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Choi YJ, Rai A, Yun SH, Lee JO, Hong S, Cho H, An S. Risk factors for intimate partner violence perpetration among college students: Impact of childhood adversities. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1103-1111. [PMID: 35549994 DOI: 10.1080/07448481.2022.2068017] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 02/23/2022] [Accepted: 04/10/2022] [Indexed: 06/15/2023]
Abstract
Objective Intimate partner violence (IPV) among college students is a significant problem that negatively affects their physical and emotional health. This study aimed at examining risk factors, especially childhood adversities at the individual, relationship, and community levels, of IPV perpetration among college students. Methods: The sample from seven universities in the U.S. and Canada (N = 3,725) completed an online survey. Major variables included IPV perpetration, five types of childhood adversities, alcohol and drug use, depression, and demographic information. Logistic regression was performed. Results: Peer violence victimization, witnessing parental IPV, experiencing child maltreatment, drug use, and depression were associated with a higher odd of perpetrating IPV. Conclusions: Research and practice must account for exposure to multiple risk factors when intervening with college students. An integrative approach that combines trauma-informed interventions with substance use and mental health treatment may be most successful at IPV perpetration prevention and intervention among college students.
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Affiliation(s)
- Y Joon Choi
- School of Social Work, University of Georgia, Athens, Georgia, USA
| | - Abha Rai
- School of Social Work, Loyola University Chicago, Chicago, Illinois, USA
| | - Sung Hyun Yun
- School of Social Work, University of Windsor, Windsor, Ontario, Canada
| | - Jungeun Olivia Lee
- School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Seunghye Hong
- School of Social Work, University of Hawaii, Honolu, Hawaii, USA
| | - Hyunkag Cho
- School of Social Work, Michigan State University, East Lansing, Michigan, USA
| | - Soonok An
- Department of Social Work and Sociology, North Carolina A&T State University, Greensboro, North Carolina, USA
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Smethurst MA, Taft CT, Creech SK. Predictors of veteran attendance in an intimate partner violence intervention. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2024; 38:443-452. [PMID: 38271068 PMCID: PMC10963154 DOI: 10.1037/fam0001200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
This study examined session attendance data from 2,754 veterans who participated in a national implementation of a trauma-informed intimate partner violence intervention, Strength at Home, across the Veterans Affairs Healthcare System. Potential correlates of attendance were demographic characteristics, posttraumatic stress disorder (PTSD) symptom severity, alcohol use, court involvement, current military involvement, and intervention modality (in-person vs. virtual). Given the trauma-informed nature of the intervention, it was expected that trauma-relevant risk factors, specifically PTSD symptom severity and racial minority status, would be less strongly associated with attendance than barriers related to other demographic variables and higher alcohol use, intervention modality, and court involvement. Results indicated that age, education level, employment status, retirement status, PTSD symptom severity, alcohol use, and court involvement were associated with session attendance in the expected direction at the bivariate level. Only education level, employment status, retirement status, alcohol use, and court involvement emerged as unique predictors of attendance such that more educated, employed, retired, and court-mandated veterans with less alcohol use attended more sessions. These findings suggest the importance of a trauma-informed, coordinated community response to intimate partner violence intervention and integration of motivational components surrounding problematic alcohol use to enhance compliance and mitigate barriers to attendance. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Madeline A. Smethurst
- Behavioral Science Division, National Center for PTSD, Boston, Massachusetts
- VA Boston Healthcare System, Boston Massachusetts
| | - Casey T. Taft
- Behavioral Science Division, National Center for PTSD, Boston, Massachusetts
- VA Boston Healthcare System, Boston Massachusetts
- The Boston University Chobanian & Avedisian School of Medicine
| | - Suzannah K. Creech
- VA VISN 17 Center of Excellence for Research on Returning War Veterans and the Central Texas Veterans Healthcare System, Temple Texas
- Dell Medical School of the University of Texas at Austin
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Creech SK, Benzer JK, Bruce L, Taft CT. Evaluation of the Strength at Home Group Intervention for Intimate Partner Violence in the Veterans Affairs Health System. JAMA Netw Open 2023; 6:e232997. [PMID: 36917105 PMCID: PMC10015307 DOI: 10.1001/jamanetworkopen.2023.2997] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
IMPORTANCE Intimate partner violence (IPV) is a serious and prevalent public health issue that is interconnected with experiences of trauma, mental and physical health difficulties, and health disparities. Strength at Home (SAH) is a group intervention for persons using IPV in their relationships. Although previous studies have provided evidence of SAH's effectiveness in reducing IPV, its patient outcomes as implemented within organized health care have not been examined. OBJECTIVE To evaluate patient outcomes from implementation of SAH in the Department of Veterans Affairs (VA) health system. DESIGN, SETTING, AND PARTICIPANTS This quality improvement study evaluated patient outcomes from a national implementation and training program conducted between December 11, 2015, and September 24, 2021. Data were collected as part of treatment and submitted by clinicians at 73 VA health care facilities. Patients were 1754 veterans seeking care aimed at addressing and/or preventing their use of aggression in intimate relationships. They completed 1 pretreatment assessment and 1 follow-up assessment in the immediate weeks after group completion. INTERVENTION Strength at Home is a 12-week trauma-informed and cognitive behavioral group intervention to address and prevent the use of IPV in relationships. MAIN OUTCOMES AND MEASURES Changes in IPV were measured with the Centers for Disease Control and Prevention 2010 National Intimate Partner and Sexual Violence Survey. Changes in posttraumatic stress disorder (PTSD) symptoms were measured with the PTSD Checklist for DSM-5, and alcohol misuse was measured with the Alcohol Use Disorders Identification Test. RESULTS The study included 1754 participants (mean [SD] age, 44.3 [13.0] years; 1421 men [81%]), of whom 1088 (62%) were involved with the criminal legal system for IPV charges. Analyses indicate that SAH was associated with reductions in use of physical IPV (odds ratio, 3.28; percentage difference from before to after treatment, -0.17 [95% CI, -0.21 to -0.13]) and psychological IPV (odds ratio, 2.73; percentage difference from before to after treatment, -0.23 [95% CI, -0.27 to -0.19]), coercive control behaviors (odds ratio, 3.19; percentage difference from before to after treatment, -0.18 [95% CI, -0.22 to -0.14), PTSD symptoms (mean change, -4.00; 95% CI, 0.90-7.09; Hedges g = 0.10), and alcohol misuse (mean change, 2.70; 95% CI, 1.54-3.86; Hedges g = 0.24). CONCLUSIONS AND RELEVANCE In this quality improvement study of the patient outcomes after implementation of SAH, results suggested that the program was associated with reductions in IPV behaviors, PTSD symptoms, and alcohol misuse. Results also suggest that IPV intervention in routine health care at VA health care facilities was successful; extension to other organized health care systems could be warranted.
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Affiliation(s)
- Suzannah K. Creech
- Veterans Affairs Veterans Integrated Services Network 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas; and the Central Texas Veterans Health Care System, Temple
- Dell Medical School of the University of Texas at Austin, Austin
| | - Justin K. Benzer
- Veterans Affairs Veterans Integrated Services Network 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas; and the Central Texas Veterans Health Care System, Temple
- Dell Medical School of the University of Texas at Austin, Austin
| | - LeAnn Bruce
- Department of Veterans Affairs, Veterans Health Care Administration, Care Management and Social Work, Washington, DC
| | - Casey T. Taft
- National Center for PTSD, Veterans Affairs Boston Healthcare System, Boston, Massachusetts
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
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Brickell TA, Wright MM, Sullivan JK, Varbedian NV, Nose KA, Rather LM, Tien NK, French LM, Lange RT. Caregiver sleep impairment and service member and veteran adjustment following traumatic brain injury is related to caregiver health-related quality of life. J Clin Sleep Med 2022; 18:2577-2588. [PMID: 35912703 PMCID: PMC9622982 DOI: 10.5664/jcsm.10164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To examine the relationship between caregiver sleep impairment and/or service member/veteran (SMV) adjustment post-traumatic brain injury, with caregiver health-related quality of life (HRQOL). METHODS Caregivers (n = 283) completed 18 measures of HRQOL, sleep impairment, and SMV adjustment. Caregivers were classified into 4 sleep impairment/SMV adjustment groups: 1) Good Sleep/Good Adjustment (n = 43), 2) Good Sleep/Poor Adjustment (n = 39), 3) Poor Sleep/Good Adjustment (n = 55), and 4) Poor Sleep/Poor Adjustment (n = 146). RESULTS The Poor Sleep/Poor Adjustment group reported significantly worse scores on most HRQOL measures and a higher prevalence of clinically elevated T-scores (≥ 60T) on the majority of comparisons compared to the other 3 groups. The Good Sleep/Poor Adjustment and Poor Sleep/Good Adjustment groups reported worse scores on the majority of the HRQOL measures and a higher prevalence of clinically elevated scores on 7 comparisons compared to the Good Sleep/Good Adjustment group. Fewer differences were found between the Good Sleep/Poor Adjustment and Poor Sleep/Good Adjustment groups. The Poor Sleep/Poor Adjustment group reported a higher prevalence of severe ratings for SMV Irritability, Anger, and Aggression compared to the Good Sleep/Poor Adjustment group. CONCLUSIONS While the presence of either caregiver sleep impairment or poor SMV adjustment singularly was associated with worse caregiver HRQOL, the presence of both sleep impairment and poor SMV adjustment was associated with further impairment in HRQOL. Caregivers could benefit from sleep intervention. Treatment of SMVs neurobehavioral problems may improve the SMV's recovery and lessen sleep problems, distress, and burden among their caregivers. CITATION Brickell TA, Wright MM, Sullivan JK, et al. Caregiver sleep impairment and service member and veteran adjustment following traumatic brain injury is related to caregiver health-related quality of life. J Clin Sleep Med. 2022;18(11):2577-2588.
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Affiliation(s)
- Tracey A. Brickell
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Contractor, General Dynamics Information Technology, Silver Spring, Maryland
| | - Megan M. Wright
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland
- Contractor, General Dynamics Information Technology, Silver Spring, Maryland
| | - Jamie K. Sullivan
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland
- Contractor, General Dynamics Information Technology, Silver Spring, Maryland
| | - Nicole V. Varbedian
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland
- Contractor, General Dynamics Information Technology, Silver Spring, Maryland
| | - Kathryn A. Nose
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland
- Contractor, General Dynamics Information Technology, Silver Spring, Maryland
| | - Lauren M. Rather
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland
- Contractor, General Dynamics Information Technology, Silver Spring, Maryland
| | - Nicole K. Tien
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland
- Contractor, General Dynamics Information Technology, Silver Spring, Maryland
| | - Louis M. French
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Rael T. Lange
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland
- Contractor, General Dynamics Information Technology, Silver Spring, Maryland
- University of British Columbia, Vancouver, British Columbia, Canada
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Wathen CN, Mantler T. Trauma- and Violence-Informed Care: Orienting Intimate Partner Violence Interventions to Equity. CURR EPIDEMIOL REP 2022; 9:233-244. [PMID: 36212738 PMCID: PMC9527731 DOI: 10.1007/s40471-022-00307-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2022] [Indexed: 12/01/2022]
Abstract
Purposeof Review Intimate partner violence (IPV) is a complex traumatic experience that often co-occurs, or is causally linked, with other forms of structural violence and oppression. However, few IPV interventions integrate this social-ecological perspective. We examine trauma- and violence-informed care (TVIC) in the context of existing IPV interventions as an explicitly equity-oriented approach to IPV prevention and response. Recent Findings Systematic reviews of IPV interventions along the public health prevention spectrum show mixed findings, with those with a theoretically grounded, structural approach that integrates a trauma lens more likely to show benefit. Summary TVIC, embedded in survivor-centered protocols with an explicit theory of change, is emerging as an equity-promoting approach underpinning IPV intervention. Explicit attention to structural violence and the complexity of IPV, systems and sites of intervention, and survivors’ diverse and intersectional lived experiences has significant potential to transform policy and practice.
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Affiliation(s)
- C. Nadine Wathen
- Arthur Labatt Family School of Nursing, Western University, FIMS & Nursing Building, Room 2307, London, ON N6A 5B9 Canada
| | - Tara Mantler
- School of Health Studies, Western University, London, Canada
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Friedman S, Shaw JG, Hamilton AB, Vinekar K, Washington DL, Mattocks K, Yano EM, Phibbs CS, Johnson AM, Saechao F, Berg E, Frayne SM. Gynecologist Supply Deserts Across the VA and in the Community. J Gen Intern Med 2022; 37:690-697. [PMID: 36042097 PMCID: PMC9481821 DOI: 10.1007/s11606-022-07591-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 04/01/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND The Veterans Health Administration (VA) refers patients to community providers for specialty services not available on-site. However, community-level specialist shortages may impede access to care. OBJECTIVE Compare gynecologist supply in veterans' county of residence versus at their VA site. DESIGN We identified women veteran VA patients from fiscal year (FY) 2017 administrative data and assessed availability of a VA gynecologist within 50 miles (hereafter called "local") of veterans' VA homesites (per national VA organizational survey data). For the same cohort, we then assessed community-level gynecologist availability; counties with < 2 gynecologists/10,000 women (per the Area Health Resource File) were "inadequate-supply" counties. We examined the proportion of women veterans with local VA gynecologist availability in counties with inadequate versus adequate gynecologist supply, stratified by individual and VA homesite characteristics. Chi-square tests assessed statistical differences. PARTICIPANTS All women veteran FY2017 VA primary care users nationally. MAIN MEASURES Availability of a VA gynecologist within 50 miles of a veteran's VA homesite; county-level "inadequate-supply" of gynecologists. KEY RESULTS Among 407,482 women, 9% were in gynecologist supply deserts (i.e., lacking local VA gynecologist and living in an inadequate-supply county). The sub-populations with the highest proportions in gynecologist supply deserts were rural residents (24%), those who got their primary care at non-VAMC satellite clinics (13%), those who got their care at a site without a women's clinic (13%), and those with American Indian or Alaska Native (12%), or white (12%) race. Among those in inadequate-supply counties, 59.9% had gynecologists at their local VA; however, 40.1% lacked a local VA gynecologist. CONCLUSIONS Most veterans living in inadequate-supply counties had local VA gynecology care, reflecting VA's critical role as a safety net provider. However, for those in gynecologist supply deserts, expanded transportation options, modified staffing models, or tele-gynecology hubs may offer solutions to extend VA gynecology capacity.
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Affiliation(s)
- Sarah Friedman
- VA HSR&D Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, CA, USA.
- School of Public Health, University of Nevada Reno, Reno, NV, USA.
| | - Jonathan G Shaw
- VA HSR&D Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, CA, USA
- Stanford University School of Medicine, Stanford, CA, USA
| | - Alison B Hamilton
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Kavita Vinekar
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Donna L Washington
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Kristin Mattocks
- VA Central Western Massachusetts Healthcare System, Leeds, MA, USA
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Elizabeth M Yano
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Ciaran S Phibbs
- VA HSR&D Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, CA, USA
- Stanford University School of Medicine, Stanford, CA, USA
- VA Health Economics Resource Center, Menlo Park, CA, USA
| | | | - Fay Saechao
- VA HSR&D Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Eric Berg
- VA HSR&D Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Susan M Frayne
- VA HSR&D Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, CA, USA
- Stanford University School of Medicine, Stanford, CA, USA
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Cowlishaw S, Freijah I, Kartal D, Sbisa A, Mulligan A, Notarianni M, Couineau AL, Forbes D, O’Donnell M, Phelps A, Iverson KM, Heber A, O’Dwyer C, Smith P, Hosseiny F. Intimate Partner Violence (IPV) in Military and Veteran Populations: A Systematic Review of Population-Based Surveys and Population Screening Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148853. [PMID: 35886702 PMCID: PMC9316917 DOI: 10.3390/ijerph19148853] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/13/2022] [Accepted: 07/14/2022] [Indexed: 12/23/2022]
Abstract
Intimate partner violence (IPV) may be a major concern in military and veteran populations, and the aims of this systematic review were to (1) provide best available estimates of overall prevalence based on studies that are most representative of relevant populations, and (2) contextualise these via examination of IPV types, impacts, and context. An electronic search of PsycINFO, CINHAL, PubMed, and the Cochrane Library databases identified studies utilising population-based designs or population screening strategies to estimate prevalence of IPV perpetration or victimisation reported by active duty (AD) military personnel or veterans. Random effects meta-analyses were used for quantitative analyses and were supplemented by narrative syntheses of heterogeneous data. Thirty-one studies involving 172,790 participants were included in meta-analyses. These indicated around 13% of all AD personnel and veterans reported any recent IPV perpetration, and around 21% reported any recent victimisation. There were higher rates of IPV perpetration in studies of veterans and health service settings, but no discernible differences were found according to gender, era of service, or country of origin. Psychological IPV was the most common form identified, while there were few studies of IPV impacts, or coercive and controlling behaviours. The findings demonstrate that IPV perpetration and victimisation occur commonly among AD personnel and veterans and highlight a strong need for responses across military and veteran-specific settings. However, there are gaps in understanding of impacts and context for IPV, including coercive and controlling behaviours, which are priority considerations for future research and policy.
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Affiliation(s)
- Sean Cowlishaw
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
- Correspondence:
| | - Isabella Freijah
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
| | - Dzenana Kartal
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
| | - Alyssa Sbisa
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
| | - Ashlee Mulligan
- Atlas Institute for Veterans and Families, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, ON K1Z 7K4, Canada; (A.M.); (M.N.); (P.S.); (F.H.)
| | - MaryAnn Notarianni
- Atlas Institute for Veterans and Families, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, ON K1Z 7K4, Canada; (A.M.); (M.N.); (P.S.); (F.H.)
| | - Anne-Laure Couineau
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
| | - David Forbes
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
| | - Meaghan O’Donnell
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
| | - Andrea Phelps
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
| | - Katherine M. Iverson
- Women’s Health Sciences Division, National Center for PTSD, Veterans Affairs Boston Healthcare System, 150 South Huntington Street, Boston, MA 02130, USA;
- Department of Psychiatry, Boston University School of Medicine, 72 E Concord Street, Boston, MA 02118, USA
| | - Alexandra Heber
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8N 3K7, Canada;
- Veterans Affairs Canada, Charlottetown, PE C1A 8M9, Canada
| | - Carol O’Dwyer
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
| | - Patrick Smith
- Atlas Institute for Veterans and Families, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, ON K1Z 7K4, Canada; (A.M.); (M.N.); (P.S.); (F.H.)
| | - Fardous Hosseiny
- Atlas Institute for Veterans and Families, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, ON K1Z 7K4, Canada; (A.M.); (M.N.); (P.S.); (F.H.)
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Recovering from Intimate Partner Violence through Strengths and Empowerment (RISE): Initial Evaluation of the Clinical Effects of RISE Administered in Routine Care in the US Veterans Health Administration. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148793. [PMID: 35886645 PMCID: PMC9320416 DOI: 10.3390/ijerph19148793] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/28/2022] [Accepted: 07/01/2022] [Indexed: 02/06/2023]
Abstract
Intimate partner violence (IPV) is a common concern among military Veterans that negatively impacts health. The United States’ Veterans Health Administration (VHA) has launched a national IPV Assistance Program (IPVAP) to provide comprehensive services to Veterans, their families and caregivers, and VHA employees who use or experience IPV. Grounded in a holistic, Veteran-centered psychosocial rehabilitation framework that guides all facets of the program, the IPVAP initiated the pilot implementation of a novel intervention called Recovering from IPV through Strengths and Empowerment (RISE). This evidence-based, person-centered, trauma-informed, and empowerment-oriented brief counseling intervention is designed to support those who experience IPV and to improve their psychosocial wellbeing. This program evaluation study describes clinical outcomes from patients who participated in a pilot implementation of RISE in routine care. We examined changes in general self-efficacy, depression, and valued living, as well as treatment satisfaction among patients who received RISE and completed program evaluation measures at VHA facilities during the pilot. Results from 45 patients (84% women) indicate that RISE was associated with significant pretreatment to posttreatment improvements in self-efficacy, depression, and valued living (Cohen’s d s of 0.97, 1.09, and 0.51, respectively). Patients reported high satisfaction with treatment. Though preliminary results were similar across gender and IPV types, findings from the evaluation of the pilot implementation of RISE demonstrate the intervention’s feasibility, acceptability, and clinical utility in routine VHA care and inform the scalability of RISE. Additionally, findings provide preliminary support for the effectiveness and acceptability of RISE with men. Modification to RISE and its implementation are discussed, which may be useful to other settings implementing IPV interventions.
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Brickell TA, French LM, Wright MM, Lange RT. Aggression in Military Members With Mild Traumatic Brain Injury and Post-Traumatic Stress Disorder Is Associated With Intimate Partner Health-Related Quality of Life. Womens Health Issues 2022; 32:526-533. [PMID: 35643836 DOI: 10.1016/j.whi.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 02/08/2022] [Accepted: 04/11/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE We aimed to examine the relationship between service member/veteran (SMV) aggression and health-related quality of life (HRQOL) in their intimate partners. METHODS This prospective cohort study included 201 female intimate partner caregivers of post-9/11 male SMVs with a diagnosis of uncomplicated mild traumatic brain injury and post-traumatic stress disorder from a military treatment facility. Caregivers completed 17 HRQOL measures and rated the level the SMV experiences problems with verbal or physical expressions of irritability, anger, or aggression on the Mayo-Portland Adaptability Inventory, 4th edition. Caregivers were classified into three SMV Aggression groups: i) none or very mild (n = 53); ii) mild (n = 47); and iii) moderate or severe (n = 101). HRQOL scores were classified as clinically elevated using a cutoff of 60T or higher. RESULTS Using χ2 analysis, the moderate or severe group had a significantly higher proportion of clinically elevated scores on 15 HRQOL measures compared with the none or very mild group, and six measures compared with the mild group. The mild group had higher scores on two measures compared with the none or very mild group. Using analysis of covariance (and controlling for caregiver strain), the moderate or severe group had significantly higher scores on 11 HRQOL measures compared with the none or very mild group, and two measures compared with the mild group. The mild group had higher scores on five measures compared with the none or very mild group. CONCLUSIONS Many caregivers who report moderate to severe SMV aggression after a traumatic brain injury, report poor HRQOL beyond the strain of care provision. Traumatic brain injury and post-traumatic stress disorder programs should screen for and treat SMV aggression, and attend to the health needs of their caregivers.
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Affiliation(s)
- Tracey A Brickell
- Department of Research, Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland; Department of Research, National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland; F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland; Department of Research, General Dynamics Information Technology, Silver Spring, Maryland.
| | - Louis M French
- Department of Research, Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland; Department of Research, National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland; F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Megan M Wright
- Department of Research, Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland; Department of Research, National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland; Department of Research, General Dynamics Information Technology, Silver Spring, Maryland
| | - Rael T Lange
- Department of Research, Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland; Department of Research, National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland; Department of Research, General Dynamics Information Technology, Silver Spring, Maryland; Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Cowlishaw S, Sbisa A, Freijah I, Kartal D, Mulligan A, Notarianni M, Iverson K, Couineau AL, Forbes D, O’Donnell M, Phelps A, Smith P, Hosseiny F. Health Service Interventions for Intimate Partner Violence among Military Personnel and Veterans: A Framework and Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063551. [PMID: 35329239 PMCID: PMC8955703 DOI: 10.3390/ijerph19063551] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/05/2022] [Accepted: 03/08/2022] [Indexed: 02/04/2023]
Abstract
IPV is a significant concern among active duty (AD) military personnel or veterans, and there is a need for initiatives to address violence perpetrated by such personnel, and IPV victimisation in military and veteran-specific contexts. The aim of this paper was to provide an overview of major IPV intervention approaches and evidence in military and veteran-specific health services. A scoping review was conducted involving a systematic search of all available published studies describing IPV interventions in military and veteran-specific health services. Findings were synthesised narratively, and in relation to a conceptual framework that distinguishes across prevention, response, and recovery-oriented strategies. The search identified 19 studies, all from the U.S., and only three comprised randomised trials. Initiatives addressed both IPV perpetration and victimisation, with varied interventions targeting the latter, including training programs, case identification and risk assessment strategies, and psychosocial interventions. Most initiatives were classified as responses to IPV, with one example of indicated prevention. The findings highlight an important role for specific health services in addressing IPV among AD personnel and veterans, and signal intervention components that should be considered. The limited amount of empirical evidence indicates that benefits of interventions remain unclear, and highlights the need for targeted research.
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Affiliation(s)
- Sean Cowlishaw
- Phoenix Australia–Centre for Post-traumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (A.S.); (I.F.); (D.K.); (A.-L.C.); (D.F.); (M.O.); (A.P.)
- Correspondence:
| | - Alyssa Sbisa
- Phoenix Australia–Centre for Post-traumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (A.S.); (I.F.); (D.K.); (A.-L.C.); (D.F.); (M.O.); (A.P.)
| | - Isabella Freijah
- Phoenix Australia–Centre for Post-traumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (A.S.); (I.F.); (D.K.); (A.-L.C.); (D.F.); (M.O.); (A.P.)
| | - Dzenana Kartal
- Phoenix Australia–Centre for Post-traumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (A.S.); (I.F.); (D.K.); (A.-L.C.); (D.F.); (M.O.); (A.P.)
| | - Ashlee Mulligan
- Centre of Excellence on Post-Traumatic Stress Disorder and Related Mental Health Conditions, 1145 Carling Avenue, Ottawa, ON K1Z 7K4, Canada; (A.M.); (M.N.); (P.S.); (F.H.)
| | - MaryAnn Notarianni
- Centre of Excellence on Post-Traumatic Stress Disorder and Related Mental Health Conditions, 1145 Carling Avenue, Ottawa, ON K1Z 7K4, Canada; (A.M.); (M.N.); (P.S.); (F.H.)
| | - Katherine Iverson
- Women’s Health Sciences Division of the National Center for PTSD, Veterans Affairs Boston Healthcare System, 150 South Huntington Street, Boston, MA 02130, USA;
- Department of Psychiatry, Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA
| | - Anne-Laure Couineau
- Phoenix Australia–Centre for Post-traumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (A.S.); (I.F.); (D.K.); (A.-L.C.); (D.F.); (M.O.); (A.P.)
| | - David Forbes
- Phoenix Australia–Centre for Post-traumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (A.S.); (I.F.); (D.K.); (A.-L.C.); (D.F.); (M.O.); (A.P.)
| | - Meaghan O’Donnell
- Phoenix Australia–Centre for Post-traumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (A.S.); (I.F.); (D.K.); (A.-L.C.); (D.F.); (M.O.); (A.P.)
| | - Andrea Phelps
- Phoenix Australia–Centre for Post-traumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (A.S.); (I.F.); (D.K.); (A.-L.C.); (D.F.); (M.O.); (A.P.)
| | - Patrick Smith
- Centre of Excellence on Post-Traumatic Stress Disorder and Related Mental Health Conditions, 1145 Carling Avenue, Ottawa, ON K1Z 7K4, Canada; (A.M.); (M.N.); (P.S.); (F.H.)
| | - Fardous Hosseiny
- Centre of Excellence on Post-Traumatic Stress Disorder and Related Mental Health Conditions, 1145 Carling Avenue, Ottawa, ON K1Z 7K4, Canada; (A.M.); (M.N.); (P.S.); (F.H.)
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Sileo KM, Kershaw TS, Gilliam S, Taylor E, Kommajosula A, Callands TA. Trauma Exposure and Intimate Partner Violence Among Young Pregnant Women in Liberia. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:10101-10127. [PMID: 31625468 PMCID: PMC7778451 DOI: 10.1177/0886260519881533] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Intimate partner violence (IPV) is a global threat to women's health and may be elevated among those exposed to traumatic events in post-conflict settings, such as Liberia. The purpose of this study was to examine potential mediators between lifetime exposure to traumatic events (i.e., war-related trauma, community violence) with recent experiences of IPV among 183 young, pregnant women in Monrovia, Liberia. Hypothesized mediators included mental health (depression, posttraumatic stress symptoms), insecure attachment style (anxious and avoidant attachment), and attitudes indicative of norms of violence (attitudes justifying wife beating). We tested a parallel multiple mediation model using the PROCESS method with bias-corrected and accelerated bootstrapping to test confidence intervals (CI). Results show that 45% of the sample had experienced any physical, sexual, or emotional IPV in their lifetime, and 32% in the 2 months prior to the interview. Exposure to traumatic events was positively associated with recent IPV severity (β = .40, p < .01). Taken together, depression, anxious attachment style, and justification of wife beating significantly mediated the relationship between exposure to traumatic events and experience of IPV (β = .15, 95% CI = [0.03, 0.31]). Only anxious attachment style (β = .07, 95% CI = [0.03, 0.16]) and justification of wife beating (β = .05, 95% CI = [0.01, 0.16]) were identified as individual mediators. This study reinforces pregnancy as an important window for both violence and mental health screening and intervention for young Liberian women. Furthermore, it adds to our theoretical understanding of mechanisms in which long-term exposure to traumatic events may lead to elevated rates of IPV in Liberia, and points to the need for trauma-informed counseling and multilevel gender transformative public health approaches to address violence against women.
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Affiliation(s)
- Katelyn M. Sileo
- The University of Texas at San Antonio, USA
- The Center for Interdisciplinary Research at Yale University, New Haven, CT, USA
| | - Trace S. Kershaw
- The Center for Interdisciplinary Research at Yale University, New Haven, CT, USA
- Yale School of Public Health, New Haven, CT, USA
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Taft CT, Franz MR, Cole HE, D’Avanzato C, Rothman EF. Examining strength at home for preventing intimate partner violence in civilians. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2021; 35:857-862. [PMID: 33734765 PMCID: PMC8591632 DOI: 10.1037/fam0000732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The Strength at Home (SAH) intervention, a trauma-informed, cognitive-behavioral intervention for intimate partner violence (IPV), was examined in a sample of court-mandated men. Evidence from prior research indicates that SAH is effective in military veterans but the program has not been examined in civilians. It was expected that SAH participants would evidence reductions in physical and psychological IPV, as well as secondary outcomes of post-traumatic stress disorder (PTSD) symptoms and alcohol use problems. Participants included 23 men court mandated to IPV intervention. The sample was low income and 72.7% had a reported prior history of severe physical IPV perpetration. Data from these participants and collateral partners were examined across assessments reflecting baseline, post-treatment, and two 3-month follow-ups. The outcome variables were assessed at each time point to examine change over time and a post-treatment satisfaction measure was also administered immediately following the intervention. Participants showed a significant linear decrease between baseline and post-treatment in all of the primary and secondary IPV outcomes, which maintained at 3- and 6-month follow-up time points. Effect sizes across models were moderate to large. Participants reported high satisfaction with SAH. Study findings provide preliminary support that the SAH intervention is associated with reductions in IPV among civilians and addresses other trauma- and alcohol-related problems. Further research including larger randomized controlled trials are needed to determine the efficacy of this intervention. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Casey T. Taft
- National Center for PTSD, VA Boston Healthcare System, and Boston University School of Medicine
| | - Molly R. Franz
- National Center for PTSD, VA Boston Healthcare System, and Boston University School of Medicine
| | - Hannah E. Cole
- National Center for PTSD, VA Boston Healthcare System, and Boston University School of Medicine
| | - Catherine D’Avanzato
- Rhode Island Hospital and Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior
| | - Emily F. Rothman
- Boston University School of Public Health and Boston University School of Medicine
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