority women (SMW; bisexual, lesbian) experience psychological intimate partner violence (IPV) disproportionately more than physical forms and have higher lifetime victimization rates than heterosexual women. This study presents an examination of perceptions of psychological IPV, sexual minority stigma, and childhood exposure to domestic violence among a sample of 183 SMW residing within the U.S. With an emphasis on group differences between bisexual and lesbian women, findings indicate that bisexual women evaluated vignettes depicting psychological IPV occurring among women in same-gender relationships with more negative sentiment than lesbian women. Significant associations between enacted and internalized forms of stigma and perceptions of psychological IPV also varied among bisexual and lesbian women. No significant relationships were found between perceived stigma and perceptions of IPV in either group. Furthermore, no moderation effects were detected for childhood exposure to domestic violence or sexual orientation in the relationship between sexual minority stigma and perceptions of IPV. Implications and suggestions are discussed with particular attention to the heterogeneity of experiences among SMW as a necessary area of further study.
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Affiliation(s)
- Sabrina Islam
- School of Public Health, University of California, 2121 Berkeley Way, Berkeley, CA 94720, USA;
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704, USA
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21
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Rizo CF, O'Brien J, Wretman C, Givens A, Kainz K, Chesworth B. Investigating the Complex Relationship Between Intimate Partner Violence Victimization and Perpetration Among System-Involved Women in Heterosexual Relationships: An Exploratory Analysis. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP3738-NP3764. [PMID: 29911478 DOI: 10.1177/0886260518780781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Research indicates women who perpetrate intimate partner violence (IPV) experience both more frequent and more severe IPV victimization. However, the IPV field needs additional research to understand the complex relationship between various forms of IPV victimization (e.g., psychological, physical, sexual) and IPV perpetration by women. In particular, the field needs a better understanding of the unique interplay of various forms of IPV victimization and perpetration among female system-involved survivors (i.e., female survivors involved with child protective services and/or the court system and mandated to services). Such understanding would aid extant efforts to ensure that mandated services address the experiences and meet the needs of these system-involved women. To address this knowledge gap, we conducted an exploratory, secondary data analysis using cross-sectional baseline data collected as part of a larger evaluation study of a psychoeducational therapeutic IPV and parenting program for system-involved IPV survivors mandated to services (N = 73). Results from multiple regression analyses revealed that both psychological and physical IPV victimization were uniquely associated with the perpetration of psychological and physical abuse by system-involved female IPV survivors. Furthermore, our examination of the interaction between physical and psychological victimization and its impact on perpetration revealed that higher levels of both physical and psychological IPV victimization were associated with significantly higher levels of psychological perpetration (p < .01) and increased likelihood of physical perpetration (p < .05). Results are discussed in the context of service provision within systems, agencies, and programs targeting system-involved women mandated to services for IPV.
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Affiliation(s)
| | | | | | - Ashley Givens
- The University of North Carolina at Chapel Hill, USA
| | - Kirsten Kainz
- The University of North Carolina at Chapel Hill, USA
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23
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Wilkerson JM, Di Paola A, Nieto D, Schick V, Latini DM, Braun-Harvey D, Zoschke IN, McCurdy S. Sexual Violence and Chemsex among Substance-Using Sexual and Gender Minorities in Texas. Subst Use Misuse 2021; 56:2141-2150. [PMID: 34550052 DOI: 10.1080/10826084.2021.1975743] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
UNLABELLED Chemsex is the use of methamphetamine or other substances to enhance sexual experiences, and is most often associated with sexual minority men. Within the chemsex literature, questions of sexual violence emerge due, in part, to ambiguity about what constitutes consent within sexualized environments with co-occurring substance use. To understand the context in which sexual violence occurs, data from an online survey of sexual and gender minority Texans were analyzed using bivariate and logistic regression (N = 1273), and qualitative interviews with substance-using sexual minority men from a separate sample were thematically analyzed (N = 22). Among survey participants, 12.8% experienced a form of sexual violence (10.1% experienced intimate partner violence and 7.6% experienced sexual assault). When participants were categorized based on past year substance use and sex party attendance, 48.0% of participants who used drugs and attended sex parties (a proxy for chemsex) experienced sexual violence (41.6% experienced intimate partner violence and 41.0% experienced sexual assault). When variables statistically significant at the bivariate-level were entered into logistic regression models, participants in the chemsex category were 12.5 [95% CI: 6.9, 22.8] times more likely to experience sexual violence. Substance-using sexual minority men experiencing sexual violence describe situations in which consent is difficult to revoke and sexual exploitation is likely to occur. Studies which more deeply explore the relationship between sexual and relationship violence and chemsex among sexual and gender minorities are needed. Particularly, the notion of consent needs further conceptualization in the context of drug use and sex parties. HIGHLIGHTS Measures of recent substance use and sex party attendance were combined to create a proxy measure for chemsex, which is the use of substances to enhance sexual experiences.Substance-using sexual and gender minorities engaging in chemsex were at increased risk of sexual violence.In addition to engaging in chemsex, variables associated with an increased odds of sexual violence among sexual and gender minorities were younger age, having a non-monosexual sexual identity, and receiving a mental health diagnoses.Studies on sexual and gender minorities engaging in chemsex should be developed to further explore sexual exploitation.
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Affiliation(s)
- J Michael Wilkerson
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA
| | - Angela Di Paola
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA
| | - Dominica Nieto
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA
| | - Vanessa Schick
- Department of Management, Policy and Community Health, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA
| | - David M Latini
- Scott Department of Urology, the Montrose Center, and the Montrose Research Institute, Baylor College of Medicine, Houston, Texas, USA
| | | | - I Niles Zoschke
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA
| | - Sheryl McCurdy
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA
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Osório L, Sani A, Soeiro C. VIOLÊNCIA NA INTIMIDADE NOS RELACIONAMENTOS HOMOSSEXUAIS GAYS E LÉSBICOS. PSICOLOGIA & SOCIEDADE 2020. [DOI: 10.1590/1807-0310/2020v32170358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo O presente estudo teve como objetivo estudar a prevalência da violência na intimidade nos relacionamentos homossexuais, gays e lésbicos. A amostra foi constituída por 48 participantes de nacionalidade portuguesa, com idades compreendidas entre os 18 e os 55 anos (M=26.50; DP=8.011), sendo que 72.9% (n=35) se identificam como lésbicas (sexo feminino) e 27.1% (n=13) se identificam como gay (sexo masculino). As tipologias de violência identificadas com maior prevalência pelas vítimas foram a violência psicológica, seguindo-se a violência física, a violência socioeconômica e a violência sexual. No contexto de perpetração de abuso, as tipologias de violência identificadas com maior prevalência foram a violência psicológica, seguindo-se a violência física e, por fim, com a mesma prevalência, a violência sexual e a violência socioeconômica. Afigura-se necessário um maior investimento na produção de conhecimento científico nesta área.
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Affiliation(s)
| | - Ana Sani
- Universidade Fernando Pessoa, Portugal; Universidade do Minho, Portugal
| | - Cristina Soeiro
- Instituto Superior de Ciências da Saúde Egas Moniz, Portugal
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McKay T, Lindquist CH, Misra S. Understanding (and Acting On) 20 Years of Research on Violence and LGBTQ + Communities. TRAUMA, VIOLENCE & ABUSE 2019; 20:665-678. [PMID: 29334007 DOI: 10.1177/1524838017728708] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Questions related to violence, vulnerability, and sexual and gender minorities continuing to occupy a focal place in U.S. public discourse. We reviewed findings from 20 years of research on that topic to make recommendations for policy, practice, and future research. This article synthesizes findings from 102 peer-reviewed articles as well as a small number of unpublished studies and grey literature. We found no data to support the idea (widespread in popular discourse) that those in the sexual or gender majority require protection from sexual or gender minority individuals. Instead, this wide body of research indicates that sexual and gender minorities are themselves at elevated risk for physical and sexual assault, harassment, bullying, and hate crime victimization throughout childhood, adolescence, and adulthood. Contradicting the image of hate crimes as perpetrated by strangers or acquaintances, we find that bias-related verbal abuse, physical, and sexual assault by close family members contribute heavily to observed victimization rates. Further, despite the perception that society is becoming more welcoming, victimization disparities appear to be stable or widening since the 1990s. More studies with probabilistic sampling approaches, standardized measures, and larger samples of gender minorities are needed. However, widespread victimization of sexual and gender minorities is clearly an urgent issue, demanding attention from clinicians, program developers, and policy makers.
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Affiliation(s)
- Tasseli McKay
- Violence and Victimization Research Program, Center for Justice, Safety and Resilience, RTI International, Durham, NC, USA
| | - Christine H Lindquist
- Courts and Corrections Research Program, Center for Justice, Safety and Resilience, RTI International, Durham, NC, USA
| | - Shilpi Misra
- Transnational Crime and Justice Research Program, Center for Justice, Safety and Resilience, RTI International, Durham, NC, USA
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26
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Bradbury-Jones C, Appleton JV, Clark M, Paavilainen E. A Profile of Gender-Based Violence Research in Europe: Findings From a Focused Mapping Review and Synthesis. TRAUMA, VIOLENCE & ABUSE 2019; 20:470-483. [PMID: 29334031 DOI: 10.1177/1524838017719234] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This article reports the findings from a new form of review: a focused mapping review and synthesis. The aim was to create a contemporary, snapshot profile of the nature and scope of gender-based violence (GBV) studies conducted in Europe. GBV is one of the most prevalent human rights violations in the world affecting mainly women and girls. The policy context of GBV in Europe has gathered momentum in recent years, but we do not have a clear picture of how this relates to research activity. Thirteen journals were purposively selected on their likelihood to publish GBV research. All articles published in these journals during 2015 and meeting our inclusion criteria were retrieved. Data were extracted according to (1) types of methodologies used, (2) geographical location of research, and (3) patterns of research activity/interest. Thirty-two articles met the inclusion criteria. Many titles and abstracts were not explicit about the gendered nature of the research which made retrieval and analysis difficult. A range of methodologies were reported, with single-country research conducted more than international collaborations. Intimate partner violence and sexual abuse attracted most research interest. No studies explored female genital mutilation/cutting and only one investigated early and forced marriage. The findings have implications regarding GBV research in Europe, and we explore them in relation to relevant European policy. Researchers can help raise the profile of the gendered nature of most violence-related research by being explicit about this in their publications. Increasing opportunities for cross-national research will help address the global nature of GBV. Tackling GBV requires synergy of empirical evidence and policy to drive the agenda.
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Affiliation(s)
- Caroline Bradbury-Jones
- 1 College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Jane V Appleton
- 2 Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom
| | - Maria Clark
- 1 College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Eija Paavilainen
- 3 School of Health Sciences, University of Tampere, Tampere, Finland
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Badenes-Ribera L, Sánchez-Meca J, Longobardi C. The Relationship Between Internalized Homophobia and Intimate Partner Violence in Same-Sex Relationships: A Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2019; 20:331-343. [PMID: 29333955 DOI: 10.1177/1524838017708781] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A meta-analysis was conducted to investigate the association between internalized homophobia and intimate partner violence (IPV) perpetration and victimization in same-sex relationships. The literature search and the application of the inclusion criteria made it possible to identify 10 studies, 2 of which were excluded due to missing data. Therefore, eight studies were finally included in the meta-analysis. The results showed positive and statistically significant associations between internalized homophobia and IPV perpetration and victimization, indicating that higher levels of internalized homophobia were related to higher levels of IPV. Specifically, the pooled effect size for the relationship between internalized homophobia and IPV perpetration (all forms), it was r+ = .147, 95% confidence interval (CI) = [.079, .214]; for the association between internalized homophobia and physical/sexual IPV perpetration, it was r+ = .166, 95% CI [.109, .221]; p < .0001; for the relationship between internalized homophobia and psychological IPV perpetration, it was r+ = .145, 95% CI [.073, .216]; and for the association between internalized homophobia and any type of IPV victimization, it was r+ = .102, 95% CI [.030, .173]. Implications of these results for clinical practice and future research are discussed.
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Affiliation(s)
- Laura Badenes-Ribera
- 1 Department of Methodology of the Behavioral Sciences, University of Valencia, Valencia, Spain
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Whitton SW, Dyar C, Mustanski B, Newcomb ME. Intimate Partner Violence Experiences of Sexual and Gender Minority Adolescents and Young Adults Assigned Female at Birth. PSYCHOLOGY OF WOMEN QUARTERLY 2019; 43:232-249. [PMID: 31649417 PMCID: PMC6812525 DOI: 10.1177/0361684319838972] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sexual and gender minority youth, especially those assigned female at birth, are at risk for intimate partner violence (IPV) due to minority stressors. With a sample of 352 sexual and gender minority youth assigned female at birth (age 16-32), we aimed to describe IPV in this population, including the prevalence, directionality, frequency, co-occurrence, and demographic correlates of various IPV types. Rates of past-6-month IPV were high, with victimization and perpetration of minor psychological IPV most common (64-70%); followed by severe psychological, minor physical, and coercive control (20-33%); and severe physical and sexual IPV (10-15%). For cyber abuse and IPV tactics leveraging anti-sexual minority stigma, victimization (12.5% and 15%, respectively) was more common than perpetration (8% and 6%, respectively). Most IPV was bidirectional and occurred 1-2 times in 6 months, although frequency varied considerably. Latent class analyses revealed that half of participants reported no or minimal IPV; one-third experienced multiple forms of psychological IPV (including coercive control); and 10-15% reported psychological, physical, sexual, and cyber abuse. Racial minority youth had higher rates of most IPV types than White participants. We hope study findings will inform policies and interventions to prevent IPV among gender and sexual minority youth assigned female at birth.
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Affiliation(s)
| | - Christina Dyar
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University Feinberg School of Medicine
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University Feinberg School of Medicine
| | - Michael E Newcomb
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University Feinberg School of Medicine
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Health service use by same-sex attracted Australian women for alcohol and mental health issues: a cross-sectional study. BJGP Open 2018; 2:bjgpopen18X101565. [PMID: 30564720 PMCID: PMC6184099 DOI: 10.3399/bjgpopen18x101565] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 02/20/2018] [Indexed: 12/05/2022] Open
Abstract
Background Same-sex attracted women (SSAW) have higher rates of alcohol and mental health problems than heterosexual women, but utilisation of and satisfaction with treatment is limited. Aim This study investigated the influences on health service use for alcohol and mental health problems among SSAW. Design & setting The Gelberg-Andersen behavioural model of health service utilisation was used to generate outcome variables. Method A convenience sample of 521 community-connected Australian SSAW completed an online survey. Health service use according to sexual identity was compared using χ2 analysis. Binary logistic regression examined associations between the independent variables with treatment utilisation. Results Reports of alcohol treatment were very low. Only 41.1% of participants with service need had utilised mental health and alcohol treatment. Bisexual women (adjusted odds ratio [AOR] = 2.76) and those with ‘other’ identities (AOR = 2.38) were more likely to use services than lesbian women. Enablers to service use were having a regular GP (AOR = 3.02); disclosure of sexuality to the GP (AOR = 2.42); lesbian, gay, bisexual and transgender (LGBT) community-connectedness (AOR = 1.11); and intimate partner violence ([IPV] AOR = 2.51). Social support was associated with a reduction in treatment use (AOR = 0.97). Significant access barriers included not feeling ready for help, and previous negative experiences related to sexual identity. Conclusion Disclosing sexual identity to a regular, trusted GP correlated with improved utilisation of alcohol and mental health treatment for SSAW. The benefits of seeking help for alcohol use, and of accessing LGBT-inclusive GPs to do so, should be promoted to SSAW.
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Denson TF, O'Dean SM, Blake KR, Beames JR. Aggression in Women: Behavior, Brain and Hormones. Front Behav Neurosci 2018; 12:81. [PMID: 29770113 PMCID: PMC5942158 DOI: 10.3389/fnbeh.2018.00081] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 04/16/2018] [Indexed: 12/18/2022] Open
Abstract
We review the literature on aggression in women with an emphasis on laboratory experimentation and hormonal and brain mechanisms. Women tend to engage in more indirect forms of aggression (e.g., spreading rumors) than other types of aggression. In laboratory studies, women are less aggressive than men, but provocation attenuates this difference. In the real world, women are just as likely to aggress against their romantic partner as men are, but men cause more serious physical and psychological harm. A very small minority of women are also sexually violent. Women are susceptible to alcohol-related aggression, but this type of aggression may be limited to women high in trait aggression. Fear of being harmed is a robust inhibitor of direct aggression in women. There are too few studies and most are underpowered to detect unique neural mechanisms associated with aggression in women. Testosterone shows the same small, positive relationship with aggression in women as in men. The role of cortisol is unclear, although some evidence suggests that women who are high in testosterone and low in cortisol show heightened aggression. Under some circumstances, oxytocin may increase aggression by enhancing reactivity to provocation and simultaneously lowering perceptions of danger that normally inhibit many women from retaliating. There is some evidence that high levels of estradiol and progesterone are associated with low levels of aggression. We highlight that more gender-specific theory-driven hypothesis testing is needed with larger samples of women and aggression paradigms relevant to women.
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Affiliation(s)
- Thomas F Denson
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Siobhan M O'Dean
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Khandis R Blake
- Evolution & Ecology Research Centre, School of Biological, Earth & Environmental Science, University of New South Wales, Sydney, NSW, Australia
| | - Joanne R Beames
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
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Wong JYH, Choi EPH, Lo HHM, Wong W, Chio JHM, Choi AWM, Fong DYT. Dating violence, quality of life and mental health in sexual minority populations: a path analysis. Qual Life Res 2016; 26:959-968. [PMID: 27679496 DOI: 10.1007/s11136-016-1415-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE Theories explaining the impact of intimate partner violence (IPV) on mental health have focused on heterosexual relationships. It is unclear whether mental health disparities between heterosexual and sexual minority people are due to IPV or factors related to sexual orientation. The present study aimed to investigate pathways of how sexual orientation influenced quality of life and mental health. METHODS The present cross-sectional study was conducted in 1076 young adults in a university population (934 heterosexual and 142 sexual minority groups). Structural equation modelling was used to examine the pathways of sexual orientation, dating violence, sexual orientation concealment, quality of life and mental health (perceived stress, anxiety and depression). RESULTS After adjusting for sociodemographic factors, quality of life in sexual minority people was poorer [estimate -2.82, 95 % confidence interval (CI) -4.77 to -0.86, p = 0.005], and stress (estimate 2.77, 95 % CI 1.64-3.92, p < 0.0001), anxiety (estimate 1.84, 95 % CI 1.13-2.56, p < 0.0001) and depression levels (estimate 0.62, 95 % CI 0.05-1.2, p < 0.0001) were higher than in heterosexual people. Dating violence and sexual orientation concealment were mediators, with the models showing a good fit. CONCLUSION Our study has progressed investigation of the link between sexual orientation and quality of life and mental health in the Chinese context. It has helped identify health disparities between heterosexual and sexual minority people and determined specific factors affecting their quality of life and mental health.
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Affiliation(s)
- Janet Yuen-Ha Wong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, SAR, People's Republic of China.
| | - Edmond Pui-Hang Choi
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, SAR, People's Republic of China
| | - Herman Hay-Ming Lo
- Department of Applied Social Sciences, The Polytechnic University of Hong Kong, Hung Hom, Kowloon, Hong Kong, SAR, People's Republic of China
| | - Wendy Wong
- School of Chinese Medicine, The Chinese University of Hong Kong, 7/F, Lui Che Woo Clinical Sciences Building, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR, People's Republic of China
| | - Jasmine Hin-Man Chio
- Department of Counselling and Psychology, Hong Kong Shue Yan University, 10 Wai Tsui Crescent, Braemar Hill, North Point, Hong Kong, SAR, People's Republic of China
| | - Anna Wai-Man Choi
- Department of Social Work and Social Administration, The University of Hong Kong, 5/F, The Centennial Campus, Pokfulam, Hong Kong, SAR, People's Republic of China
| | - Daniel Yee-Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, SAR, People's Republic of China
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Stewart DE, Vigod S, Riazantseva E. New Developments in Intimate Partner Violence and Management of Its Mental Health Sequelae. Curr Psychiatry Rep 2016; 18:4. [PMID: 26711508 DOI: 10.1007/s11920-015-0644-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Intimate partner violence (IPV) is a global public health and human rights problem that causes physical, sexual and psychological harms to men and women. IPV includes physical aggression, sexual coercion, psychological abuse and/or controlling behaviours perpetrated by a current or previous intimate partner in a heterosexual or same-sex relationship. IPV affects both men and women, but women are disproportionately affected with nearly one third reporting IPV during their lifetime. Physical and sexual harms from IPV include injury, increased risk for sexually transmitted diseases, pregnancy complications and sometimes death. Psychological consequences include depression, anxiety, posttraumatic stress disorder, substance abuse, impulsivity and suicidality and non-specific physical complaints thought to be related to the traumatic nature and chronic stress of IPV. Children who witness IPV are also negatively impacted in the short and long term. This paper reviews prevalence, risk factors, adverse effects and current evidence-based mental health treatment advice for IPV victims.
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Affiliation(s)
- Donna E Stewart
- UHN Centre for Mental Health, Toronto General Research Institute, University of Toronto, 200 Elizabeth Street, EN-7-229, Toronto, M5G2C4, Ontario, Canada. .,Women's Health Program, University Health Network, Toronto, Ontario, Canada.
| | - Simone Vigod
- Shirley Brown Clinician Scientist in Women's Mental Health, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
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