Characteristics and Impacts of Sexual Violence and Stalking Victimization by the Same Perpetrator Using a Nationally Representative Sample

Because a substantial proportion of sexual violence, stalking, and intimate partner violence is experienced at a young age, primary prevention of these forms of violence must begin early. Prevention efforts should take into consideration that female sexual violence and stalking victimization is perpetrated predominately by men and that a substantial proportion of male sexual violence and stalking victimization (including rape, unwanted sexual contact, noncontact unwanted sexual experiences, and stalking) also is perpetrated by men. CDC seeks to prevent these forms of violence with strategies that address known risk factors for perpetration and by changing social norms and behaviors by using bystander and other prevention strategies. In addition, primary prevention of intimate partner violence is focused on the promotion of healthy relationship behaviors and other protective factors, with the goal of helping adolescents develop these positive behaviors before their first relationships. The early promotion of healthy relationships while behaviors are still relatively modifiable makes it more likely that young persons can avoid violence in their relationships.

Back to table of contents Previous article Next article Professional NewsFull AccessFree WPA Curriculum Available on Intimate Partner, Sexual ViolenceMark MoranMark MoranSearch for more papers by this authorPublished Online:17 Oct 2016https://doi.org/10.1176/appi.pn.2016.10b1AbstractThe curriculum is designed for training medical students, psychiatrists in residency programs, and practicing psychiatrists, with increasing levels of competency at each level.A new competency-based curriculum focusing on intimate partner violence and sexual violence against women, issued by the World Psychiatric Association (WPA), seeks to educate medical students, trainees, and practicing psychiatrists about interviewing, assessing, and treating women victims of intimate partner or sexual violence. The WPA’s International Competency-Based Curriculum for Mental Health Care Providers on Intimate Partner Violence/Sexual Violence Against Women, issued in July, is a 55-page document freely accessible on the WPA website. It outlines a wide range of teaching tools—didactic material, PowerPoint slides, case vignettes, and videos. “We owe it to our trainees to help them be up to speed on inter-viewing, assessing, and treating women exposed to intimate partner violence and sexual violence.” —Donna Stewart, M.D.The curriculum was developed by a steering committee of the WPA Section on Women’s Mental Health. Donna Stewart, M.D., co-chair of the committee and University Professor and chair of Women’s Health at the University of Toronto, said that psychiatric educators are welcome to use the resources in whole or in part with attribution.In an interview with Psychiatric News, Stewart said research indicates that few women who experience abuse or violence ever tell a health professional, and few physicians ask about intimate partner or sexual victimization. She said that’s true in mental health settings as well. The major barriers offered by psychiatrists for failing to discuss intimate partner or sexual violence include lack of adequate training about how to ask or respond, lack of knowledge regarding prevalence, skepticism about treatment effectiveness, concern about legal involvement, uncertainty about appropriate referrals, physician discomfort with the issues, time constraints, fear of offending or losing patients, and fear of safety for the women or oneself. “Worldwide the prevalence of intimate partner violence is at least 30 percent,” Stewart continued. “And we know that intimate partner violence and sexual violence dramatically affect mental health.” She added that while it is recognized that men can be victims of intimate partner violence, it is women who are disproportionately on the receiving end of such violence and tend to suffer greater injury.The curriculum is built around observable “competencies”—similar to the core competencies set by the Accreditation Council for Graduate Medical Education—that should be mastered in successive stages. The nine competencies described in the curriculum, each of which is divided into subtopics, require learners to be able to do the following: Define physical, psychological, and sexual intimate partner violence. Discuss prevalence.Be aware of myths and preconceptions.Have knowledge of sequelae. Assess for presence in a clinical setting.Provide psychological first aid.Have knowledge of resources.Communicate and document details of assessment.Manage violence-related psychological trauma.The curriculum offers five forms of resources. These include the World Health Organization’s Guidance on Health for Women subjected to intimate partner violence or sexual violence; links and abstracts of key papers, books, manual, and toolkits; a number of PowerPoint slides on intimate partner and sexual violence; case vignettes and teaching points; and video-based learning vignettes accessible on YouTube.One case vignette, for instance, is on “Treatment of Posttraumatic Stress Disorder After Sexual Violence (or Intimate Partner Violence)”: A family doctor refers a 25-year-old woman who was raped six months ago by an ex-partner to a community psychiatrist for intrusive memories of the assault, distressing dreams, flashbacks, avoidance of being alone, sadness, anxiety, trouble concentrating, hypervigilance, and inability to work. The woman was previously well and has no psychiatric history. The vignette is accompanied by teaching points about diagnosis, the range of treatment options, and documentation. Stewart said that the WPA’s Section on Women’s Mental Health began work on the curriculum three years ago, when the steering committee was selected from international leaders with expertise in intimate partner violence and sexual violence. It was cited as a priority by WPA President Dineesh Buhgra, M.D., Ph.D., of the United Kingdom. The co-chair of the curriculum steering committee is Prabha Chandra, M.D., professor and chair of the Department of Psychiatry at the National Institute of Mental Health and Neurosciences in Bangalore, India. Past APA President Michelle Riba, M.D., a member of the WPA Section on Women’s Mental Health and secretary of scientific publications for the WPA, said the curriculum is being disseminated at psychiatric meetings around the world, including APA’s, and a number of universities and training programs have already begun using it. The curriculum is accompanied by the Position Statement on Intimate Partner Violence and Sexual Violence Against Women, also issued in July, that declares the WPA’s support for public and professional awareness of violence against women as a critical women’s mental health determinant and for research to develop and evaluate the best treatments for women who have been victimized. “As many as 30 percent of our female patients will have experienced intimate partner violence, so we owe it to our trainees to help them be up to speed on interviewing, assessing, and treating women exposed to intimate partner violence and sexual violence,” Stewart said. “And practicing psychiatrists owe it to themselves and their patients to be current as well.” ■The International Competency-Based Curriculum for Mental Health Care Providers on Intimate Partner Violence/Sexual Violence Against Women can be accessed here. The WPA Position Statement on Intimate Partner Violence and Sexual Violence Against Women is available here. ISSUES NewArchived

Economic Insecurity and Intimate Partner and Sexual Violence Victimization

The costs and consequences of intimate partner violence (IPV) and sexual violence (SV) are well-documented; however, little is known about how experiences of violence are connected to specific economic insecurities including food, healthcare, and housing insecurity among both men and women. This study investigates (1) the prevalence of food, healthcare, and housing insecurity across gender and racial groups exposed to IPV and SV and (2) associations between exposure to past-year IPV and SV and past-year food, healthcare, and housing insecurity controlling for confounding factors. A cross-sectional survey design was used in this study. Data from 2010 National Intimate Partner and Sexual Violence Survey (NISVS) were analyzed in a nationally representative sample of men (N = 8079) and women (N = 9970). Logistic regressions were used to model associations between past-year intimate partner and sexual violence and dependent variables of food, healthcare, and housing insecurity. Analyses were stratified by gender and included control variables of age, income, education, and race/ethnicity. Higher rates of food, housing, and healthcare insecurity were found among men and women of color exposed to violence, particularly among respondents who identified as Black/African American, Latinx, American Indian/Alaska Native, and other racial/ethnic minority groups. For men, IPV and SV was associated with higher odds for experiencing food (AOR = 2.40, p <.001), housing (AOR = 2.06, p <.001), and healthcare insecurity (AOR = 2.39, p <.001). For women, IPV and SV was also associated with higher odds for experiencing food (AOR = 2.16, p <.001), housing (AOR = 1.94, p <.001), and healthcare insecurity (AOR = 2.38, p <.001). Findings identify specific economic needs among survivors and suggest that the burdens of IPV and SV are not equitably shared across racial/ethnic populations. Findings can inform policy that aims to reduce inequalities in food, housing, and healthcare associated with IPV and SV.

Short-term Lost Productivity per Victim: Intimate Partner Violence, Sexual Violence, or Stalking

The association between disability and intimate partner violence in the United States

Intimate partner violence (IPV) is an important social and public health problem, affecting millions of women worldwide. Violence in a relationship can occur in multiple ways, including physical violence, psychological aggression, and sexual violence. In this study, utilizing data from the National Intimate Partner and Sexual Violence Survey (NISVS), we comprehensively investigate the interplay between physical, psychological, and sexual violence, in terms of their co-occurrence patterns, their relation to trauma symptoms and overall health of victims. For this purpose, we perform network analysis and develop a visualization technique that enables in-depth navigation of the three-dimensional (physical, psychological, sexual) space of violence. Our findings show that physical violence tends to significantly co-occur with psychological abuse, and violence intensifies when both are present. We also find that sexual violence tends to overlap less with other types of violence, particularly with physical violence. Milder forms of psychological abuse are prominent in the population and seem to represent a separate type of abuse (micro-aggression) in terms of its occurrence patterns. Finally, we observe that trauma symptoms and health problems tend to be reported more by survivors at the presence of intense psychological aggression. Our findings can be useful in developing treatments that target different patterns of IPV.

Neighborhood Effects and Intimate Partner and Sexual Violence: Latest Results

On 25 November 2018, the United Nations chillingly reported that the most dangerous place for women is inside their own homes. Each year more than half of female homicides are...

Abuse of older adults is a public health problem. The National Intimate Partner and Sexual Violence Survey (NISVS) is a nationally-representative, telephone survey for non-institutionalized adults in the United States. To determine the prevalence and factors of intimate partner psychological aggression and physical violence and sexual violence by any perpetrator against older adults, we analyzed NISVS 2016/2017 data (n = 10,171, aged ≥ 60 years). Past 12-month prevalence of psychological aggression, physical violence, and sexual violence was 2.1%, 0.8%, and 1.7%, respectively. Odds of psychological aggression were significantly higher among those with hearing or vision impairment, and lower among those aged ≥70 years. Odds of physical violence were significantly higher for males and for those with hearing or vision impairment. Odds of sexual violence were significantly higher for unpartnered individuals and those with cognitive impairment; and lower for those aged ≥ 70 years. Epidemiologic studies of violence against older adults can inform population-specific prevention strategies.

The current study examined past year intimate partner violence (IPV; physical violence, coercive control, reproductive control, and psychological aggression) and sexual victimization on self-reported physical and mental health. Doing so provides a proxy longitudinal analysis of victimization on self-reported health outcomes. Data were from the 2010 National Intimate Partner and Sexual Violence Survey, a nationally representative sample of U.S. men and women. Given the differential risk of victimization, gender specific analyses were conducted. Findings from the logistic regression (N = 13,699) of the full sample (i.e., both women and men in analyses) indicated past year victimization was not significantly associated with self-reported poor/fair physical health. Among the full sample and the female-only sample (N = 7433), past year coercive control increased the odds of self-reported poor/fair mental health. The remaining types of victimization were not associated with self-reported mental health among the full sample or female respondents. Past year victimization was not associated with self-reported physical or mental health for male respondents (N = 6266). Directions for future research and policy implications related to interventions within healthcare settings are discussed.

The aim of this study was to describe the U.S. population-level prevalence of multiple perpetrator types (intimate partner, acquaintance, stranger, person of authority, or family member) per victim and to describe the prevalence of victim-offender relationship status combinations. Authors analyzed U.S. nationally representative data from noninstitutionalized adult respondents with self-reported lifetime exposure to intimate partner violence, sexual violence, or stalking in the 2012 National Intimate Partner and Sexual Violence Survey (NISVS). An estimated 142 million U.S. adults had some lifetime exposure to intimate partner violence, sexual violence, or stalking. An estimated 55 million victims (39% of total victims) had more than one perpetrator type during their lifetimes. A significantly higher proportion of female victims reported more than one perpetrator type compared with male victims (49% vs. 27%). Among both female and male victims with >1 perpetrator type, the most prevalent victim-offender relationship status combinations all included an intimate partner perpetrator. Many victims of interpersonal violence are subject to multiple perpetrator types during their lifetimes. Prevention strategies that address polyvictimization and protect victims from additional perpetrators can have a substantial and beneficial societal impact. Research on victim experiences to inform prevention strategies is strengthened by comprehensively accounting for lifetime victimizations.

Individuals who are LGB—lesbian, gay, bisexual (LGB)—are at high risk of being victimized by intimate partner violence and sexual abuse. Although research has begun to uncover the extent to which individuals experience both revictimization and polyvictimization, little is known about the extent of these two types of victimization among LGB persons. Data were drawn from the 2010 National Intimate Partner and Sexual Violence Survey (NISVS), a nationally representative telephone survey of eighteen thousand US residents, weighted to represent 232,458,335 proportional (49%) male and (51%) female adults aged 18 and older. Victimization was measured based on individuals’ responses to a series of questions about psychological aggression, coercive control and entrapment, physical violence, and sexual violence. Patterns of recurrent and poly victimization across LGB people and heterosexual people were compared. The findings indicate that LGB individuals face a greater risk of victimization than heterosexuals. Further, they are more likely to experience revictimization and polyvictimization. Sex differences emerged in that LGB females were likely to be victimized, revictimized, and polyvictimized when compared to their heterosexual counterparts. Fewer differences emerged between LGB males and male heterosexuals. This research suggests that LGB individuals face greater victimization risks, which is important because they may need special and specific interventions. Such interventions may be able to reduce not just an initial victimization but subsequent ones as well.

Few studies of intimate partner violence and health outcomes include multiple forms of intimate partner victimization, so this paper sought to examine health associations with intimate partner violence (IPV), including sexual, physical, stalking, and psychological forms, as well as polyvictimization. Data are from the 2010-2012 National Intimate Partner and Sexual Violence Survey, an on-going national random-digit-dial telephone survey of U.S. adults. There were 41,174 respondents. Logistic regression was used to compute prevalence ratios for any IPV, adjusted for demographics and non-IPV victimization. For individual forms of IPV, prevalence ratios were further adjusted for other forms of IPV. Tests for linear trend in poly-victimization were performed. Any IPV was associated with all health conditions for both sexes with a few exceptions for males. Female penetrative sexual victimization and male stalking victimization were associated with the most health conditions. For each health condition, a significant linear trend indicated that as the number of forms of IPV experienced increased, prevalence of each health condition increased, with a few exceptions for males. It is important for service providers to screen for multiple forms of IPV, including psychological aggression, because individual forms or polyvictimization may have unique and cumulative health effects.

Intimate partner violence (IPV) is a serious, and preventable, public health problem in the United States. IPV can involve physical and sexual violence, threats of physical or sexual violence, and psychological abuse, including stalking. It can occur within opposite-sex or same-sex couples and can range from one incident to an ongoing pattern of violence. On average, 24 persons per minute are victims of rape, physical violence, or stalking by an intimate partner in the United States. These numbers underestimate the problem because many victims do not report IPV to police, friends, or families. In 2010, IPV contributed to 1,295 deaths, accounting for 10% of all homicides for that year. The combined medical, mental health, and lost productivity costs of IPV against women are estimated to exceed $8.3 billion per year. In addition to the economic burden of IPV, victims are more likely to experience adverse health outcomes, such as depression, anxiety, posttraumatic stress disorder symptoms, suicidal behavior, sexually transmitted infections, and unintended pregnancy.