Risk factors for intimate partner violence and abuse among adolescents and young adults: findings from a UK population-based cohort

Trends in outcomes used to measure the effectiveness of UK-based support interventions and services targeted at adults with experience of domestic and sexual violence and abuse: a scoping review

OBJECTIVES

In the UK, a range of support services and interventions are available to people who have experienced or perpetrated domestic and sexual violence and abuse (DSVA). However, it is currently not clear which outcomes and outcome measures are used to assess their effectiveness. The objective of this review is to summarise, map and identify trends in outcome measures in evaluations of DSVA services and interventions in the UK.

DESIGN

Scoping review.

DATA SOURCES

MEDLINE, EMBASE, PsycINFO, Social Policy and Practice, ASSIA, IBSS, Sociological abstracts and SSCI electronic databases were searched from inception until 21 June 2022. Grey literature sources were identified and searched.

ELIGIBILITY

We included randomised controlled trials, non-randomised comparative studies, pre-post studies and service evaluations, with at least one outcome relating to the effectiveness of the support intervention or service for people who have experienced and/or perpetrated DSVA. Outcomes had to be assessed at baseline and at least one more time point, or compared with a comparison group.

CHARTING METHODS

Outcome measures were extracted, iteratively thematically grouped into categories, domains and subdomains, and trends were explored.

RESULTS

80 studies reporting 87 DSVA interventions or services were included. A total of 426 outcome measures were extracted, of which 200 were used more than once. The most commonly reported outcome subdomain was DSVA perpetration. Cessation of abuse according to the Severity of Abuse Grid was the most common individual outcome. Analysis of temporal trends showed that the number of studies and outcomes used has increased since the 1990s.

CONCLUSIONS

Our findings highlight inconsistencies between studies in outcome measurement. The increase in the number of studies and variety of measures suggests that as evaluation of DSVA services and interventions matures, there is an increased need for a core of common, reliable metrics to aid comparability.

PROTOCOL REGISTRATION

https://osf.io/frh2e.

How effective are UK-based support interventions and services targeted at adults who have experienced domestic and sexual violence and abuse at improving their safety and wellbeing? A systematic review protocol

BACKGROUND

Domestic and sexual violence and abuse (DSVA) is prevalent in the UK, with wide-ranging impacts both on individuals and society. However, to date, there has been no systematic synthesis of the evidence for the effectiveness of UK-based support interventions and services for victim-survivors of DSVA. This review will aim to systematically collate, synthesise and quality assess the evidence regarding the effectiveness of UK support interventions and services targeted at those who have experienced DSVA. The review will use findings of a preliminary scoping review, as well as input from stakeholders representing domestic and sexual violence third sector organisations to identify and prioritise the most relevant outcomes to focus on.

METHODS

We will undertake a systematic search for peer-reviewed literature in MEDLINE, EMBASE, PsycINFO, Social Policy and Practice, Applied Social Sciences Index and Abstracts (ASSIA), International Bibliography of the Social Sciences (IBSS), Sociological abstracts and SSCI. Grey literature will be identified by searching grey literature databases, circulating a call for evidence to local and national DSVA charities and organisations, and targeted website searching. Two reviewers will independently perform study selection and quality appraisal, with data extraction undertaken by one reviewer and checked for accuracy by a second reviewer. Narrative synthesis will be conducted, with meta-analysis if possible.

DISCUSSION

Existing individual studies and evaluations have reported positive impacts of support interventions and services for those who have experienced DSVA. Thus, it is expected that this review and synthesis will provide robust and conclusive evidence of these effects. It will also allow comparisons to be made between different types of support interventions and services, to inform policy makers and funders regarding the most effective ways of reducing domestic and sexual violence and abuse and its impacts.

Maternal Childhood Maltreatment, Internal Working Models, and Perinatal Substance Use: Is There a Role for Hyperkatifeia? A Systematic Review

The parent-infant relationship is critical for socioemotional development and is adversely impacted by perinatal substance use. This systematic review posits that the mechanisms underlying these risks to mother-infant relationships center on 3 primary processes: (1) mothers' childhood maltreatment experiences; (2) attachment styles and consequent internal working models of interpersonal relationships; and (3) perinatal substance use. Further, the review considers the role of hyperkatifeia, or hypersensitivity to negative affect which occurs when people with substance use disorders are not using substances, and which drives the negative reinforcement in addiction. The authors performed a systematic review of articles (published 2000-2022) related to these constructs and their impact on mother-infant relationships and offspring outcomes, including original clinical research articles addressing relationships between these constructs, and excluding case studies, reviews, non-human animal studies, intervention studies, studies with fewer than 30% female-sex participants, clinical guidelines, studies limited to obstetric outcomes, mechanistic/biological studies, and studies with methodological issues precluding interpretation. Overall 1844 articles were screened, 377 were selected for full text review, and data were extracted from 157 articles. Results revealed strong relationships between mothers' childhood maltreatment experiences, less optimal internal working models, and increased risk for perinatal substance use, and importantly, all of these predictors interacted with hyperkatifeia and exerted a marked impact on mother-infant relationships with less data available on offspring outcomes. These data strongly support the need for future studies addressing the additive impact of maternal childhood maltreatment experiences, suboptimal internal working models, and perinatal substance use, with hyperkatifeia as a potential moderator, and their interacting effects on mother-infant socioemotional outcomes.

Depression Transmission From Parents to Their Adult Children in China: The Mediating Role of Family Violence

Depression can be transmitted from parents to children through the gene-environment interaction. Previous studies have focused on the short-term effects of parental depression on children and adolescents while neglecting the long-term effects. Furthermore, as a major indicator of stressful environment, the mediating role of different types of family violence has rarely been studied. The purpose of this study was to examine the long-term effects of parental depressive symptoms on those of adult children and to explore the potential mediating roles of different types of family violence (physical abuse, witnessing interparental violence, and sibling violence) in China. Data came from the 2014 and 2018 waves of the China Health and Retirement Longitudinal Study (CHARLS), which consisted of 10,973 participants aged 45 years and older. Logistic regression models were performed. The total effect was decomposed into direct and indirect effects by logistic regression based on the Karlson/Holm/Breen (KHB) method. The results indicated that parental depressive symptoms were related to adult children's depressive symptoms (odds ratio [OR], 1.20; 95% confidence interval [CI] [1.16-1.25]). The KHB method showed that this relationship was mediated by physical abuse (OR, 1.01; 95% CI [1.00-1.01]) and witnessing interparental violence (OR, 1.01; 95% CI [1.01-1.02]). In China, depression can be transmitted from parents to their adult children through family violence. The findings suggest that regular mental health screening across entire lifespan and family violence prevention programs targeting depressed parents may bring long-term benefit to adult children's mental health.

The impact of sexual violence in mid-adolescence on mental health: a UK population-based longitudinal study

BACKGROUND

A large gender gap appears in internalising mental health conditions during adolescence, with higher rates in girls than boys. There is little high-quality longitudinal population-based research investigating the role of sexual violence experiences, which are disproportionately experienced by girls. We aimed to estimate the effects of sexual violence experienced in mid-adolescence on mental health outcomes.

METHODS

In this study, we used data from the longitudinal UK Millennium Cohort Study, a large nationally representative cohort of children born in the UK in 2000-02, for participants with information available at age 17 years on sexual violence in the past year (eg, sexual assault or unwelcome sexual approach), mental health outcomes (eg, completion of the Kessler Psychological Distress K6 scale in the past 30 days, self-harm in the past year, and lifetime attempted suicide). Multivariable confounder adjusted regressions and propensity matching approaches were used, and population attributable fractions (PAFs) were calculated.

FINDINGS

We included 5119 girls and 4852 boys (8063 [80·8%] of whom were White) in the full analysis sample. In the fully adjusted model, compared with no sexual violence, sexual violence was associated with greater mean psychological distress in girls (mean difference 2·09 [95% CI 1·51-2·68]) and boys (2·56 [1·59-3·53]), higher risk of high psychological distress in girls (risk ratio [RR] 1·65 [95% CI 1·37-2·00]) and boys (1·55 [1·00-2·40]), higher risk of self-harm in girls (RR 1·79 [1·52-2·10]) and boys (RR 2·16 [1·63-2·84]), and higher risk of attempted suicide in girls (RR 1·75 [1·26-2·41]) and boys (RR 2·73 [1·59-4·67]). PAF estimates suggest that, in a hypothetical scenario with no sexual violence, the prevalence of adverse mental health outcomes at age 17 years would be 3·7-10·5% lower in boys and 14·0-18·7% lower in girls than the prevalence in this cohort.

INTERPRETATION

Reductions in sexual violence via policy and societal changes would benefit the mental health of adolescents and might contribute to narrowing the gender gap in internalising mental ill health. Clinicians and others working to support adolescents should be aware that sexual violence has a widespread, gendered nature and an impact on mental health.

FUNDING

UK Medical Research Council.

Emerging ecophenotype: reward anticipation is linked to high-risk behaviours after sexual abuse

Adolescents frequently engage in high-risk behaviours (HRB) following childhood sexual abuse (CSA). Aberrant reward processes are implicated in HRB, and their underlying fronto-striatal networks are vulnerable to neurodevelopmental changes during adversity representing a promising candidate for understanding links between CSA and HRB. We examined whether fronto-striatal responses during reward anticipation and feedback (i) are altered in depressed adolescents with CSA compared to depressed, non-abused peers and (ii) moderate the relationship between CSA and HRB irrespective of depression. Forty-eight female adolescents {14 with CSA and depression [CSA +  major depressive disorder (MDD)]; 17 with MDD but no CSA (MDD); 17 healthy, non-abused controls} completed a monetary reward task during functional magnetic resonance imaging. No differences in fronto-striatal response to reward emerged between CSA + MDD and MDD. Critically, high left nucleus accumbens activation during reward anticipation was associated with greater HRB in CSA + MDD compared to MDD and controls. Low left putamen activation during reward feedback was associated with the absence of HRB in CSA + MDD compared to MDD. Striatal reward responses appear to play a key role in HRB for adolescents with CSA irrespective of depression, providing initial support for a CSA ecophenotype. Such information is pivotal to identify at-risk youth and prevent HRB in adolescents after CSA.

Exploring the causal role of intimate partner violence and abuse on depressive symptoms in young adults: a population-based cohort study

BACKGROUND

Previous studies have shown an association between experience of intimate partner violence and abuse (IPVA) and depression. Whether this is a causal relationship or explained by prior vulnerability that influences the risk of both IPVA and depression is not known.

METHODS

We analysed data from the Avon Longitudinal Study of Parents and Children prospective cohort (N = 1764 women, 1028 men). To assess the causal association between IPVA at 18-21 years old and logged depressive symptom scores at age 23, we used (i) multivariable linear regression, (ii) inverse probability of treatment weighting (IPTW), and (iii) difference-in-difference (DiD) analysis, which compared the mean change in logged depressive symptom scores between ages 16 and 23 between those who experienced IPVA and those who did not.

RESULTS

Women who experienced IPVA had on average 26% higher depressive symptom scores after adjustment for measured confounders (ratio of geometric means 1.26, 95% CI 1.13 to 1.40). In men, the difference was 5% (ratio of geometric means 1.05, 95% CI 0.92 to 1.21). Results from IPTW analysis were similar. In the DiD analysis, there was no evidence that being exposed to IPVA affected the change in depressive symptom scores over time compared to being in the non-exposed group for either women (difference-in-differences 1%, -12 to 16%) or men (-1%, -19 to 20%).

CONCLUSIONS

Multivariable linear regression and IPTW suggested an association between IPVA and higher depressive symptom score in women but not men, but DiD analysis indicated a null effect in both women and men. This suggests the causal origins of higher depressive symptoms in this young adult population are likely to reflect prior vulnerability that leads to both higher depressive symptoms and increased risk of IPVA exposure.

Intimate Partner Violence during the COVID-19 Pandemic: A Review of the Phenomenon from Victims' and Help Professionals' Perspectives

Social isolation is considered one of the main risk factors leading to intimate partner violence episodes; this evidence also emerged during the application of stay-at-home policies to contain the COVID-19 pandemic. For this reason, we aimed to collect data on intimate partner violence over the last year, comparing data reported by victims with data collected by help professionals. In accordance with PRISMA guidelines, through keywords related to abuse, pandemic and containment measures, 3174 articles were identified for screening. After full-text reading and risk of bias analysis, 19 studies were included, and a thematic synthesis was conducted according to two categories: "studies with victims" and "studies with help professionals". The results of the present review showed that there were significant differences between the data provided by victims and the data collected by health care facilities and police departments; additionally, differences among different forms and severity of victimization emerged. The results have been discussed according to the literature; in particular, we reflected on how containment measures have apparently made it more difficult for victims to report, thus making the existence of the dark figure of crime even more salient.

Risk Behaviours Associated with Dating and Relationship Violence among 11-16 Year Olds in Wales: Results from the 2019 Student Health and Wellbeing Survey

(1) Background: This study examines the associations between risk behaviours and adolescent emotional and physical dating and relationship violence (DRV) victimisation and perpetration, and how these vary by gender. The risk behaviours explored include bullying, cyberbullying, sexting, alcohol, and cannabis use; (2) Methods: Cross-sectional self-report data from the School Health Research Network (SHRN) 2019 Student Health Wellbeing (SHW) survey of 48,397 students aged 11–16 from 149 schools across Wales were analysed using single and multiple-behaviour logistic regression models to explore the associations between each risk behaviour and emotional and physical DRV victimisation and perpetration; (3) Results: Bivariate analyses revealed a statistically significant association between DRV and all risk behaviours. In multivariate analyses, students who reported bullying, cyberbullying, sexting, and substance use, compared to those that had not, had significantly higher odds of experiencing and perpetrating emotional and physical DRV; and (4) Conclusions: Future studies on DRV should consider a mixed-methods approach to explore the context in which DRV and risk behaviours interrelate. Results from this study indicate the possibility that prevention and intervention programmes in school settings that seek to develop healthy school environments and peer-to-peer relationships, could inadvertently reduce the occurrence of future DRV and associated risk behaviours.