Childhood Firearm Deaths During Intimate Partner Violence Incidents: 2004-2020.

This study examines a hypothesis that has not received adequate scrutiny: that an important proportion of intimate partner violence (IPV) incidents, particularly those that are more serious, involve generalist offenders known to the police. Many criminological theories and empirical studies suggest that offenders are often generalists, yet few IPV studies consider this hypothesis. Based on a sample of 52,149 IPV incidents recorded by police, we found that 31% of IPV incidents involved suspects only with criminal records for non-IPV criminality, 9% involved victims only with criminal records for non-IPV criminality, and 14% involved both suspects and victims with criminal records for non-IPV criminality. Thus, 45% of IPV offenders and 23% of IPV victims had criminal records for non-IPV criminality. Multilevel regression analyses reveal that controlling for prior IPV incidents, community context, and other individual and couple variables, IPV offenders with criminal records are 16% more likely to be involved in more serious incidents, and victims of IPV with criminal records are 17% more likely to be involved in more serious incidents. In addition, IPV incidents for which both suspects and victims had criminal records were 46% more likely to be more serious incidents. These results suggest that generalist criminals known by police have an important impact on the proportion of IPV incidents, particularly the more serious ones.

The risk of harm/injury in homes where intimate partner violence (IPV) occurs is not limited to humans; animals reside in as many as 80% of these homes and may be at substantial risk of suffering severe or fatal injury. Gaining a better understanding of IPV-pet abuse overlap is imperative in more accurately identifying the risks of harm for all individuals and animals residing in these homes. The objectives of this study were to utilize law enforcement officers' observations and IPV victim reports from the scene of the incident to (a) determine the prevalence of pet abuse perpetration among suspects involved in IPV incidents, (b) compare characteristics of IPV incidents and the home environments in which they occur when the suspect has a history of pet abuse with incidents involving suspects with no reported history of pet abuse, and (c) compare IPV incident outcomes involving suspects with a history of pet abuse with those involving suspects with no reported history of pet abuse. IPV victims residing in homes with a suspect who has a history of pet abuse often describe "extremely high-risk" environments. With nearly 80% reporting concern that they will eventually be killed by the suspect, victims in these environments should be considered at significant risk of suffering serious injury or death. In addition, IPV victims involved in incidents with a suspect that has a history of pet abuse were significantly more likely to have had at least one prior unreported IPV incident with the suspect (80%) and to have ever been strangled (76%) or forced to have sex with the suspect (26%). Effective prevention/detection/intervention strategies are likely to require multidisciplinary collaboration and safety plans that address the susbstantial risk of harm/injury for all adults, children, and animals residing in the home.

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

Few studies have examined adolescent victims of intimate partner violence (IPV) whose victimization is reported to the police or the nature of the incidents that led to the police call. This oversight is problematic for healthcare providers, given that overlap between the use of healthcare and police services is high among IPV victims. We assessed the frequency and nature of police-documented incidents of IPV by men against female adolescents aged 15-17 compared with those against young women aged 18-22. A systematic case ascertainment strategy was applied to administrative data from the Compstat database of a large U.S. metropolitan police department to identify IPV incidents with victims <23 years old. We created additional variables from incident narratives and conducted descriptive analyses on the identified cases. During January-September 2005, police filed reports on 1607 incidents of IPV against women <23 years old: one tenth were younger than 18. Although their risk of police-documented IPV was lower, adolescents' experiences of IPV were remarkably similar to those of 18-22-year-olds. As with adult victims, most assaults against adolescents were through bodily force (94.4%) and occurred in a private residence (75.0%). A substantial minority of adolescents were in adultlike relationships: 9.0% were married, 31.3% were cohabiting, and 20.2% had a child in common. A higher proportion of adolescents, however, experienced an aggravated (vs. simple) assault (11.1%) and sustained visible injuries (12.1%). The commonalities between adolescent and young women's experiences of IPV regarding the nature of the assault, observed injuries, and relationship to assailants have important implications for policy and practice. Findings suggest that routine screening for IPV should begin in adolescence to help prevent future abuse and injury.

Recognizing Isolated Ulnar Fractures as Potential Markers for Intimate Partner Violence.

There are few longitudinal estimates of intimate partner violence (IPV) incidence and continuation. This report provides estimates of IPV incidence and continuation in women receiving health care in clinics participating in an IPV assessment and services intervention study. The Women's Experience with Battering Scale was used in combination with questions addressing physical and sexual assault to annually screen women for IPV. Between April 2002 and August 2005, 657 women in rural South Carolina consented and were screened at least twice. Among those with a current partner (n = 530), the majority (86.2%) had never experienced IPV. Among prevalent victims, IPV continued over time for 37%. IPV continuation rates were higher among older women and those who considered abuse as a problem in their relationship. Of those women who were IPV negative at time 1, IPV incidence at time 2 was 4.2%. A higher score on the Women's Experience with Battering Scale at time 1, a marker of psychological abuse, was a strong predictor of physical IPV incidence (p(trend) = 0.0001). These data suggest that the incidence of IPV over a short follow-up period is relatively low and that the majority of IPV desists over this short follow-up period.

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.

BackgroundIntimate partner violence (IPV) is a global social and public health problem but published literature regarding the exacerbation of physical IPV during the COVID-19 pandemic is lacking.PurposeTo assess the incidence, patterns, and severity of injuries in victims of intimate partner violence (IPV) during the COVID-19 pandemic in 2020, compared with the prior three years.Materials and MethodsThe demographics, clinical presentation, injuries, and radiological findings of patients reporting physical abuse arising from IPV during the statewide COVID-19 pandemic between March 11th and May 3rd, 2020 were compared with the same period over the past three years. Pearson’s chi-squared and Fischer’s exact have been used for analysis.Results26 physical IPV victims from 2020 (37+/-13 years, 25 women) were evaluated and compared with 42 physical IPV victims (41+/-15 years, 40 women) from 2017-2019. While the overall number of patients reporting IPV decreased during the pandemic, the incidence of physical IPV was 1.8 times greater (95% confidence interval [CI] 1.1 to 3.0, p = 0.01). The total number of deep injuries was 28 during 2020 versus 16 from 2017-2019; the number of deep injuries per victim was 1.1 during 2020 compared with 0.4 from 2017-2019 (p<0.001). The incidence of high-risk abuse defined by mechanism was greater by 2 times (95% CI 1.2 to 4.7, p = 0.01). Patients with IPV in during the COVID-19 pandemic were more likely to be ethnically white, 17 (65%) victims in 2020 were ethnically white compared to 11 (26%) in the prior years (p=0.007).ConclusionThere was a higher incidence and severity of physical intimate partner violence (IPV) during the COVID 19 pandemic compared with the prior three years. These results suggest that IPV victims delayed reaching out to health care services until the late stages of the abuse cycle during the COVID-19 pandemic.

Missed Opportunities: Emergency Department Visits by Police-Identified Victims of Intimate Partner Violence

Significant research has focused on intimate partner violence (IPV) victimization among women Veterans, yet much less is known about women Veterans’ IPV perpetration. Although military sexual trauma (MST) is a predictor of IPV victimization, military sexual assault (MSA), a component of MST, may predict especially adverse consequences for women Veterans. This study examined the unique effects of MSA on IPV victimization of, and perpetration by, women Veterans, and investigated posttraumatic stress disorder (PTSD) symptoms and prior IPV victimization as potential mediators of IPV perpetration. Participants included 187 women Veterans drawn from a larger web-based survey. We assessed the two components of MST (MSA and harassment) at Time 1 (T1), PTSD symptoms at Time 2 (T2), IPV victimization at T2 and Time 3 (T3), and IPV perpetration at T3. MSA predicted multiple subtypes of IPV victimization and perpetration, whereas harassment predicted neither. Those who reported MSA were more likely to experience T3 psychological and sexual IPV victimization, with PTSD symptoms significantly mediating this path. MSA was also directly related to T3 psychological IPV perpetration and indirectly related to physical and sexual IPV perpetration through PTSD symptoms. MSA was directly related to T2 PTSD symptoms while T2 IPV victimization was directly related to T3 IPV perpetration. These findings underscore that women Veterans’ IPV perpetration may be in response to their own IPV victimization through self-defense and/or due to their PTSD symptoms. Results support prevention, screening, and treatment for IPV victimization and PTSD symptoms to lower risk of future IPV revictimization and perpetration.

Background Most studies have focused on women’s intimate partner violence (IPV) victimization but perpetration and bi-directional violence remain understudied. Methods Using linked criminal justice and population registers in Manitoba, Canada, we assessed the risk of death according to the role in IPV incidents (accused-only, victim-only, bidirectional, none). In this retrospective matched cohort study, we assembled a cohort of 212,068 adults who were followed from April 2004 to March 2023 to assess IPV incidents and subsequent death. Those involved in an IPV incident were 1:3 matched to persons with no history of IPV based on birth year, sex and marital status at the time of the incident. Results Men comprised 85% of accused-only, 21% of victim-only, and 50-51% in the other two groups. Overall, compared to those without IPV involvement, the adjusted Hazard Ratios for all-cause mortality were 1.38 [95% Confidence Intervals (CI): 1.28, 1.49] for accused-only, 1.39 (1.29, 1.50) for victim-only and 1.45 (1.19, 1.77) for bidirectional IPV. The associations were stronger among women, particularly that of bidirectional violence [1.24 (0.97, 1.60) among men and 1.92 (1.39, 2.66) among women]. Similar patterns were found for intentional mortality [0.96 (0.56, 1.64) among men and 2.43 (1.27, 4.65) among women]. Conclusions There are clear sex inequities in IPV involvement. Any type IPV involvement is associated with higher risk of death, particularly among women, who comprise most of the victims. Key messages • Any type IPV involvement is associated with higher risk of death, particularly among women, who comprise most of the victim. • Use of linked criminal justice data allows studying the consequences of IPV victimization, perpetration and bidirectional violence and monitor gender inequities over time.

Objective and ApproachMost studies have focused on women’s IPV victimization but perpetration and bi-directional violence remain understudied. Using linked criminal justice and population registers in Manitoba, Canada, we assessed the risk of death according to the role in IPV incidents (accused-only, victim-only, bidirectional, none). In this retrospective matched cohort study, we assembled a cohort of 212,068 adults who were followed from April 2004 to March 2023 to assess IPV incidents and subsequent death. Those involved in an IPV incident were 1:3 matched to persons with no history of IPV based on birth year, sex and marital status at the time of the incident. ResultsMen comprised 85% of accused-only, 21% of victim-only, and 50-51% in the other two groups. Overall, compared to those without IPV involvement, the adjusted Hazard Ratios for all-cause mortality were 1.38 [95% Confidence Intervals (CI): 1.28, 1.49] for accused-only, 1.39 (1.29, 1.50) for victim-only and 1.45 (1.19, 1.77) for bidirectional IPV. The associations were stronger among women, particularly that of bidirectional violence [1.24 (0.97, 1.60) among men and 1.92 (1.39, 2.66) among women]. Similar patterns were found for intentional mortality [0.96 (0.56, 1.64) among men and 2.43 (1.27, 4.65) among women]. ConclusionsThere are clear sex inequities in IPV involvement. Any type IPV involvement is associated with higher risk of death, particularly among women, who comprise most of the victims. ImplicationsUse of linked criminal justice data allows studying the consequences of IPV victimization, perpetration and bidirectional violence and monitor gender inequities over time.

This study examines the overlap between victimization and offending within officially recorded incidents of intimate partner violence (IPV). Using official police data, 1,256 individuals are initially differentiated by their role as the victim or the offender in an IPV incident and then categorized into four distinct groups (e.g., as victims, persistent offenders, desistent offenders, or victim-offenders) based on their role in further officially recorded IPV incidents during an 18-to 30-month follow-up period. Of particular interest is the victim-offender category, which involves individuals who switched roles from the original IPV incident (e.g., IPV victims who later became IPV offenders or IPV offenders who later became IPV victims). Results suggest that important distinctions exist across categories related to sex and crime exposure. Compared with victims who were predominately female and offenders who were predominately male, victim-offenders were the most gender symmetric and exhibited greater contacts with the justice process prior to and after the original IPV incident. Implications from these findings, as well as limitations and suggestions for further research are discussed.

Intentional injury and violent death after intimate partner violence. A retrospective matched-cohort study

Objectives. To investigate the prevalence, pattern, and socioeconomic risk factors of intimate partner violence (IPV) before and 6 months after the pandemic onset among a cohort of Iranian women. Methods. We conducted a population-based IPV survey among 2502 partnered Iranian women aged 18 to 60 years before (n = 2502) and 6 months after (n=2116) the pandemic's onset. We estimated prevalence and incidence of psychological, physical, and sexual IPV, and the odds of different forms of IPV associated with main exposure variables, adjusted for participant relationship factors. Results. Pandemic prevalence of IPV (65.4%; 95% confidence interval [CI] = 63.4%, 67.4%) was higher than prepandemic prevalence (54.2%; 95% CI = 52.2%, 56.3%). At follow-up, the incidence of IPV was 25.5% (95% CI = 22.9%, 28.4%). The highest incidence was in cases of physical and sexual IPV. Women whose partners lost their employment were at significant risk of new exposure to IPV. Highest socioeconomic status (SES) was associated with less physical IPV (odds ratio = 0.03; 95% CI = 0.01, 0.14). Conclusions. IPV prevalence has risen since the COVID-19 epidemic began with many women who had never experienced IPV now facing it. Unemployment of women or their partners and prepandemic lower socioeconomic status are risk factors of IPV. Monitoring programs should target these populations. (Am J Public Health. 2023;113(2):228-237. https://doi.org/10.2105/AJPH.2022.306839).