The differential effects of intimate terrorism and situational couple violence on mental health outcomes among abused Chinese women: a mixed-method study

Dissociative Symptoms in Women with Histories of Intimate Partner Victimization: A Focus on Coercive Control

Identifying and contrasting different patterns of intimate partner violence (IPV) (e.g. situational couple violence, coercive controlling violence) is useful for understanding IPV and its connections with health. Applying this approach to dissociation may be fruitful, given theoretical perspectives that predict a specific connection between coercive controlling violence and dissociative symptoms. To address this, community women with divorce histories (N = 188) completed measures to identify patterns of IPV victimization in prior relationships (no direct violence, situational couple violence, coercive controlling violence), and to quantify recent dissociative symptoms and number of depressed days, for comparison. Contrary to predictions, the predicted odds of recent dissociative symptoms did not differ between women who experienced situational couple violence versus coercive controlling violence. However, the latter group had greater odds of recent dissociative symptoms, but not depressed days, compared to women with no histories of direct violence. Further, a continuous measure of coercive control was uniquely associated with increased odds of dissociative symptoms. This study provides preliminary empirical support for a connection between coercive controlling violence and dissociative symptoms, compared to women without histories of direct violence. This deserves further attention given the strong theoretical rationale for this link, and the importance of dissociation for mental health.

The Trauma and Mental Health Impacts of Coercive Control: A Systematic Review and Meta-Analysis

Coercive control is an under researched type of intimate partner violence (IPV). The aims of this review were to (a) synthesize all available evidence regarding associations with coercive control and mental health outcomes including post-traumatic stress disorder (PTSD), complex PTSD, and depression; and (b) compare these with associations involving broader categories of psychological IPV. Primary studies which measured associations of coercive control with PTSD, complex PTSD, depression, or other mental health symptoms, were identified via a systematic search of electronic databases (PsycINFO, Medline, CINAHL, Scopus). Eligible studies involved observational designs and reported associations between coercive control and mental health outcomes, among participants who were at least 18 years old. Studies were published in peer-reviewed journals and English language. Random-effects meta-analyses were used to synthesize correlational data from eligible studies. The search identified 68 studies while data from 45 studies could be included in the meta-analyses. These indicated moderate associations involving coercive control and PTSD (r = .32; 95% confidence interval [.28, .37]) and depression (r = .27; [.22, .31]). These associations were comparable to those involving psychological IPV and PTSD (r = .34; [.25, .42]) and depression (r = .33; [.26, .40]). Only one study reported on the relationship between coercive control and complex PTSD and meta-analyses could not be performed. This review indicated that coercive control exposure is moderately associated with both PTSD and depression. This highlights that mental health care is needed for those exposed to coercive control, including trauma-informed psychological interventions.

Changing Patterns of Intimate Partner Violence against Pregnant Women: A Three-Year Longitudinal Study

Intimate partner violence (IPV) against pregnant women adversely impacts women's and infants' health. This study aims to provide longitudinal evidence regarding how pregnant women's exposure to IPV changes over time. Additionally, we examine the risk and protective factors associated with these changes. In total, 340 pregnant women were recruited from an antenatal clinic in Hong Kong. IPV experiences and health conditions were assessed at pregnancy and at both 4 weeks and 3 years after childbirth. The women also reported adverse childhood experiences (ACEs), their family support, and perceived partner involvement. We found IPV prevalence among the study sample decreased from 22.9% before pregnancy to 13.5% during pregnancy, 14.7% at 4 weeks after childbirth, and 11.8% at 3 years after childbirth. We further found three types of IPV: 11.8% of women had a violent relationship (VR) persistently over time from pregnancy to 3 years after childbirth, 20.6% experienced decreased IPV (DVR), and 67.6% reported a nonviolent relationship (NVR) throughout the study period. VRs were associated with more severe mental health problems and higher ACEs. Family support and partner involvement may be protective factors for decreased IPV. Our present findings highlight the importance of identifying different IPV types over time to provide targeted intervention to the most vulnerable groups.

Intimate Partner Violence Before Pregnancy, During Pregnancy, and After Childbirth: A New Conceptualization Highlighting Individual Changes in Violence Against Pregnant Women Over Time

Intimate partner violence (IPV) against pregnant women is a global public health problem. Yet, the trajectory of IPV during pregnancy and its association with health are unclear. This study set out to investigate the trajectory of IPV by categorizing pregnant women according to changes of IPV exposure before, during, and after pregnancy and to examine the predictive factors of these IPV-related categories. During 2016 and 2017, we conducted a longitudinal study with a sample of 1,083 pregnant women in Hong Kong. Pregnant women reported their IPV experiences, depression, and demographics in the baseline survey (at about 24-week gestation), and their IPV experiences, mental health outcomes, social support, and perceived father's involvement in the follow-up survey (around 4 weeks postpartum). We categorized pregnant women into four groups, including women with (a) sustaining abusive relationship (AR); (b) relationship with decreased violence over pregnancy (DVR); (c) relationship with stress-related violence (SVR); and (d) nonviolent relationship (NVR). Although we found an overall decline of IPV during pregnancy from 24.6% to 14.3%, there were still a considerable proportion of women reporting as a victim of IPV. We observed that a higher proportion of pregnant women were actually suffering from IPV during pregnancy and after childbirth continuously (22.3% of AR and SVR) than experiencing a termination of IPV due to pregnancy (11.4% of DVR). We also observed that more severe maternal depression, lower levels of father's involvement, and poorer social support were significantly associated with the categories that reflected greater severity of IPV over the course of pregnancy. Our findings reflected that the complexity of IPV related to pregnancy should never be overlooked. Mere reporting of prevalence in an aggregate might not sufficiently explain the problem. Father's involvement and social support are two important factors that might help reduce IPV related to pregnancy and childbirth.

Prevalence and factors associated with the use of sleep-inducing medication among women receiving Primary Health Care: a cross-sectional study in Vitória, Espírito Santo, Brazil, 2014

OBJECTIVE

To verify prevalence and factors associated with the use of sleep-inducing medication among women receiving primary health care (PHC) in Vitória, ES, Brazil.

METHODS

This was a cross-sectional study conducted in 2014 with women aged 20-59. We analyzed association of sleep-inducing medication use with socioeconomic factors and experiences of violence (Poisson regression).

RESULTS

Out of 991 participants, 18.5% were using sleep-inducing medication and 45.9% had used it at some point in their lives. Current and lifetime use of these medications was associated with age, years of education, as well as psychological, physical and sexual violence in the last year (p-value<0.05). Lower family income (PR=1.30; 95%CI 1.03;1.64) and controlling partner (PR=1.35; 95%CI 1.08;1.69) were associated with current use, while experience of sexual violence in childhood (PR=1.33; 95%CI 1.13;1.56) was associated with lifetime use.

CONCLUSION

Use of sleep-inducing medication was frequent among PHC service users, and was associated with socioeconomic factors and experiences of violence.

Intimate Partner Violence Victimization and Depressive Symptoms in Sichuan, China: Are There Gender Variations?

An emerging body of research has linked intimate partner violence (IPV) victimization with negative mental health outcomes among women in postreform China. However, limited scholarly attention has been given to the independent effects of multiple types of IPV victimization on depressive symptoms among men and women. Little is known if these independent effects will vary by gender in China where research on the association between IPV victimization and mental health did not emerge until fairly recently. Given this research paucity, this study aims to (a) examine the independent effects of different types of lifetime IPV victimization among married men and women in Sichuan province on their self-reported past 30-day depressive symptoms and (b) explore possible gender variations in these effects. The data utilized in this study came from a subsample of married men (N = 1,083) and women (N = 1,185) from the Third Survey of Chinese Women's Social Status 2010, a representative sample of adults aged 18 to 64 in Sichuan province. Statistical analyses indicate that all types of lifetime IPV victimization are significantly and positively associated with past 30-day depressive symptoms for women, whereas for men lifetime experiences of general controlling behavior and sexual IPV were not statistically associated with depressive symptoms. Moreover, the effects of multiple types of IPV victimization on depressive symptoms do not significantly vary by gender. Bearing this gender-neutral pattern in mind, health professionals, governmental officials, and researchers are strongly encouraged to focus on both married men and women in their IPV and mental health intervention, prevention, and treatment endeavors in postreform China.

Relationship Dynamics and Perpetration of Intimate Partner Violence Among Female Chinese College Students

In China, most intimate partner violence (IPV) research focuses on male perpetration and female victimization, whereas studies on dating violence and female IPV perpetration are less common. Although research on female IPV perpetration in China has surfaced recently, there have been limited studies examining factors related to female perpetration in dating relationships in China. In the current research, we sought to examine how relationship factors, including anger management, communication problems, relationship conflict, and relationship distress, are linked with female physical and psychological IPV perpetration. We included 857 female college students in three regions in China from the International Dating Violence database. We found that Chinese women's anger management skills and communication problems were both significantly associated with physical and psychological IPV perpetration on both minor and severe levels. Furthermore, we found that relationship conflict was significantly associated with minor and severe physical abuse perpetration and severe psychological abuse perpetration. Anger management skills moderated the negative effects of relationship conflict on minor physical IPV perpetration as well as minor and severe psychological IPV perpetration. Anger management skills also moderated the negative effects of relationship distress on minor and severe physical IPV perpetration among Chinese women. Our findings suggest that it may be important to explore the role of college women's anger management skills, communication problems, and conflict resolution skills in their dating relationships, as well as to develop female-based intervention programs to increase Chinese college women's relationship skills to reduce their levels of IPV perpetration.

Characteristics of Intimate Partner Violence in China: Gender Symmetry, Mutuality, and Associated Factors

The primary research focus on female victims of intimate partner violence (IPV), coupled with a lack of discussion on mutual violence between intimate partners, has affected our understanding of IPV in China. In the current study, we aim to examine gender symmetry and mutuality in IPV in China. We also produce the first age-specific and gender-specific prevalence estimates for different types of IPV. The associations between IPV, demographic factors, personal factors, and relationship factors are also examined. We analyzed a set of data from 7,466 households in six regions in China collected between 2009 and 2010. Three-way cross-tab analyses and multinomial logistic regressions were performed to examine the prevalence of IPV in the preceding year by gender and age groups and its associations with different individual and relationship factors, respectively. For sexual violence and severe physical assault and injury, most victims experienced unidirectional violence. For psychological aggression and minor physical assault, mutual violence was more likely to occur among intimate partners. Gender symmetry was found in regard to physical assault and psychological aggression. There is gender asymmetry in sexual violence between Chinese intimate partners. Older individuals are less likely to be victims or perpetrators of IPV or to be involved in mutual violence. Factors associated with IPV show that mutual violence is generally analogous to violence perpetration. To prevent IPV, it is important to understand gender symmetry and mutuality of IPV in China. We need to involve both men and women in violence prevention and develop age-appropriate programs in the future.

Nursing research on intimate partner violence in China: A scoping review

Intimate partner violence (IPV) is a serious public health issue, and nurses have the potential to screen, navigate to interventions, and provide support, but responses to IPV differ greatly in mainland China, Hong Kong, Macao, and Taiwan. We conducted a scoping review to examine the nursing literature on IPV in the above four regions in China. We conducted a comprehensive search of 11 Chinese and English databases from database inception to January 31, 2020, for eligible papers including empirical studies, reviews, reports, and expert opinion articles. We hand searched references lists and other studies published by the first and corresponding authors of included articles. Two reviewers independently screened articles and extracted data, and three reviewers cross-checked the extracted results. We also conducted quality appraisal for applicable empirical studies. A total of 58 Chinese-language and 63 English-language articles were included, 58 from Taiwan, 44 from Hong Kong, 13 from mainland China, and six from institutions outside China, but none from Macao. The quantitative and qualitative studies described the prevalence and complex nature of IPV, comparable to non-nursing and international studies. Nurse-led advocacy and Qigong (traditional Chinese mind-body health practice) interventions showed promise for improving mental health in women in Hong Kong. There was a low level of knowledge and preparedness to respond to IPV among Chinese nurses, especially in mainland China. Mixed methods studies in Hong Kong and Taiwan as complex designs were generally well-conducted. Nursing case reports from Taiwan uniquely supplemented the evidence base. In Hong Kong and Taiwan, varying designs were used to study various facets of IPV, targeting victims, nurses and other key stakeholders. In mainland China and Macao, IPV research was limited in quantity, quality, and diversity. As more research in the area of IPV is needed, factors influencing nursing research on IPV also merit investigation, while taking into consideration socio-economic-political-cultural factors.

Types of non-psychotic mental disorders in adult women who suffered intimate partner violence: an integrative review

OBJECTIVE

Identifying the types of non-psychotic mental disorders in adult women who suffered intimate partner violence in the literature.

METHOD

An integrative review carried out in the MEDLINE, CINAHL, LILACS, Web of Science and SCOPUS databases.

RESULTS

We selected 19 articles published in international journals in English, with a predominance of cross-sectional study studies (78.9%). The most common types of non-psychotic mental disorders were: depression (73.7%) and post-traumatic stress disorder (52.6%). It was observed that 78.9% of the articles presented a 2C level of evidence.

CONCLUSION

Studies have shown that adult women who are victims of intimate partner violence mostly suffer from depression and post-traumatic stress disorder, as well as other morbidities; a fact that highlights how devastating violence by an intimate partner can impact on the mental health of those who experience it.

Intimate Terrorism and Situational Couple Violence: Classification Variability Across Five Methods to Distinguish Johnson's Violent Relationship Types

Johnson's (1995, 2008) theory of violent relationship types represents an opportunity to resolve debates surrounding intimate partner violence (IPV) prevalence and to adapt policy and treatment options for victims accordingly. However, the use of quantitative methods to distinguish between situational couple violence (SCV) and intimate terrorism (IT) remains in its initial stages of discovery. This study included a 2-phase (N = 840; via targeted community and agency sampling) online survey design comparing the utility and grouping variability across 5 methods of IT/SCV classification: victimization-variables and coercive-control-variable hierarchical clustering, vignette-choice, cutoff scoring, and expert coding. Findings are discussed in terms of contributions to differing IPV-research perspectives, researchers' understanding of existing classification methods, and practitioners' awareness of victims' voices in quantitative research.

Association Among Father Involvement, Partner Violence, and Paternal Health: UN Multi-Country Cross-Sectional Study on Men and Violence

INTRODUCTION

The influence of father involvement on intimate partner violence (IPV) and men's health is poorly understood. This study aimed to investigate the prevalence of six aspects of father involvement in delivery and child care, and to explore their individual associations with IPV against women and paternal health in an Asia-Pacific context.

METHODS

This study analyzed data from the 2011-2012 UN Multi-Country Cross-Sectional Study on Men and Violence, which surveyed >10,000 men from Bangladesh, Cambodia, China, Indonesia, Papua New Guinea, and Sri Lanka. Multivariate regression analyses were conducted in 2016 to examine the associations among father involvement, IPV, and paternal health.

RESULTS

The sample comprised 6,184 men (aged 18-49 years) who had at least one child. The prevalence ranged from 40.0% to 62.9% across different aspects of father involvement. Presence at prenatal visits, taking paternity leave, and helping children with homework were associated with a reduced likelihood of IPV against women (all p<0.05). When possible confounding factors were adjusted for, father involvement accounted for 2% of the variance of men's perceived health, 4% of depression, and 2% of life satisfaction (all p<0.05).

CONCLUSIONS

Father involvement may be beneficial in reducing IPV and improving paternal health. More family-friendly policies should be adopted by policymakers to promote father involvement throughout pregnancy to improve family well-being and child development.