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Forkus SR, Goldstein SC, Schick MR, Flanagan JC, Weiss NH. Hair cortisol and substance use among women currently experiencing intimate partner violence: The role of PTSD symptom severity. Drug Alcohol Depend 2024; 261:111378. [PMID: 38936182 DOI: 10.1016/j.drugalcdep.2024.111378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 06/03/2024] [Accepted: 06/18/2024] [Indexed: 06/29/2024]
Abstract
INTRODUCTION Substance use is highly prevalent among women experiencing intimate partner violence (IPV) and has been associated with dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis and resulting cortisol response. Posttraumatic stress disorder (PTSD) symptoms may play an important role in exacerbating the association between cortisol levels and substance use behaviors. PURPOSE This study examined the role of PTSD symptoms in the relation between cortisol and past month substance use behaviors. The current study used hair cortisol as an index of past 30-day HPA-axis functioning and ecological momentary assessment (EMA) to characterize substance use behaviors more accurately over a 30-day period. METHOD Participants were 90 community women who had experienced physical or sexual IPV in the past 30 days by their current male partner and used any amount of alcohol or drugs (M age = 40.71; 54.4 % white). Participants completed (a) a baseline interview, (b) EMA for 30-days, and (c) a follow up interview where they were asked to provide a hair sample for cortisol analyses. Data collection took place from 2018 to 2020. RESULTS PTSD severity moderated the relations between cortisol and days of drinking and binge drinking. In the context of high PTSD symptomology, women with high cortisol levels spent, on average, an additional 7.4 days drinking and 8.1 days binge drinking in the past 30 days compared to women with low cortisol levels, in a model adjusted for age. CONCLUSIONS Results highlight the prominent role of PTSD symptoms in the association between cortisol and alcohol use among women experiencing IPV.
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Affiliation(s)
- Shannon R Forkus
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
| | - Silvi C Goldstein
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | | | - Julianne C Flanagan
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Nicole H Weiss
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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Wemrell M, Tegel E, Öberg J, Ivert AK. Assessing the use of clinical guidelines against domestic violence in southern Sweden: A mixed-methods study. Scand J Caring Sci 2023; 37:828-841. [PMID: 37002636 DOI: 10.1111/scs.13168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/09/2023] [Accepted: 03/18/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND AND AIM Domestic violence is a prevalent public health issue. While clinical guidelines and care programs for its identification and handling have been formulated in all administrative regions of Sweden, their degree of implementation is largely unknown. This study aims to assess the implementation of one administrative region's care program, including how it is seen to align with and function in clinical practice, and any perceived barriers to or facilitators of its use. METHODS A survey was distributed to first-line managers for healthcare units with patient contact in the region (n = 807). The responses were analysed using descriptive statistics. Open responses were analysed thematically. Group interviews (n = 5) were held with caregivers (n = 15) working primarily with young patients and analysed thematically. RESULTS 73% of the survey respondents reported previous awareness of the care program, and 27% reported knowledge of its content. The extent to which their staff knew about and followed the care program was assessed to be relatively low. The survey response rate was 19%. Among interview participants, knowledge of the care program was generally quite low. Survey responses and interview discussions pointed to the importance of developing routines, of collegial and managerial support and of training on domestic violence and the care program. CONCLUSION This study indicates that the knowledge and use of the regional care program is limited among healthcare staff, including among those working with young patients. This underscores the importance of information and training for furthering the implementation of clinical guidelines on domestic violence.
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Affiliation(s)
- Maria Wemrell
- Department of Gender Studies, Faculty of Social Sciences, Lund University, Lund, Sweden
- Unit for Social Epidemiology, Faculty of Medicine, Lund University, Lund, Sweden
| | - Emma Tegel
- Department of Criminology, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Johan Öberg
- Unit for Social Epidemiology, Faculty of Medicine, Lund University, Lund, Sweden
- Department of Health and Medical Care Management, Region Skåne, Malmö, Sweden
| | - Anna-Karin Ivert
- Unit for Social Epidemiology, Faculty of Medicine, Lund University, Lund, Sweden
- Department of Criminology, Faculty of Health and Society, Malmö University, Malmö, Sweden
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Eikemo R, Barimani M, Elvin-Nowak Y, Eriksson J, Vikström A, Nyman V, Backman-Enelius M, Jonas W. Intimate partner violence during pregnancy - Prevalence and associations with women's health: A cross-sectional study. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 36:100843. [PMID: 37062226 DOI: 10.1016/j.srhc.2023.100843] [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: 09/14/2022] [Revised: 03/15/2023] [Accepted: 03/28/2023] [Indexed: 04/18/2023]
Abstract
OBJECTIVE Intimate partner violence (IPV) against women occurs in all settings. Exposure to intimate partner violence, especially during pregnancy, is associated with serious adverse health outcomes and is recognized as a global health issue. AIM To describe the prevalence of physical, psychological, and sexual intimate partner violence among pregnant women in Sweden during current pregnancy, and to investigate potential associations between exposure and sociodemographic characteristics and health. METHODS Between October and December 2020, a cross-sectional survey study was conducted at 35 midwifery clinics in Stockholm, Sweden. RESULTS The questionnaire was answered by 3399 pregnant women. The results showed that 2.1% of the women reported exposure to intimate partner violence during pregnancy, with exposure to psychological violence being most common (1.8%), followed by exposure to physical violence (0.6%) and sexual violence (0.1%). Exposure to intimate partner violence was significantly associated with living situation and depressive symptoms, as well as education, country of birth, and employment status. CONCLUSION Exposure to intimate partner violence occurs even during pregnancy and it is crucial to identify pregnant women exposed to intimate partner violence in order to inform clinical practice and to provide adequate support. More research is needed to develop screening instruments to detect violence against pregnant women.
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Affiliation(s)
- R Eikemo
- Academic Primary Care Centre, Region Stockholm, Sweden; Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institute, Stockholm, Sweden.
| | - M Barimani
- Academic Primary Care Centre, Region Stockholm, Sweden; Department of Medical and Health Sciences, Linköping University, Sweden.
| | - Y Elvin-Nowak
- Academic Primary Care Centre, Region Stockholm, Sweden.
| | - J Eriksson
- Department of Environmental Medicine, Division of Biostatistics, Karolinska Institute, Stockholm, Sweden.
| | - A Vikström
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institute, Stockholm, Sweden.
| | - V Nyman
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.
| | | | - W Jonas
- Departement of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
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Hester M, Walker SJ, Myhill A. The Measurement of Domestic Abuse - Redeveloping the Crime Survey for England and Wales. JOURNAL OF FAMILY VIOLENCE 2023; 38:1-15. [PMID: 36817846 PMCID: PMC9928589 DOI: 10.1007/s10896-023-00507-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
Purpose In 2020 the England and Wales Office for National Statistics commissioned the research reported here to review the current questions on domestic abuse in the Crime Survey for England and Wales (CSEW) and to establish how better data for policy and practice might be produced. The CSEW is a representative population survey that since the early 2000s has provided ongoing measurement of domestic abuse via a dedicated domestic abuse module, with regular publication of headline prevalence and other descriptive data. At the same time the measurement of domestic violence in the CSEW has also been the subject of ongoing debate and critique, in particular whether it is appropriate to use catch-all prevalence measures in the context of policy, practice and commissioning of services. Method The research included analysis of CSEW user survey data (N = 39), focus group and individual interviews with male and female victims/survivors (N = 11), consultation with core stakeholders (N = 18), and consideration of international surveys and recent legislation. Results Current CSEW questions do not capture domestic abuse accurately or reflect lived experience, coercive control needs to be seen at the core of domestic abuse, and while physical assault is an important part of measuring domestic abuse establishing frequency through counting events is probably impossible. Conclusion A fundamental rethink of the current CSEW self-completion module is required, with a wider set of questions about domestic abuse and impact. A revised module should identify and provide estimation of prevalence for different 'abuse profiles' that would complement improved headline measures and better inform policy and practice.
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Bringas Molleda C, Beltrán Espitia M, Mosquera Ruiz Y, Herrero Díez J, Rodríguez Díaz FJ. Evaluation of Affective Coexistence in Young Afro-Colombians in the Department of Chocó-Colombia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1147. [PMID: 36673904 PMCID: PMC9859228 DOI: 10.3390/ijerph20021147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/02/2023] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
Various works of research into violence in relationships between young couples refer to a lack of perception of some behavior patterns such as abuse. This means that the relationship has the potential risk of developing into one of victimization should it last into adulthood. Although it has been shown that this phenomenon may occur in any sector of the population, the interest of our study rests upon determining the prevalence of the perception of violent behavior patterns in relationships between adolescent and young adult couples. We also aim to analyze the differences obtained with respect to the characteristics of the aggressors in the young Afro-Colombian population of Quibdó, Colombia. The participants in the study consisted of 540 young Afro-Colombians of both sexes between 15 and 27 years of age. The instrument used was the reduced version of the Dating Violence Questionnaire. The results show a high level of victimization through violent behavior on the part of the partner, in great measure exercised by generalist aggressors. However, a small proportion could be perceived as abuse. The implications and possible means of intervention are discussed.
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Affiliation(s)
| | | | - Yineth Mosquera Ruiz
- Department of Humanities, University Foundation Claretiana, Quibdó 270001, Colombia
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Moon D, Sohn M, Kim J. The Gendered Pathways Through Which Intimate Partner Violence Affects Health: Exploring the Role of Unmet Healthcare Needs. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP21366-NP21385. [PMID: 36065603 DOI: 10.1177/08862605221120907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The aim of this study was to examine the relationships between intimate partner violence (IPV), gender, unmet healthcare needs, and health. Specifically, this study identified how unmet healthcare needs mediate the relationship between IPV and health, and how this mediation is moderated by gender. Using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) (N = 15,425), we first estimated ordinary least squares regression models to investigate the association between IPV and self-rated health. Then, we used structural equation models to examine how unmet healthcare needs mediate this relationship. Lastly, we conducted a moderated mediation model to investigate whether gender moderates these mediation patterns. The results of this study showed that experiencing IPV was associated with a decrease in self-rated health and an increase in the unmet need for medical care (but not in unmet need for routine health check-ups). Unmet need for medical care explained about one-quarter of the negative association between IPV and self-rated health. A moderated mediation model revealed that indirect effects of IPV on health via unmet medical care needs were more pronounced among victimized women than victimized men. This study filled knowledge gaps about the mechanisms underlying the association between IPV and poor health status. Unmet healthcare needs partially mediated the relationship between IPV victimization and health. This mechanism was more salient for the health of victimized women than victimized men. Interventions designed to improve the health of IPV victims may focus on addressing unmet healthcare needs and could be tailored according to the gender of patients.
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Affiliation(s)
- Daseul Moon
- People's Health Institute, Seoul, Republic of Korea
| | - Minsung Sohn
- The Cyber University of Korea, Seoul, Republic of Korea
| | - Jinho Kim
- Korea University, Seoul, Republic of Korea
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Sikstrom S, Dahl M, Claesdotter-Knutsson E. Removing Biases in Communication of Severity Assessments of Intimate partner Violence : model development and evaluation (Preprint). J Med Internet Res 2022; 25:e43499. [PMID: 37115589 PMCID: PMC10182463 DOI: 10.2196/43499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 02/03/2023] [Accepted: 03/02/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND To support a victim of violence and establish the correct penalty for the perpetrator, it is crucial to correctly evaluate and communicate the severity of the violence. Recent data have shown these communications to be biased. However, computational language models provide opportunities for automated evaluation of the severity to mitigate the biases. OBJECTIVE We investigated whether these biases can be removed with computational algorithms trained to measure the severity of violence described. METHODS In phase 1 (P1), participants (N=71) were instructed to write some text and type 5 keywords describing an event where they experienced physical violence and 1 keyword describing an event where they experienced psychological violence in an intimate partner relationship. They were also asked to rate the severity. In phase 2 (P2), another set of participants (N=40) read the texts and rated them for severity of violence on the same scale as in P1. We also quantified the text data to word embeddings. Machine learning was used to train a model to predict the severity ratings. RESULTS For physical violence, there was a greater accuracy bias for humans (r2=0.22) compared to the computational model (r2=0.31; t38=-2.37, P=.023). For psychological violence, the accuracy bias was greater for humans (r2=0.058) than for the computational model (r2=0.35; t38=-14.58, P<.001). Participants in P1 experienced psychological violence as more severe (mean 6.46, SD 1.69) than participants rating the same events in P2 (mean 5.84, SD 2.80; t86=-2.22, P=.029<.05), whereas no calibration bias was found for the computational model (t134=1.30, P=.195). However, no calibration bias was found for physical violence for humans between P1 (mean 6.59, SD 1.81) and P2 (mean 7.54, SD 2.62; t86=1.32, P=.19) or for the computational model (t134=0.62, P=.534). There was no difference in the severity ratings between psychological and physical violence in P1. However, the bias (ie, the ratings in P2 minus the ratings in P1) was highly negatively correlated with the severity ratings in P1 (r2=0.29) and in P2 (r2=0.37), whereas the ratings in P1 and P2 were somewhat less correlated (r2=0.11) using the psychological and physical data combined. CONCLUSIONS The results show that the computational model mitigates accuracy bias and removes calibration biases. These results suggest that computational models can be used for debiasing the severity evaluations of violence. These findings may have application in a legal context, prioritizing resources in society and how violent events are presented in the media.
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Affiliation(s)
| | - Mats Dahl
- Department of Psychology, Lund, Sweden
| | - Emma Claesdotter-Knutsson
- Child and Adolescent Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Department of Child and Adolescent Psychiatry, Skåne University Hospital, Lund, Sweden
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Alroy KA, Wang A, Sanderson M, Gould LH, Stayton C. Psychological and Physical Intimate Partner Violence, Measured by the New York City Community Health Survey - New York City, 2018. JOURNAL OF FAMILY VIOLENCE 2022; 38:1-12. [PMID: 36186740 PMCID: PMC9510726 DOI: 10.1007/s10896-022-00442-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/10/2022] [Indexed: 06/16/2023]
Abstract
Purpose Intimate partner violence (IPV) can damage long-term physical and mental health, yet IPV prevalence in New York City (NYC) is unknown. We described prevalence and health correlates of psychological and physical IPV in NYC. Method The 2018 NYC Community Health Survey, a representative telephone survey among adult residents, asked about lifetime psychological or physical IPV experiences. We estimated age-adjusted physical and psychological prevalence, stratified by demographic variables, and created log-linear multivariable models with 95% CIs to measure the association of each IPV type with health conditions and behaviors. Results Overall, 10,076 surveys were completed. We excluded responses with missing IPV values. Of 9,945 adults, 16.7% reported ever having experienced psychological IPV; higher prevalence among females (18.6%; CI:17.0-20.2) than males (14.5%; CI:13.1-16.2). Prevalence of not getting needed mental health treatment (PR: 4.5; CI:3.3-6.1) and current depression (PR:2.6 CI:2.1-3.1) was higher among adults who had ever experienced psychological IPV, compared with those who had not. Of 9,964 adults, 9.8% reported ever having experienced physical IPV; higher prevalence among females (12.4%; CI:11.1-13.8) than males (6.8%; CI:5.8-8.0). Prevalence of not getting needed mental health treatment (PR:3.9, CI:2.8-5.4) and current depression (PR:2.6, CI:2.1-3.2) was higher among adults who had ever experienced physical IPV, compared with those who had not. Conclusions One in six (16.7%) and one in 10 (9.8%) NYC adults reported ever experiencing psychological IPV and ever experiencing physical IPV, respectively. Key implications suggest that IPV potentially underlies public health priority health conditions and behaviors. Supplementary Information The online version contains supplementary material available at 10.1007/s10896-022-00442-1.
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Affiliation(s)
- Karen A. Alroy
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention, Atlanta, GA USA
- Bureau of Epidemiology Services, Division of Epidemiology, New York City Department of Health and Mental Hygiene, New York City, NY USA
| | - Amy Wang
- Bureau of Environmental Disease and Injury Prevention, Division of Environmental Health, New York City Department of Health and Mental Hygiene, New York City, NY USA
| | - Michael Sanderson
- Bureau of Epidemiology Services, Division of Epidemiology, New York City Department of Health and Mental Hygiene, New York City, NY USA
| | - L. Hannah Gould
- Bureau of Epidemiology Services, Division of Epidemiology, New York City Department of Health and Mental Hygiene, New York City, NY USA
| | - Catherine Stayton
- Bureau of Environmental Disease and Injury Prevention, Division of Environmental Health, New York City Department of Health and Mental Hygiene, New York City, NY USA
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Social support and intimate partner violence in rural Pakistan: A longitudinal investigation of the bi-directional relationship. SSM Popul Health 2022; 19:101173. [PMID: 35928171 PMCID: PMC9343409 DOI: 10.1016/j.ssmph.2022.101173] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/11/2022] [Accepted: 07/11/2022] [Indexed: 11/23/2022] Open
Abstract
A large body of cross-sectional evidence finds strong and consistent associations between social support and intimate partner violence (IPV). However, the directionality of this relationship has not been firmly established due to a dearth of longitudinal evidence. Using cohort study data collected over a 3 year period from 945 women in rural Pakistan, we investigated the longitudinal relationship between IPV and social support. Friend and family social support was measured with the Multidimensional Perceived Social Support Scale, and IPV was measured with questions adopted from the World Health Organization's Violence Against Women Instrument, which was used to construct a measure of IPV severity. We estimated longitudinal associations in linear regression models that controlled for women's educational level, age at marriage, age, household composition, household assets, depressive symptoms, and Adverse Childhood Experiences. We found evidence of a bi-directional, mutually re-enforcing relationship that showed unique associations by type of social support. Specifically, we found that high social support from family, though not friends, decreased IPV severity 1 year later, and that higher IPV severity led to reductions in both friend and family social support 1 year later. Results suggest that interventions involving family members could be especially effective at reducing IPV in this context, and - given that low social support leads to many adverse health outcomes - results suggest that IPV can result in secondary harms due to diminished social support. In summary, our study confirms a bi-directional relationship between IPV and social support and suggests that IPV interventions that integrate social support may be especially effective at reducing IPV and mitigating secondary harms.
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Kamalikhah T, Mehri A, Gharibi F, Rouhani-Tonekaboni N, Japelaghi M, Dadgar E. Prevalence and related factors of intimate partner violence among married women in Garmsar, Iran. J Inj Violence Res 2022; 14:1693. [PMID: 35780333 PMCID: PMC9805666 DOI: 10.5249/jivr.v14i3.1693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 06/25/2022] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is the most common type of domestic violence often used by men against their wives. Due to the destructive and widespread social and health consequences of IPV, the present study aimed to investigate the prevalence and related factors of IPV among married women in Garmsar, Iran. METHODS Using multi-stage clusters sampling method, this cross-sectional study included 400 married women in Garmsar, Iran. The data collection process was conducted during October and December 2019 using a researcher-made questionnaire. The content validity of the questionnaire was confirmed using content validity ratio (CVR) and content validity index (CVI) indicators (0.85 and 0.88, respectively). Also, the reliability was confirmed by examining the internal consistency and obtaining a score of 0.93 for Cronbach's alpha. Descriptive and analytical statistics were performed using t-test, analysis of variance (ANOVA), and Tukey's post-hoc test. RESULTS Most participants were in the age range of 20-40 years (mean age: 34.9 years). The overall exposure of women to IPV was 56.11%. In addition, the most prevalent types of IPV included legal (24%), social (24%), financial (22%), verbal (16%), physical (13%), emotional (12%), and sexual (11%). The effective factors on the prevalence of IPV included number of children, education level, occupation, and age (P less than 0.05). CONCLUSIONS We witnessed that women living in Garmsar faced different types of IPV and their overall exposure to this phenomenon was higher than the national and global average. To resolve the problem, the following measurements are recommended: a careful investigation of the reasons for the spread of IPV, implementing interventions based on reliable evidence, and serious cooperation of the experts and relevant governmental and non-governmental institutions, particularly citizens.
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Affiliation(s)
- Tahereh Kamalikhah
- Student Research Committee, School of Nutrition and Food Sciences, Semnan University of Medical Science, Semnan, Iran
| | - Ali Mehri
- Health Education and Promotion Department, Sabzevar University of Medical Science, Sabzevar, Iran
| | - Farid Gharibi
- Social Determinants of Health Research Center, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran.
| | - Nooshin Rouhani-Tonekaboni
- Health Education and Promotion Department, Research Center of Health and Environment, School of Health, Gilan University of Medical Science, Gilan, Iran
| | - Masoume Japelaghi
- Student Research Committee, School of Nutrition and Food Sciences, Semnan University of Medical Science, Semnan, Iran
| | - Elham Dadgar
- Department of Nursing, Aligoudarz School of Nursing, Lorestan University of Medical Sciences, Aligoudarz, Iran
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Simmons J, Swahnberg K. Characteristics Associated With Being Asked About Violence Victimization in Health Care: A Swedish Random Population Study. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP8479-NP8506. [PMID: 33283603 PMCID: PMC9136474 DOI: 10.1177/0886260520977836] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Recommendations to routinely question patients about violence victimization have been around for many years; nonetheless, many patients suffering in the aftermath of violence go unnoticed in health care. The main aim of this study was to explore characteristics associated with being asked about experiences of violence in health care and thereby making visible victims that go unnoticed. In this study, we used cross-sectional survey data from 754 men (response rate 35%) and 749 women (response rate 38%) collected at random from the Swedish population, age 25-85. Questions were asked about experiences of emotional, physical, and sexual violence from both family, partner, and other perpetrators. Only 13.1% of those reporting some form of victimization reported ever being asked about experiences of violence in health care. Low subjective social status was associated with being asked questions (adj OR 2.23) but not with victimization, possibly indicating prejudice believes among providers concerning who can be a victim of violence. Other factors associated with increased odds of being asked questions were: being a woman (adj OR 2.09), young age (24-44 years, adj OR 6.90), having been treated for depression (adj OR 2.45) or depression and anxiety (adj OR 2.19) as well as reporting physical violence (adj OR 2.74) or polyvictimization (adj OR 2.85). The main finding of the study was that only few victims had been asked questions. For example, among those reporting ≥4 visits to a primary care physician during the past 12 months, 43% reported some form of victimization but only 6% had been asked questions. Our findings underline the importance of continuing to improve the health care response offered to victims of violence.
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Drieskens S, Braekman E, Ridder KD, Gisle L, Charafeddine R, Hermans L, Demarest S. Domestic violence during the COVID-19 confinement: do victims feel more socially isolated? Arch Public Health 2022; 80:39. [PMID: 35078519 PMCID: PMC8787181 DOI: 10.1186/s13690-021-00765-3] [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: 09/01/2021] [Accepted: 12/14/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Since March 13th 2020, confinement measures have been introduced in Belgium to curb the spread of the coronavirus (COVID-19). These measures also have an impact on people's daily life (closure of school/businesses, teleworking, recommendation to stay at home). This can cause stress on social, economic and psychological levels and thereby can trigger domestic violence. Besides, confinement also fosters social isolation, which can complicate help seeking behaviour. The aim of this study is to determine the prevalence of domestic violence during the coronavirus crisis and to assess whether there is an association between domestic violence and social isolation. METHODS Several online COVID-19 Health Surveys were organised among Belgian residents aged 18+ via snowball sampling. This study is based on the second (April 2020) and the sixth survey (March 2021). After excluding 1-person households and missing data, the sample size was respectively 25,251 and 12,589. Weighted prevalence of domestic violence was evaluated for the two surveys. The association (OR; 95% CI; p-value) between domestic violence and subjective social isolation was assessed with logistic regression stratified by survey and adjusted for covariates. RESULTS In April 2020, 4.0% of the adult population reported being a victim of domestic violence (1.2% in the Health Interview Survey 2018); in March 2021, this was 6.2%. In April 2020, victims of domestic violence had higher odds of being unsatisfied with their social contacts (OR = 1.25; 95% CI: 1.08-1.44; p < .05), weak social support (OR = 2.26; 95% CI: 1.97-2.58; p < .0001) and having less confidence in health care services (OR = 1.38; 95% CI: 1.13-1.71; p < .05). In March 2021, victims had higher odds of being unsatisfied with their social contacts (OR = 1.30; 95% CI: 1.08-1.56; p < .05) and weak social support (OR = 2.41; 95% CI: 2.04-2.84; p < .0001), and social (OR = 2.64; 95% CI: 2.23-3.13; p < .0001) and emotional loneliness (OR = 2.22; 95% CI: 1.80-2.73; p < .0001). CONCLUSIONS More people have reported domestic violence since the start of the coronavirus crisis than did in 2018. An association between domestic violence and social isolation was determined. Although confinement is needed to counteract the virus, it can put people in a dangerous situation since they do not get the help they need. Therefore, adequate support is essential.
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Affiliation(s)
- Sabine Drieskens
- Scientific Direction Epidemiology and public health, Sciensano, J. Wytsmanstreet 14, 1050, Brussels, Belgium.
| | - Elise Braekman
- Scientific Direction Epidemiology and public health, Sciensano, J. Wytsmanstreet 14, 1050, Brussels, Belgium
| | - Karin De Ridder
- Scientific Direction Epidemiology and public health, Sciensano, J. Wytsmanstreet 14, 1050, Brussels, Belgium
| | - Lydia Gisle
- Scientific Direction Epidemiology and public health, Sciensano, J. Wytsmanstreet 14, 1050, Brussels, Belgium
| | - Rana Charafeddine
- Scientific Direction Epidemiology and public health, Sciensano, J. Wytsmanstreet 14, 1050, Brussels, Belgium
| | - Lize Hermans
- Scientific Direction Epidemiology and public health, Sciensano, J. Wytsmanstreet 14, 1050, Brussels, Belgium
| | - Stefaan Demarest
- Scientific Direction Epidemiology and public health, Sciensano, J. Wytsmanstreet 14, 1050, Brussels, Belgium
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13
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Fanslow JL, Malihi Z, Hashemi L, Gulliver P, McIntosh T. Prevalence of interpersonal violence against women and men in New Zealand: results of a cross-sectional study. Aust N Z J Public Health 2022; 46:117-126. [PMID: 34978353 DOI: 10.1111/1753-6405.13206] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 09/01/2021] [Accepted: 11/01/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To determine prevalence rates of non-partner and partner violence (IPV) in men and women from a population-based study. METHODS We recruited 2,887 randomly selected respondents (1,464 women and 1,423 men) from three regions of New Zealand between 2017 and 2019. Face-to-face interviews using a questionnaire adapted from the WHO multi-country study on violence against women was used for data collection. RESULTS Physical violence by non-partners was most commonly experienced by men (39.9% lifetime exposure) compared with 11.9% of women. More women (8.2%) experienced lifetime non-partner sexual violence compared with men (2.2%). About 29% of men and women reported at least one act of physical-IPV in their lifetime, and about 12.4% of women and 2.1% of men reported at least one act of lifetime sexual IPV. More women than men reported serious injuries, fear, and physical and mental health impacts following IPV experience. CONCLUSIONS These findings indicate high prevalence of interpersonal violence exposure in the population, with marked gender differences in the types and impacts of violence reported. Implications for public health: Study results call for the urgent implementation of violence prevention programs, and funding for both services to rehabilitate people who have perpetrated violence and services to support recovery of those affected.
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Affiliation(s)
- Janet L Fanslow
- Social and Community Health, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Zarintaj Malihi
- Social and Community Health, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Ladan Hashemi
- Social and Community Health, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Pauline Gulliver
- Social and Community Health, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Tracey McIntosh
- School of Māori Studies and Pacific Studies, Faculty of Arts, University of Auckland, Auckland, New Zealand
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14
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Sikström S, Dahl M, Lettmann H, Alexandersson A, Schwörer E, Stille L, Kjell O, Innes-Ker Å, Ngaosuvan L. What you say and what I hear-Investigating differences in the perception of the severity of psychological and physical violence in intimate partner relationships. PLoS One 2021; 16:e0255785. [PMID: 34407140 PMCID: PMC8659990 DOI: 10.1371/journal.pone.0255785] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 07/09/2021] [Indexed: 11/25/2022] Open
Abstract
The correct communication of the severity of violence is essential in the context of legal trials, custody cases, support of victims, etc., for providing fair treatment. A narrator that communicates their experiences of interpersonal violence may rate the seriousness of the incident differently than a rater reading the narrator's text, suggesting that there exist perceptual differences (PD) in severity ratings between the narrator and the rater. We propose that these perceptual differences may depend on whether the narrative is based on physical or psychological violence, and on gender differences. Physical violence may be evaluated as more serious by the receiver of the narrative than by the narrator (Calibration PD), whereas the seriousness of psychological violence may be difficult to convey, leading to a discrepancy in the seriousness ratings between the narrator and the rater (Accuracy PD). In addition, gender stereotypes may influence the seriousness rating (Gender PD), resulting in violence against women being perceived as more serious than the same violence against men. These perceptual differences were investigated in 3 phases using a new experimental procedure. In Phase 1, 113 narrators provided descriptions and seriousness ratings of self-experienced physical and psychological violence in relationships. In Phase 2, 340 independent raters rated the seriousness of 10 randomly selected narrations from Phase 1. In Phase 3, the genders in the narrations were changed to the opposite gender, and seriousness ratings were collected from 340 different raters. Our results confirmed the hypothesized perceptual differences. Violence to male victims was considerably more likely to be seen as severe when the raters were misled to believe the victim was a woman. We propose that these data provide practical guidelines for how to deal with misinformation in the communication of violence. The data also show that mean values and the confidence of such severity ratings need to be adjusted for several factors, such as whether it is self-experienced or communicated, the type of violence, and the gender of the victims and raters.
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Affiliation(s)
| | - Mats Dahl
- Department of Psychology, Lund University, Lund, Sweden
| | | | | | | | - Lotta Stille
- Department of Psychology, Lund University, Lund, Sweden
| | - Oscar Kjell
- Department of Psychology, Lund University, Lund, Sweden
| | - Åse Innes-Ker
- Department of Psychology, Lund University, Lund, Sweden
| | - Leonard Ngaosuvan
- Department of Culture and Society, Linköping University, Linköping,
Sweden
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15
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Fanslow J, Malihi Z, Hashemi L, Gulliver P, McIntosh T. Change in prevalence of psychological and economic abuse, and controlling behaviours against women by an intimate partner in two cross-sectional studies in New Zealand, 2003 and 2019. BMJ Open 2021; 11:e044910. [PMID: 33757951 PMCID: PMC7993235 DOI: 10.1136/bmjopen-2020-044910] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Changes in reported lifetime prevalence of psychological abuse, controlling behaviours and economic abuse between 2003 and 2019, and past 12-month prevalence of psychological abuse by an intimate partner were examined. DESIGN Cross-sectional analysis. SETTING AND PARTICIPANTS Data came from two surveys of family violence in New Zealand, conducted in 2003 and 2019. Respondents were ever partnered women aged 18-64 years old (2003 n=2673; 2019 n=935). MAIN OUTCOME MEASURES Prevalence rates for psychological abuse, controlling behaviours and economic abuse were compared between the two study years using logistic regression. Sociodemographic and economic correlates of each abuse subtype were investigated. Interactions were examined between sociodemographic factors and the study year for reported prevalence rates. RESULTS There was a reduction in reported past 12-month experience of two or more acts of psychological intimate partner violence (IPV) from 8.4% (95% CI 7.3 to 9.6) in 2003 to 4.7% (95% CI 3.2 to 6.2) in 2019. The reported lifetime prevalence of two or more acts of controlling behaviours increased from 8.2% in 2003 (95% CI 7.0 to 9.5) to 13.4% in 2019 (95% CI 11.0 to 15.7). Lifetime prevalence of economic IPV also increased from 4.5% in 2003 (95% CI 3.5 to 5.5) to 8.9% in 2019 (95% CI 6.7 to 11.1). Those who were divorced/separated or cohabiting, and those living in the most deprived areas were more likely to report past year psychological IPV, lifetime controlling behaviours and economic abuse. A higher proportion of women who were married or cohabiting reported controlling behaviours in 2019 compared with 2003. CONCLUSION While the reduction in reported past year psychological IPV is encouraging, the increase in the lifetime prevalence of controlling behaviours and economic abuse from 2003 to 2019 is worth critical evaluation. Results highlight potential gaps in current IPV prevention programmes, the need to identify and address underlying drivers of abusive behaviour and the importance of measuring multiple forms of IPV independently.
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Affiliation(s)
- Janet Fanslow
- Social and Community Health, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Zarintaj Malihi
- Social and Community Health, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Ladan Hashemi
- Social and Community Health, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Pauline Gulliver
- Social and Community Health, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Tracey McIntosh
- School of Māori Studies and Pacific Studies, Faculty of Arts, University of Auckland, Auckland, New Zealand
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16
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Dias NG, Fraga S, Soares J, Hatzidimitriadou E, Ioannidi-Kapolou E, Lindert J, Sundin Ö, Toth O, Barros H, Ribeiro AI. Contextual determinants of intimate partner violence: a multi-level analysis in six European cities. Int J Public Health 2020; 65:1669-1679. [PMID: 33141326 DOI: 10.1007/s00038-020-01516-x] [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: 10/17/2018] [Revised: 09/24/2020] [Accepted: 10/19/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES To assess whether city-level characteristics influence the risk of intimate partner violence (IPV) victimization across six European cities. METHODS The DOVE study included 3496 participants from Athens-Greece, Budapest-Hungary, London-UK, Östersund-Sweden, Porto-Portugal and Stuttgart-Germany. IPV victimization was assessed using the Revised Conflict Tactics Scales, and several contextual variables were included: GINI coefficient, gender equality index, an index of social support, unemployment rate and proportion of residents with tertiary education. Multilevel models were fitted to estimate the associations (odds ratio, 95% confidence intervals) between each type of victimization and contextual and individual-level variables. RESULTS 62.3% of the participants reported being a victim of IPV during the previous year, with large between-city differences (53.9%-72.4%). Contextual variables accounted for a substantial amount of this heterogeneity. Unemployment rates were associated with psychological (1.05, 1.01-1.08) and physical IPV (1.07, 1.01-1.13). GINI coefficient showed a positive association with any form of IPV (1.06, 1.01-1.11) and sexual coercion (1.13, 1.01-1.25). CONCLUSIONS We found significant associations between contextual determinants and IPV, which emphasizes the importance of considering contextual socioeconomic conditions when policy measures are designed to address IPV.
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Affiliation(s)
- Nicole Geovana Dias
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas nº 135, 4050-600, Porto, Portugal.,Departamento de Saúde Coletiva, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Silvia Fraga
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas nº 135, 4050-600, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Joaquim Soares
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas nº 135, 4050-600, Porto, Portugal.,Department of Public Health Science, Mid Sweden University, Sundsvall, Sweden
| | | | | | - Jutta Lindert
- University of Applied Sciences Emden, Emden, Germany.,Women's Studies Research Center, Brandeis University, Waltham, MA, USA
| | - Örjan Sundin
- Department of Psychology, Mid Sweden University, Östersund, Sweden
| | - Olga Toth
- Institute of Sociology, Hungarian Academy of Sciences, Budapest, Hungary
| | - Henrique Barros
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas nº 135, 4050-600, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Ana Isabel Ribeiro
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas nº 135, 4050-600, Porto, Portugal. .,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
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17
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Tesfa A, Dida N, Girma T, Aboma M. Intimate Partner Violence, Its Sociocultural Practice, and Its Associated Factors Among Women in Central Ethiopia. Risk Manag Healthc Policy 2020; 13:2251-2259. [PMID: 33117003 PMCID: PMC7585865 DOI: 10.2147/rmhp.s277310] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 10/10/2020] [Indexed: 11/30/2022] Open
Abstract
Background Intimate partner violence is a serious and widespread problem worldwide. It is a domestic violence by a spouse or partner in an intimate relationship against the other spouse or partner. Even though Ethiopia is also one of the countries where the condition has been seriously happening, there is a dearth of information in the study area. Objective To assess the prevalence of intimate partner violence and its sociocultural practice, and its associated factors among married women in Oromia, Central Ethiopia. Methods A community-based cross-sectional study was conducted on 671 women of Ambo district who were in marriage from March 1 to 30, 2018. Multistage sampling method was employed to select study participants. Data were collected using interviewer-administered WHO Multi-country Study on Women’s Health and Life Experiences Questionnaire. Descriptive, bivariate, and multivariate logistic regression analyses were done using SPSS version 20.0. Results Out of 671 married women expected to participate, 657 of them participated in the study making a response rate of 98%. Overall, 77% (95% CI 73.7–80.1%), and 62.4% (95% CI, 58.6–66.1%) of the respondents reported that they have experienced intimate partner violence in their lifetime and in the last one year, respectively. Lack of formal education by husband (AOR 2.30, 95% CI 1.28–4.15), housewife occupation of respondents (AOR 2.04, 95% CI 1.02–4.06), number of children (AOR 4.37, 95% CI 1.40–13.66), perceived husband dominance (AOR 1.74, 95% CI 1.15–2.63), grow up in domestic violence (AOR 1.53, 95% CI 1.00–2.35) and partner’s alcohol intake (AOR 1.77, 95% CI 1.12–2.79) were independently associated with intimate partner violence. Conclusion Intimate partner violence against women remains an important public health problem. This needs urgent attention at all levels of societal hierarchy including policymakers, stakeholders, and professionals to alleviate the situation.
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Affiliation(s)
- Ayantu Tesfa
- Department of Public Health, Medicine and Health Science College, Ambo University, Ambo, Ethiopia
| | - Nagasa Dida
- Department of Public Health, Medicine and Health Science College, Ambo University, Ambo, Ethiopia
| | - Teka Girma
- Department of Public Health, Medicine and Health Science College, Ambo University, Ambo, Ethiopia
| | - Mecha Aboma
- Department of Public Health, Medicine and Health Science College, Ambo University, Ambo, Ethiopia
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18
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Aye WT, Lien L, Stigum H, Schei B, Sundby J, Bjertness E. Domestic violence victimisation and its association with mental distress: a cross-sectional study of the Yangon Region, Myanmar. BMJ Open 2020; 10:e037936. [PMID: 32938598 PMCID: PMC7497540 DOI: 10.1136/bmjopen-2020-037936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To estimate the prevalence of domestic violence, with subgroups of physical, sexual and emotional violence, among men and women and to assess the association between any lifetime domestic violence (DV) and mental distress among ever-married men and women. DESIGN We conducted a cross-sectional study from October to November 2016 using a multistage sampling design. DV questionnaire was adopted from the Demographic and Health Survey programme. Mental distress was estimated using the Hopkins Symptom Checklist-10 (HSCL-10). HSCL-score and DV were the outcome and exposure variables, respectively, in multiple linear regression. Prevalence estimates and associations were presented with a 95% CI and the Wald test. SETTING Urban and rural areas of the Yangon region, Myanmar. PARTICIPANTS Men and women ages 18 to 49 years were included. Institutionalised people, monks, nuns and individuals deemed too ill physically and/or mentally to participate were excluded. RESULTS A random sample of 2383 people was included in the analyses. Among ever-married participants, lifetime (LT) and past-12-month (12M) prevalence of any domestic violence victimisation was higher in women compared with men: LT women: 61.8% (95% CI: 54.3 to 68.9) versus LT men: 42.4% (95% CI: 37.5 to 47.5) and 12M women: 51.2% (95% CI: 44.9 to 57.5) versus 12M men: 37.7% (95% CI: 32.9 to 42.7). Among never-married participants, lifetime physical and sexual violence victimisation rates was higher in men (34.3% and 7.9%) compared with women (19.1% and 6.4%). Mental distress was significantly associated with lifetime DV in women who were afraid of their husbands and men who had wives who exhibited controlling behaviours. CONCLUSIONS Domestic violence is prevalent among both men and women and is associated with mental distress. The findings highlight an urgent need to prevent domestic violence in both sexes, including through legal and policy reform and improved mental health services for DV victims.
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Affiliation(s)
- Win Thuzar Aye
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo Faculty of Medicine, Oslo, Norway
- Department of Preventive and Social Medicine, University of Medicine (2), Yangon, Myanmar
| | - Lars Lien
- National Norwegian advisory board for concurrent addiction and mental health problems, Innlandet Hospital Trust, Brumunddal and Faculty of Social and Health Sciences, Inland Norway University of Applied Science, Elverum, Oslo, Norway
| | - Hein Stigum
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo Faculty of Medicine, Oslo, Norway
| | - Berit Schei
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Johanne Sundby
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo Faculty of Medicine, Oslo, Norway
| | - Espen Bjertness
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo Faculty of Medicine, Oslo, Norway
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19
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Lövestad S, Vaez M, Löve J, Hensing G, Krantz G. Intimate partner violence, associations with perceived need for help and health care utilization: a population-based sample of women in Sweden. Scand J Public Health 2020; 49:268-276. [PMID: 32854572 PMCID: PMC8056709 DOI: 10.1177/1403494820930952] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aim: To assess the association between physical intimate partner violence (physical IPV) in the past 5 years, perceived need for help and primary health care utilization due to mental health problems in a general population-based sample of women in Sweden. Methods: We performed structured follow-up interviews with 616 women between 1995 and 2015. Associations between physical IPV in the past 5 years and (i) perceived need for help and (ii) primary health care utilization due to mental health problems, were estimated by logistic regression analyses with crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Results: Of the women who had experienced physical IPV in the past 5 years, 45.1% perceived a need for help but refrained from seeking care. After adjusting for sociodemographic factors, exposure to physical IPV in the past 5 years remained associated with perceived need for help (OR 3.54; CI 1.77–7.11). After adjusting for sociodemographic factors, the association between exposure to physical IPV and primary health care utilization did not remain statistically significant. Conclusions: Women exposed to physical IPV were more likely to perceive the need for help compared with unexposed women. A large proportion of IPV-exposed women in the general population may refrain from seeking care although they perceive a need for help. Future studies need to investigate potential barriers to mental health care seeking among women exposed to IPV. Routine questioning about IPV should be implemented in primary health care with improved referral to available support services.
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Affiliation(s)
- Solveig Lövestad
- School of Public Health and Community Medicine, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden
| | - Marjan Vaez
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jesper Löve
- School of Public Health and Community Medicine, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden
| | - Gunnel Hensing
- School of Public Health and Community Medicine, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden
| | - Gunilla Krantz
- School of Public Health and Community Medicine, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden
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20
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Lippus H, Soo K, Laanpere M, Yount KM, Part K, Ringmets I, Ainsaar M, Karro H. The prevalence and patterns of exposure to interpersonal violence among men and women in Estonia. PLoS One 2020; 15:e0237562. [PMID: 32797115 PMCID: PMC7428354 DOI: 10.1371/journal.pone.0237562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 07/29/2020] [Indexed: 11/18/2022] Open
Abstract
Background To understand better the total burden of interpersonal violence on society, it is useful to assess the prevalence of interpersonal violence among both, men and women. Exposure to multiple forms of interpersonal violence, referred to as polyvictimization, has been associated with more severe health consequences than exposure to any form separately. The aims of this study were to assess the prevalence of emotional, physical and sexual interpersonal violence in childhood, adulthood and at both childhood and adulthood among men and women in Estonia, analyze the patterns of interpersonal violence and socio-demographic correlates of polyvictimization in adulthood by gender. Methods The analysis was based on two population-based, cross-sectional, self-administered surveys carried out among men and women in Estonia in 2014. In both surveys, the NorVold Abuse questionnaire was used to measure exposure to interpersonal violence. Men and women aged 18–44 were included to the analysis. Results Among men 66.6% and among women 54.2% had been exposed to at least one form of interpersonal violence during lifetime. Men had been more often exposed to isolated physical interpersonal violence, among women the distribution of different forms of interpersonal violence was more even and exposure to sexual violence was more common. The prevalence of polyvictimization in adulthood was two times higher among women compared to men and more socio-demographic correlates, were associated with it. Exposure to violence in childhood was associated with polyvictimization in adulthood across gender. Conclusions The prevalence of interpersonal violence in Estonia is high among men and women. The most prevalent forms and patterns of interpersonal violence, however, differ by gender, as do the socio-demographic correlates. Screening for interpersonal violence, in childhood and adulthood, and gender-specific interventions are needed, especially for high-risk groups identified in this study. Primary prevention of childhood violence should be a priority, as it was associated with higher risk for exposure to violence later in life across gender.
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Affiliation(s)
- Hedda Lippus
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- * E-mail:
| | - Kadri Soo
- Institute of Social Studies, University of Tartu, Tartu, Estonia
| | - Made Laanpere
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
- Tartu University Hospital Women’s Clinic, Tartu, Estonia
- Sexual Health Clinic of Tartu, Tartu, Estonia
| | - Kathryn M. Yount
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- Department of Sociology, Emory University, Atlanta, Georgia, United States of America
| | - Kai Part
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
- Tartu University Hospital Women’s Clinic, Tartu, Estonia
- Sexual Health Clinic of Tartu, Tartu, Estonia
| | - Inge Ringmets
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Mare Ainsaar
- Institute of Social Studies, University of Tartu, Tartu, Estonia
| | - Helle Karro
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
- Tartu University Hospital Women’s Clinic, Tartu, Estonia
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21
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Karlsson N, Lila M, Gracia E, Wemrell M. Representation of Intimate Partner Violence Against Women in Swedish News Media: A Discourse Analysis. Violence Against Women 2020; 27:1499-1524. [PMID: 32713268 PMCID: PMC8239991 DOI: 10.1177/1077801220940403] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Despite being rated as some of the world's most gender equal countries, Sweden and neighboring Nordic nations show high rates of intimate partner violence against women (IPVAW). As the news media contribute to the shaping of public attitudes, this article pursues a two-step discourse analysis of how IPVAW was represented in seven Swedish newspapers during 2018. Although an individualistic discourse on IPVAW was found to be most prevalent, articles where perpetrators were presented as non-Swedish more frequently contained a structural framing of IPVAW. This confirms previously noted tendencies toward individualization and othering of IPVAW in Sweden.
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Affiliation(s)
- Nadja Karlsson
- Lund University, Malmö, Sweden.,Unit for Social Epidemiology, Lund University, Malmö, Sweden
| | | | | | - Maria Wemrell
- Lund University, Malmö, Sweden.,Department of Gender Studies, Lund University, Malmö, Sweden
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22
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Mental disorders and intimate partner violence perpetrated by men towards women: A Swedish population-based longitudinal study. PLoS Med 2019; 16:e1002995. [PMID: 31846461 PMCID: PMC6917212 DOI: 10.1371/journal.pmed.1002995] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 11/18/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) against women is associated with a wide range of adverse outcomes. Although mental disorders have been linked to an increased risk of perpetrating IPV against women, the direction and magnitude of the association remain uncertain. In a longitudinal design, we examined the association between mental disorders and IPV perpetrated by men towards women in a population-based sample and used sibling comparisons to control for factors shared by siblings, such as genetic and early family environmental factors. METHODS AND FINDINGS Using Swedish nationwide registries, we identified men from 9 diagnostic groups over 1998-2013, with sample sizes ranging from 9,529 with autism to 88,182 with depressive disorder. We matched individuals by age and sex to general population controls (ranging from 186,017 to 1,719,318 controls), and calculated the hazard ratios of IPV against women. We also estimated the hazard ratios of IPV against women in unaffected full siblings (ranging from 4,818 to 37,885 individuals) compared with the population controls. Afterwards, we compared the hazard ratios for individuals with psychiatric diagnoses with those for siblings using the ratio of hazard ratios (RHR). In sensitivity analyses, we examined the contribution of previous IPV against women and common psychiatric comorbidities, substance use disorders and personality disorders. The average follow-up time across diagnoses ranged from 3.4 to 4.8 years. In comparison to general population controls, all psychiatric diagnoses studied except autism were associated with an increased risk of IPV against women in men, with hazard ratios ranging from 1.5 (95% CI 1.3-1.7) to 7.7 (7.2-8.3) (p-values < 0.001). In sibling analyses, we found that men with depressive disorder, anxiety disorder, alcohol use disorder, drug use disorder, attention deficit hyperactivity disorder, and personality disorders had a higher risk of IPV against women than their unaffected siblings, with RHR values ranging from 1.7 (1.3-2.1) to 4.4 (3.7-5.2) (p-values < 0.001). Sensitivity analyses showed higher risk of IPV against women in men when comorbid substance use disorders and personality disorders were present, compared to risk when these comorbidities were absent. In addition, increased IPV risk was also found in those without previous IPV against women. The absolute rates of IPV against women ranged from 0.1% to 2.1% across diagnoses over 3.4 to 4.8 years. Individuals with alcohol use disorders (1.7%, 1,406/82,731) and drug use disorders (2.1%, 1,216/57,901) had the highest rates. Our analyses were restricted to IPV leading to arrest, suggesting that the applicability of our results may be limited to more severe forms of IPV perpetration. CONCLUSIONS Our results indicate that most of the studied mental disorders are associated with an increased risk of perpetrating IPV towards women, and that substance use disorders, as principal or comorbid diagnoses, have the highest absolute and relative risks. The findings support the development of IPV risk identification and prevention services among men with substance use disorders as an approach to reduce the prevalence of IPV.
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Costa D, Hatzidimitriadou E, Ioannidi-Kapolo E, Lindert J, Soares J, Sundin Ö, Toth O, Barros H. The impact of intimate partner violence on forgone healthcare: a population-based, multicentre European study. Eur J Public Health 2019; 29:359-364. [PMID: 30169658 DOI: 10.1093/eurpub/cky167] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To examine the relationship between forgone healthcare and involvement in intimate partner violence (IPV) as victims, perpetrators or both. METHODS This cross-sectional multicentre study assessed community non-institutionalized residents (n = 3496, aged 18-64) randomly selected from six European cities: Athens, Budapest, London, Östersund, Porto, Stuttgart. A common questionnaire was used, including self-reports of IPV and forgone healthcare ('Have you been in need of a certain care service in the past year, but did not seek any help?'). Odds ratios (ORs), 95% confidence intervals (CIs) were computed fitting logistic regression models adjusted for city, chronic disease, self-assessed health status and financial strain. RESULTS Participants experiencing past year IPV (vs. no violence) reported more often to forgone healthcare (n = 3279, 18.6% vs. 15.3%, P = 0.016). IPV experienced as both a victim and perpetrator was associated with forgone healthcare (adjusted OR, 95%CI: 1.32, 1.02-1.70). CONCLUSION IPV was associated with forgone healthcare, particularly for those experiencing violence as both victims and perpetrators. Results suggest that preventing IPV among adults may improve timely healthcare uptake.
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Affiliation(s)
- Diogo Costa
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
| | - Eleni Hatzidimitriadou
- Faculty of Health and Wellbeing, Canterbury Christ Church University, Canterbury, Kent, UK
| | | | - Jutta Lindert
- Department of Public Health Science Ludwigsburg, Protestant University of Applied Sciences Ludwigsburg, Ludwigsburg, Germany.,University of Applied Sciences Emden, Emden, Germany.,WRSC, Brandeis University, Waltham, MA, USA
| | - Joaquim Soares
- Institution for Health Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Örjan Sundin
- Department of Psychology, Mid Sweden University, Östersund, Sweden
| | - Olga Toth
- Institute of Sociology, Hungarian Academy of Sciences, Budapest, Hungary
| | - Henrique Barros
- EPIUnit, Institute of Public Health, University of Porto and University of Porto Medical School, Porto, Portugal
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Rivas C, Vigurs C, Cameron J, Yeo L. A realist review of which advocacy interventions work for which abused women under what circumstances. Cochrane Database Syst Rev 2019; 6:CD013135. [PMID: 31254283 PMCID: PMC6598804 DOI: 10.1002/14651858.cd013135.pub2] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Intimate partner abuse (including coercive control, physical, sexual, economic, emotional and economic abuse) is common worldwide. Advocacy may help women who are in, or have left, an abusive intimate relationship, to stop or reduce repeat victimisation and overcome consequences of the abuse. Advocacy primarily involves education, safety planning support and increasing access to different services. It may be stand-alone or part of other services and interventions, and may be provided within healthcare, criminal justice, social, government or specialist domestic violence services. We focus on the abuse of women, as interventions for abused men require different considerations. OBJECTIVES To assess advocacy interventions for intimate partner abuse in women, in terms of which interventions work for whom, why and in what circumstances. SEARCH METHODS In January 2019 we searched CENTRAL, MEDLINE, 12 other databases, two trials registers and two relevant websites. The search had three phases: scoping of articles to identify candidate theories; iterative recursive search for studies to explore and fill gaps in these theories; and systematic search for studies to test, confirm or refute our explanatory theory. SELECTION CRITERIA Empirical studies of any advocacy or multi-component intervention including advocacy, intended for women aged 15 years and over who were experiencing or had experienced any form of intimate partner abuse, or of advocates delivering such interventions, or experiences of women who were receiving or had received such an intervention. Partner abuse encompasses coercive control in the absence of physical abuse. For theory development, we included studies that did not strictly fit our original criteria but provided information useful for theory development. DATA COLLECTION AND ANALYSIS Four review authors independently extracted data, with double assessment of 10% of the data, and assessed risk of bias and quality of the evidence. We adopted RAMESES (Realist and meta-narrative evidence syntheses: evolving standards) standards for reporting results. We applied a realist approach to the analysis. MAIN RESULTS We included 98 studies (147 articles). There were 88 core studies: 37 focused on advocates (4 survey-based, 3 instrument development, 30 qualitative focus) and seven on abused women (6 qualitative studies, 1 survey); 44 were experimental intervention studies (some including qualitative evaluations). Ten further studies (3 randomised controlled trials (RCTs), 1 intervention process evaluation, 1 qualitative study, 2 mixed methods studies, 2 surveys of women, and 1 mixed methods study of women and staff) did not fit the original criteria but added useful information, as befitting a realist approach. Two studies are awaiting classification and three are ongoing.Advocacy interventions varied considerably in contact hours, profession delivering and setting.We constructed a conceptual model from six essential principles based on context-mechanism-outcome (CMO) patterns.We have moderate and high confidence in evidence for the importance of considering both women's vulnerabilities and intersectionalities and the trade-offs of abuse-related decisions in the contexts of individual women's lives. Decisions should consider the risks to the woman's safety from the abuse. Whether actions resulting from advocacy increase or decrease abuse depends on contextual factors (e.g. severity and type of abuse), and the outcomes the particular advocacy intervention is designed to address (e.g. increasing successful court orders versus decreasing depression).We have low confidence in evidence regarding the significance of physical dependencies, being pregnant or having children. There were links between setting (high confidence), and potentially also theoretical underpinnings of interventions, type, duration and intensity of advocacy, advocate discipline and outcomes (moderate and low confidence). A good therapeutic alliance was important (high confidence); this alliance might be improved when advocates are matched with abused women on ethnicity or abuse experience, exercise cultural humility, and remove structural barriers to resource access by marginalised women. We identified significant challenges for advocates in inter-organisational working, vicarious traumatisation, and lack of clarity on how much support to give a woman (moderate and high confidence). To work effectively, advocates need ongoing training, role clarity, access to resources, and peer and institutional support.Our provisional model highlights the complex way that factors combine and interact for effective advocacy. We confirmed the core ingredients of advocacy according to both women and advocates, supported by studies and theoretical considerations: education and information on abuse; rights and resources; active referral and liaising with other services; risk assessment and safety planning. We were unable to confirm the impact of complexity of the intervention (low confidence). Our low confidence in the evidence was driven mostly by a lack of relevant studies, rather than poor-quality studies, despite the size of the review. AUTHORS' CONCLUSIONS Results confirm the core ingredients of advocacy and suggest its use rests on sound theoretical underpinnings. We determined the elements of a good therapeutic alliance and how it might be improved, with a need for particular considerations of the factors affecting marginalised women. Women's goals from advocacy should be considered in the contexts of their personal lives. Women's safety was not necessarily at greatest risk from staying with the abuser. Potentially, if undertaken for long enough, advocacy should benefit an abused woman in terms of at least one outcome providing the goals are matched to each woman's needs. Some outcomes may take months to be determined. Where abuse is severe, some interventions may increase abuse. Advocates have a challenging role and must be supported emotionally, through provision of resources and through professional training, by organisations and peers.Future research should consider the different principles identified in this review, and study outcomes should be considered in relation to the mechanisms and contexts elucidated. More longitudinal evidence is needed. Single-subject research designs may help determine exactly when effect no longer increases, to determine the duration of longitudinal work, which will likely differ for vulnerable and marginalised women. Further work is needed to ascertain how to tailor advocacy interventions to cultural variations and rural and resource-poor settings. The methods used in the included studies may, in some cases, limit the applicability and completeness of the data reported. Economic analyses are required to ascertain if resources devoted to advocacy interventions are cost-effective in healthcare and community settings.
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Affiliation(s)
- Carol Rivas
- University College LondonDepartment of Social Science, UCL Institute of Education18 Woburn SquareLondonUKWC1H 0NR
| | - Carol Vigurs
- University College LondonDepartment of Social Science, UCL Institute of Education18 Woburn SquareLondonUKWC1H 0NR
| | - Jacqui Cameron
- The University of MelbourneDepartment of Social Work, Melbourne School of Health SciencesMelbourneVICAustralia
- Finders UniversityNational Centre for Education and Training on Addiction (NCETA)AdelaideSouth AustraliaAustralia
| | - Lucia Yeo
- University College LondonDepartment of Social Science, UCL Institute of Education18 Woburn SquareLondonUKWC1H 0NR
- KK Women's and Children's HospitalDepartment of Child DevelopmentSingaporeSingapore229899
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Simmons J, Swahnberg K. Can nonresponse bias and known methodological differences explain the large discrepancies in the reported prevalence rate of violence found in Swedish studies? PLoS One 2019; 14:e0216451. [PMID: 31071131 PMCID: PMC6508645 DOI: 10.1371/journal.pone.0216451] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 04/16/2019] [Indexed: 11/20/2022] Open
Abstract
Introduction The reported prevalence rate of violence varies considerably between studies, even when conducted in similar populations. The reasons for this are largely unknown. This article considers the effects of nonresponse bias on the reported prevalence rate of interpersonal violence. We also single out violence perpetrated in intimate relationships and compare our results to previous Swedish studies. The aim was to explore the reasons for the large discrepancies in the prevalence rates found between studies. Material and method This is a cross sectional study of a random population sample. The NorVold Abuse Questionnaire (NorAQ), covering emotional, physical, and sexual violence, was answered by 754 men (response rate 35%) and 749 women (response rate 38%). Nonresponse bias was investigated in six ways, e.g., findings were replicated in two samples and we explored non-responders’ reasons for declining participation. Also, the prevalence rate of intimate partner violence was compared to four previous studies conducted in Sweden, considering the methodological differences. Results and discussion The only evidence of nonresponse bias found was for differences between the sample and the background population concerning the sociodemographic characteristics. However, the magnitude of that effect is bleak in comparison with the large discrepancies found in the prevalence rates between studies concerning intimate partner violence, e.g., emotional violence women: 11–41% and men: 4–37%; sexual and/or physical violence women: 12–27% and men: 2–21%. Some of the reasons behind these differences were obvious and pertained to differences in the definition and operationalization of violence. However, a considerable proportion of the difference could not easily be accounted for. Conclusion It is not reasonable that so little is known about the large discrepancies in the prevalence rate for what is supposedly the same concept, i.e., intimate partner violence. This study is a call for more empirical research on methods to investigate violence.
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Affiliation(s)
- Johanna Simmons
- Department of Acute Internal Medicine and Geriatrics, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
| | - Katarina Swahnberg
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
- * E-mail:
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Drieskens S, Demarest S, D'Hoker N, Ortiz B, Tafforeau J. Is a Health Interview Survey an appropriate tool to assess domestic violence? Eur J Public Health 2017. [PMID: 28633419 DOI: 10.1093/eurpub/ckx078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background The aim of this study is to assess if a Health Interview Survey (HIS) targeting the general population is an appropriate tool to collect valid data on domestic violence. Studying item non-response on the question on domestic violence and its association with socio-demographic and health characteristics compared with victims of domestic violence can contribute to this. Methods Cross-sectional data from the Belgian HIS 2013 were analysed. A question whether the perpetrator of a violent event was a member of the respondents' household was embedded in a general topic on violence in the self-administered questionnaire. This study is limited to people aged 15+ that at least completed the first question of this topic. Socio-demographic characteristics of item non-respondents and of victims of domestic violence were explored and the association with health status was assessed through ORs calculated via logistic regression. Results The year prevalence of domestic violence is 1.1%. Although the question on domestic violence yields a high level of non-response (62%), this does not hinder the further completion of the questionnaire. When compared with victims of domestic violence, those not responding on the question on the perpetrator have better (mental) health. When compared with those not being victim of domestic violence, victims report poorer physical and mental health. Conclusion An HIS can be an appropriate tool to assess domestic violence in the general population and its association with health. However, a solution should be found for the high item non-response on the question on the perpetrator of the violent event.
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Affiliation(s)
- Sabine Drieskens
- Department of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium
| | - Stefaan Demarest
- Department of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium
| | - Nicola D'Hoker
- Institute for the equality of women and men, Brussels, Belgium
| | - Barbara Ortiz
- Institute for the equality of women and men, Brussels, Belgium
| | - Jean Tafforeau
- Department of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium
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García-Díaz V, Lana-Pérez A, Fernández-Feito A, Bringas-Molleda C, Rodríguez-Franco L, Rodríguez-Díaz FJ. [Sexist attitudes and recognition of abuse in young couples]. Aten Primaria 2017; 50:398-405. [PMID: 28935381 PMCID: PMC6836904 DOI: 10.1016/j.aprim.2017.04.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 04/03/2017] [Accepted: 04/05/2017] [Indexed: 11/05/2022] Open
Abstract
Objetivo Explorar la asociación entre las actitudes de rol de género y el reconocimiento del maltrato en jóvenes. Diseño Estudio transversal. Emplazamiento Cincuenta y siete centros de educación secundaria, formación profesional y universitaria de 5 provincias españolas (Huelva, Sevilla, A Coruña, Pontevedra y Asturias). Participantes Un total de 4.337 estudiantes de entre 15 y 26 años (40,6% chicos y 59,4% chicas) que mantuvieron una relación de pareja durante un mes o más. Mediciones principales Se utilizó la Escala de Actitudes de Rol de Género, con 20 indicadores de actitudes igualitarias o sexistas a nivel familiar, social y laboral. También se estudió si la persona estaba en una situación de maltrato percibido (MP), maltrato no percibido (MNP) o no maltrato (NM). Resultados En el conjunto de la muestra, el 68,6% se declaró NM, el 26,4% vivía una situación de MNP y el 5,0% reconoció sufrir maltrato. El MP fue más frecuente entre las chicas (6,3%), en los/as ≥ 18 años (6,4%) y en el alumnado universitario (6,9%). El MNP fue más habitual en los chicos (30,2%). Las actitudes más sexistas se encontraron en la dimensión laboral, y especialmente en varones y en adolescentes (15-17 años). Las actitudes menos sexistas se asociaron con menor probabilidad de vivir situaciones de MNP (odds ratio = 0,71; p-tendencia < 0,001). Conclusiones El sexismo parece dificultar el reconocimiento del maltrato. Lograr la equidad de género en la adolescencia y juventud es imprescindible. Los esfuerzos deberían centrarse en los varones, por ser el grupo con actitudes más sexistas y con mayor prevalencia de MNP.
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Affiliation(s)
- Vanesa García-Díaz
- Departamento de Medicina, Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, España
| | - Alberto Lana-Pérez
- Departamento de Medicina, Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, España.
| | - Ana Fernández-Feito
- Departamento de Medicina, Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, España
| | - Carolina Bringas-Molleda
- Departamento de Psicología y Antropología, Facultad de Formación del Profesorado, Universidad de Extremadura, Cáceres, España
| | - Luis Rodríguez-Franco
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universidad de Sevilla, Sevilla, España
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Lövestad S, Löve J, Vaez M, Krantz G. Prevalence of intimate partner violence and its association with symptoms of depression; a cross-sectional study based on a female population sample in Sweden. BMC Public Health 2017; 17:335. [PMID: 28424072 PMCID: PMC5397670 DOI: 10.1186/s12889-017-4222-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 04/01/2017] [Indexed: 12/04/2022] Open
Abstract
Background Intimate Partner Violence (IPV) is the most common type of violence targeting women. IPV includes acts of physical aggression, sexual coercion, psychological abuse and controlling behaviors and these forms of violence often coexist in the same relationship. Living with IPV is associated with serious mental health outcomes such as depression and depressive symptoms. Few population based studies from Sweden have investigated the relationship between different forms of IPV and women’s depressive symptoms and even fewer used controlling behavior as an independent variable in such studies. The aim of this study was therefore to assess the prevalence of exposure to IPV in terms of controlling behavior, sexual, and physical violence and their association with self-reported symptoms of depression in a female population based sample. Methods The cross-sectional, population based sample contained 573 women aged 18–65 years randomly selected in Sweden. Five self-reported symptoms that define depression in the Diagnostic and Statistical Manual of Mental Disorders were assessed. Physical and sexual violence were inquired about using the World Health Organization’s (WHO) Violence Against Women Instrument (VAWI), while controlling behavior was assessed with the Controlling Behavior Scale (CBS). Associations between different forms of IPV and symptoms of depression were estimated by crude and adjusted odds ratio (OR) with 95% confidence intervals (CI). Results Bivariable associations revealed that women exposed to controlling behavior, had higher OR of depressive symptoms compared to unexposed women (OR 2.43; 95% CI 1.63–3.63). Women exposed to physical and sexual violence had also a higher OR of depressive symptoms (OR 3.78; 95% CI 1.99–7.17 and OR 5.10; 95% CI 1.74–14.91 respectively). After adjusting for socio-demographic and psychosocial covariates, all three forms of IPV showed statistically significant associations with self-reported symptoms of depression. Conclusions A strength with this study is the analysis of controlling behavior and its association with self-reported symptoms of depression in a female population based sample. Exposure to controlling behavior, physical and sexual violence by an intimate partner were clearly associated with women’s self-reported symptoms of depression.
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Affiliation(s)
- Solveig Lövestad
- Department of Community Medicine and Public Health, Sahlgrenska Academy at University of Gothenburg, Box 453, 405 30, Göteborg, Sweden.
| | - Jesper Löve
- Department of Community Medicine and Public Health, Sahlgrenska Academy at University of Gothenburg, Box 453, 405 30, Göteborg, Sweden
| | - Marjan Vaez
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE- 171 77, Stockholm, Sweden
| | - Gunilla Krantz
- Department of Community Medicine and Public Health, Sahlgrenska Academy at University of Gothenburg, Box 453, 405 30, Göteborg, Sweden
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Umubyeyi A, Persson M, Mogren I, Krantz G. Gender Inequality Prevents Abused Women from Seeking Care Despite Protection Given in Gender-Based Violence Legislation: A Qualitative Study from Rwanda. PLoS One 2016; 11:e0154540. [PMID: 27152680 PMCID: PMC4859471 DOI: 10.1371/journal.pone.0154540] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 03/25/2016] [Indexed: 11/19/2022] Open
Abstract
Objective Despite its burden on a person’s life, Intimate Partner Violence (IPV) is known to be poorly recognised and managed in most countries and communities. This study aimed to explore health care professionals’ experiences of the health care seeking processes of women exposed to intimate partner violence in Rwanda. Methods Six focus group discussions were conducted in three district hospitals and three mental health units in Rwanda. A sample of 43 health care professionals with various professions and length of work experience, who regularly took care of patients subjected to IPV, was selected for focus group discussions. The analysis was performed using qualitative content analysis. Results The theme “Gendered norms and values defeat the violence legislation in women’s health care seeking when women are abused” expressed the health care professionals’ experiences of the double-faced situation which women exposed to IPV met in their help seeking process. Positive initiatives to protect women were identified, but the potential for abused women to seek help and support was reduced because of poverty, gender inequality with prevailing strong norms of male superiority, and the tendency to keep abuse as a private family matter. Conclusion Legislative measures have been instituted to protect women from abuse. Still many Rwandan women do not benefit from these efforts. The role of the health care services needs to be reinforced as an important and available resource for help and support for abused women but further legislative changes are also needed. Initiatives to further improve gender equality, and institutionalised collaboration between different sectors in society would contribute to protecting women from IPV.
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Affiliation(s)
- Aline Umubyeyi
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- * E-mail:
| | | | - Ingrid Mogren
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - Gunilla Krantz
- Department of Public Health and Community Medicine, Section of Epidemiology and Social Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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Lifetime co-occurrence of violence victimisation and symptoms of psychological ill health: a cross-sectional study of Swedish male and female clinical and population samples. BMC Public Health 2015; 15:979. [PMID: 26415496 PMCID: PMC4587579 DOI: 10.1186/s12889-015-2311-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 09/22/2015] [Indexed: 11/10/2022] Open
Abstract
Background Lifetime co-occurrence of violence victimisation is common. A large proportion of victims report being exposed to multiple forms of violence (physical, sexual, emotional violence) and/or violence by multiple kinds of perpetrators (family members, intimate partners, acquaintances/strangers). Yet much research focuses on only one kind of victimisation. The aim of this study was to investigate the association between symptoms of psychological ill health, and A) exposure to multiple forms of violence, and B) violence by multiple perpetrators. Method Secondary analysis of cross-sectional data previously collected for prevalence studies on interpersonal violence in Sweden was used. Respondents were recruited at hospital clinics (women n = 2439, men n = 1767) and at random from the general population (women n = 1168, men n = 2924). Multinomial regression analysis was used to estimate associations between exposure to violence and symptoms of psychological ill health. Results Among both men and women and in both clinical and population samples, exposure to multiple forms of violence as well as violence by multiple perpetrators were more strongly associated with symptoms of psychological ill health than reporting one form of violence or violence by one perpetrator. For example, in the female population sample, victims reporting all three forms of violence were four times more likely to report many symptoms of psychological ill health compared to those reporting only one form of violence (adj OR: 3.8, 95 % CI 1.6–8.8). In the male clinical sample, victims reporting two or three kind of perpetrators were three times more likely to report many symptoms of psychological ill health than those reporting violence by one perpetrator (adj OR 3.3 95 % CI 1.9–5.9). Discussion The strong association found between lifetime co-occurrence of violence victimisation and symptoms of psychological ill-health is important to consider in both research and clinic work. If only the effect of one form of violence or violence by one kind of perpetrator is considered this may lead to a misinterpretation of the association between violence and psychological ill health. When the effect of unmeasured traumata is ignored, the full burden of violence experienced by victims may be underestimated. Conclusion Different kinds of victimisation can work interactively, making exposure to multiple forms of violence as well as violence by multiple perpetrators more strongly associated with symptoms of psychological ill health than any one kind of victimisation alone.
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Exposure to violence among women with unwanted pregnancies and the association with post-traumatic stress disorder, symptoms of anxiety and depression. SEXUAL & REPRODUCTIVE HEALTHCARE 2015; 6:50-3. [DOI: 10.1016/j.srhc.2014.08.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 08/04/2014] [Accepted: 08/20/2014] [Indexed: 11/18/2022]
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Intimate partner violence: a study in men and women from six European countries. Int J Public Health 2015; 60:467-78. [DOI: 10.1007/s00038-015-0663-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 01/31/2015] [Accepted: 02/03/2015] [Indexed: 10/24/2022] Open
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Dufort M, Stenbacka M, Gumpert CH. Physical domestic violence exposure is highly associated with suicidal attempts in both women and men. Results from the national public health survey in Sweden. Eur J Public Health 2014; 25:413-8. [PMID: 25471557 PMCID: PMC4440449 DOI: 10.1093/eurpub/cku198] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Studies on a national level concerning domestic violence (DV) among both men and women are few. DV and its relation to other social and health outcomes within the framework of the Swedish Public Health Survey have remained unexplored. Aim: To compare women and men regarding their social situation and health status in relation to self-reported exposure to physical DV as measured in the Swedish National Public Health Survey. Methods: This study used cross-sectional data from the Swedish Public Health Survey, years 2004–09 with a total sample of 50 350 respondents, of which 205 women and 93 men reported DV exposure. Logistic regression analyses stratified by sex with physical DV exposure as the outcome measure were conducted, and the multivariate models were fitted using the likelihood ratio test. Results: Being foreign-born [women odds ratio (OR) = 1.52, men OR = 1.92] and lack of social support (women OR = 2.81, men OR = 1.92) were associated with DV exposure among both sexes. Higher psychological distress (women OR = 2.81, men OR = 1.92) and hazardous drinking (women OR = 1.61, men OR = 2.33) were also associated with DV exposure. Among women, financial problems were associated with DV exposure (OR = 1.83), whereas among men, sum of medicines used and higher odds of DV were associated (OR = 1.17). Further, suicidal attempts were associated with DV exposure among both women (OR = 5.59) and men (OR = 8.34). Conclusions: In this national survey, prevalence rates of violence exposure were lower than in other studies, but despite this, both women and men exposed to physical DV reported increased odds of having attempted suicide.
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Affiliation(s)
- Mariana Dufort
- Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden
| | - Marlene Stenbacka
- Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden
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López-Cepero J, Lana A, Rodríguez-Franco L, Paíno SG, Rodríguez-Díaz FJ. [Perception and description of violent experience in youth dating relationships]. GACETA SANITARIA 2014; 29:21-6. [PMID: 25176129 DOI: 10.1016/j.gaceta.2014.07.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 07/10/2014] [Accepted: 07/12/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe the intimate partner violence suffered by youth and to identify the descriptions that best classify it according to gender. METHODS A cross-sectional study was carried out among a sample of 3,087 adult Spanish students. The CUVINO questionnaire was used, which measures 8 forms of intimate partner violence and uses 3 descriptions to classify it (abuse, fear and entrapment). Logistic regressions were carried out to identify differences by gender and associations between the subtypes of intimate partner violence and descriptions of the violent experience. RESULTS Nearly half of the sample (44.6%) had some situation of unperceived violence, mainly of "detachment" (30.0%) and "coercion" (25.1%). All subtypes of intimate partner violence were more frequently perpetrated by women. The largest difference by gender was found in "emotional punishment" (experienced by 20.9% of men vs. 7.6% of women) and "physical violence" (6.6% vs. 2.3%). A total of 28.7% felt trapped, 11.8% felt fear and 6.3% felt mistreated. Men more frequently described themselves as trapped, but less often as afraid or abused. The subtype of intimate partner violence most associated with the feeling of entrapment was coercion in both men (OR=3.8) and women (OR=5.7). CONCLUSIONS Men and women face intimate partner violence while dating differently; resources are needed to address them specifically. The inclusion of routine questions about the sense of entrapment may contribute to the early detection of intimate partner violence. Subtle forms of violence, such as coercion, should be taken into account in awareness campaigns.
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Affiliation(s)
- Javier López-Cepero
- Facultad de Psicología, Área de Personalidad, Evaluación y Tratamiento Psicológicos, Universidad de Sevilla, Sevilla, España
| | - Alberto Lana
- Facultad de Medicina y Ciencias de la Salud, Área de Medicina Preventiva y Salud Pública, Universidad de Oviedo, Oviedo, España.
| | - Luis Rodríguez-Franco
- Facultad de Psicología, Área de Personalidad, Evaluación y Tratamiento Psicológicos, Universidad de Sevilla, Sevilla, España
| | - Susana G Paíno
- Facultad de Ciencias de la Educación, Área de Personalidad, Evaluación y Tratamiento Psicológicos, Universidad de Huelva, Huelva, España
| | - F Javier Rodríguez-Díaz
- Facultad de Psicología, Área de Personalidad, Evaluación y Tratamiento Psicológicos, Universidad de Oviedo, Oviedo, España
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Umubyeyi A, Mogren I, Ntaganira J, Krantz G. Women are considerably more exposed to intimate partner violence than men in Rwanda: results from a population-based, cross-sectional study. BMC WOMENS HEALTH 2014; 14:99. [PMID: 25155576 PMCID: PMC4148406 DOI: 10.1186/1472-6874-14-99] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Accepted: 08/15/2014] [Indexed: 11/22/2022]
Abstract
Background Intimate partner violence (IPV) against women is an important, yet often neglected public health issue. The existence of gender norms imbalance expressed by men’s and women’s attitudes in relation to power and decision-making in intimate relationships may influence the magnitude of IPV. The aim of this study was to investigate the prevalence and potential risk factors of physical, sexual and psychological IPV in young men and women in Rwanda. Methods This population-based, cross-sectional study included a representative sample of men and women from the Southern Province of Rwanda. Face-to-face interviews were performed using the World Health Organization (WHO) questionnaire for violence exposure to estimate past year and earlier in life IPV occurrence. Risk factor patterns were analyzed by use of bi- and multivariate logistic regression. Results Women were, to a considerably higher extent, exposed to physical, sexual and psychological IPV than men. Of the women, 18.8% (n = 78) reported physical abuse in the past year, compared to 4.3% (n = 18) of men. The corresponding figures for women and men for sexual abuse were 17.4% (n = 71) and 1.5% (n = 6), respectively, and for psychological abuse, the corresponding figures were 21.4% (n = 92) and 7.3% (n = 32). Findings illustrate that violence against women was recurrent, as the highest frequency (>3 times) dominated in women for the various acts of all forms of violence. Identified risk factors for women’s exposure to physical violence were being low educated, having poor social support, being poor and having many children. For men exposed to physical violence, no statistically significant risk factor was identified. Conclusions In this setting, IPV exposure was more common in women than men in the Southern Province of Rwanda. Promotion of gender equality at the individual level is needed to make a positive difference in a relatively short term perspective. Men’s lower reporting of IPV confirms women’s subordinate position, but men’s denial of incidents could also explain the gender role pattern.
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Affiliation(s)
- Aline Umubyeyi
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, University of Rwanda, P,O Box 5229, Kigali, Rwanda.
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Costa D, Hatzidimitriadou E, Ioannidi-Kapolou E, Lindert J, Soares J, Sundin Ö, Toth O, Barros H. Intimate partner violence and health-related quality of life in European men and women: findings from the DOVE study. Qual Life Res 2014; 24:463-71. [DOI: 10.1007/s11136-014-0766-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2014] [Indexed: 10/25/2022]
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Simmons J, Wijma B, Swahnberg K. Associations and experiences observed for family and nonfamily forms of violent behavior in different relational contexts among Swedish men and women. VIOLENCE AND VICTIMS 2014; 29:152-170. [PMID: 24673000 DOI: 10.1891/0886-6708.vv-d-12-00084] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The aim of this study was to examine how lifetime experiences of different types of violent behavior as well as violence by different kinds of perpetrators overlap, and to investigate the co-occurrence of experiences of violent behavior by kind of perpetrator. This was done among both sexes in both a random sample from a county population (women n = 1,168, men n = 2,924) and a clinical sample (women n = 2,439, men, n = 1,767) in Sweden. More than 1 kind of perpetrator was reported by 33%-37% of female and 22%-23% of male victims of some kind of violence, whereas 47%-48% of female and 29%-31% of male victims reported more than 1 kind of violence. The reporting of 2 or 3 kinds of perpetrators was associated with the reporting of experiences of more than 1 kind of violent behavior. Health care providers must be trained to recognize the overlap of violent victimization and help prevent further victimization of those who already have such experiences.
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