The Predictive Validity of the Danger Assessment for Immigrant Women (DA-I).

Immigrant women are vulnerable to intimate partner violence (IPV), and differences in immigration history, language, and culture impact their trauma responses. Although Chinese are the largest Asian immigrant subgroup in the U.S., little IPV research has specifically focused on this population. Therefore, we aimed to gain a better understanding of help-seeking experiences of Chinese immigrant women who had IPV. Twenty female Chinese immigrant survivors of recent IPV completed a Mandarin-language qualitative phone interview about their IPV experiences, help-seeking behaviors, and barriers to services. Interviews were analyzed using thematic analyses. Women in our sample relied on family, friends, and self-help strategies to cope with IPV. They experienced feelings of shame, stigma, and "losing face," and had little social support. They also faced significant sociocultural and immigration-specific problems with formal services (e.g., culturally incongruent therapists, language, financial and transportation barriers, concerns about partner's reputation and legal status), lacked knowledge about available services, and rarely engaged with them. Abused Chinese immigrant women may be exceptionally isolated, and culturally specific barriers may substantially impact both their understanding of their IPV experiences and their use of services. Practitioners need training and support to engage survivors in culturally competent ways. While safety planning and other formal IPV services are critical to safety and trauma recovery, these survivors underutilize them, and community outreach is needed to U.S. Chinese communities to raise awareness regarding available IPV resources and services. Finally, research is needed to develop and test culturally competent, evidence-based interventions for this isolated and vulnerable population. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Purpose: The purpose of this study is to compare perspectives on economic empowerment in the context of employment seeking among intimate partner violence (IPV) survivors and service providers specializing in IPV-related trauma. This study addressed the following question is: How do employment-seeking IPV survivors and service providers conceptualize and understand empowerment? Insights into how each group conceives of economic empowerment and its attainment following IPV experiences can help to inform an effective service curriculum that can be used to facilitate optimal employment outcomes among survivors. Methods: A constructivist grounded theory method was used to develop a theoretical framework for conceptualizing how economic empowerment is understood by employment-seeking survivors of IPV, and IPV service providers. Twenty-six participants were recruited (survivors, n = 16; service providers, n = 10) in a large northeastern U.S. city. Interview questions focused on how IPV survivors and service providers identify and conceptualize economic empowerment, and how support services respond to survivors’ needs around empowerment, particularly through help with employment seeking. Results: Data were coded and analyzed following data analysis stages: (a) initial coding; (b) constant comparison; and, (c) focused coding. Three main themes emerged from the narrative data: (1) structural characteristics shape individual experiences and perspectives of empowerment; (2) peer support as an integral component to empowerment; and (3) employment attainment as economic empowerment. Though perspectives on economic empowerment were often aligned, some key differences emerged. Whereas providers tended toward a more restricted, micro-level view of empowerment as primarily an attribute of the individual, survivors were inclined toward a structuralist perspective that considers how individuals’ experiences of empowerment are shaped by broader, institutional-level factors. Conclusions: Findings from this study build on prior research on the experiences of IPV survivors. The focus on experiences of empowerment in the context of employment-seeking can inform work on building more effective support services for survivors that avoid reductionist approaches that could be perceived by survivors as “victim-blaming” by incorporating a sensitivity to empowerment as derived from structural factors that shape individual experience.

The practice of screening women for intimate partner violence (IPV) in health care settings has been a critical part of responding to this major public health problem. Yet, IPV prevention would be enhanced with detection efforts that extend beyond screening for IPV experiences to identifying those who use violence in relationships as well. To determine rates of IPV experiences and use (ie, among perpetrators of IPV) and factors associated with disclosures among adult patients seeking mental health services at the Veterans Health Administration. This cross-sectional study used electronic medical record data drawn from a quality improvement initiative at 5 Veterans Health Administration medical centers conducted between November 2021 and February 2022 to examine IPV disclosures following concurrent screening for IPV experience and use. Participants included patients engaged in mental health services. Data were analyzed in April and May 2023. Mental health clinicians were trained to screen for IPV experience and use concurrently and instructed to screen all patients encountered through routine mental health care visits during a 3-month period. Outcomes of interest were past-year prevalence of IPV use and experience, sociodemographic characteristics, and clinical diagnoses among screened patients. A total of 200 patients were offered IPV screening. Of 155 participants (mean [SD] age, 52.45 [15.65] years; 124 [80.0%] men) with completed screenings, 74 (47.7%) denied past-year IPV experience and use, 76 (49.0%) endorsed past-year IPV experience, and 72 (46.4%) endorsed past-year IPV use, including 67 participants (43.2%) who reported IPV experience and use concurrently; only 9 participants (5.8%) endorsed unidirectional IPV experiences and 5 participants (3.2%) endorsed unidirectional IPV use. Patients who reported past-year IPV experience and use were younger than those who denied IPV (experience: mean difference, -7.34 [95% CI, 2.51-12.17] years; use: mean difference, -7.20 [95% CI, 2.40-12.00] years). Patients with a posttraumatic stress disorder diagnosis were more likely to report IPV use (43 patients [59.7%]) than those without a posttraumatic stress disorder diagnosis (29 patients [40.3%]; odds ratio, 2.14; [95% CI, 1.12-4.06]). No other demographic characteristics or clinical diagnoses were associated with IPV use or experience. In this cross-sectional study of IPV rates and associated factors, screening for IPV found high rates of both IPV experience and use among patients receiving mental health care. These findings highlight the benefit of screening for IPV experience and use concurrently across gender and age. Additionally, the associations found between PTSD and IPV use underscore the importance of strengthening and developing additional targeted treatment for IPV.

Despite increasing acknowledgment of intimate partner violence (IPV) as a potentially traumatic experience, there is a gap in research investigating women's perspectives of trauma related to their experiences of IPV from an intersectional lens. Intersectionality, which illuminates interconnected inequalities due to constructions of race, gender, sexuality, class, and culture, is particularly important for exploring the broader contexts of women's experiences of IPV and trauma. In response to this dearth in research, this paper presents qualitative findings from a constructivist grounded theory study of 15 women's experiences of IPV and trauma. To conceptualize IPV-related trauma from an intersectional lens, this study addressed the following research questions: (a) How do women who have experienced IPV understand and view trauma? (b) What do women who have experienced IPV indicate are experiences of trauma? and (c) How do women's differing identities, experiences of oppression, or other hardships or adversities relate to their experiences of IPV? Through analysis, six distinct themes were identified: (a) changing perceptions of trauma; (b) the pain of trauma; (c) fear, anxiety, and triggers; (d) lasting impact of trauma; (e) struggle for acceptance; and (f) growth and insight. Implications from these findings illustrate the pervasiveness of IPV and other forms of trauma among women who have been abused by a partner, the long-lasting traumatic impacts of IPV, and the multiple experiences of being blamed and not believed that many women have experienced. These findings represent first steps in understanding the relationship between IPV and trauma from the perspectives of women who have survived IPV, offering an important contribution to previous knowledge on IPV. As well, this study provides first steps in understanding the interacting, intersectional effects of multiple forms of adversity, oppression, and IPV, and their relationships to trauma.

Associations between state-level restorative justice policies and mental health among women survivors of intimate partner violence

Those who have served in the military are at heightened risk for intimate partner violence (IPV), defined as threatened or actual physical, sexual, or psychological abuse from a current or former romantic partner, relative to the general population. However, no known efforts have compared patterns of IPV use (i.e., perpetration) and IPV experience (i.e., victimization) disaggregated by current military affiliation (i.e., service member or veteran), nor have they compared patterns of unidirectional IPV (either IPV use or experience only) versus bidirectional IPV (i.e., concurrent IPV use and IPV experience) by military affiliation. Using dyadic data from United States service members, veterans, and their spouses who participated in the Millennium Cohort Family Study-the only Department of Defense-wide longitudinal study on military families-we compared rates and frequencies of IPV use, IPV experience, and IPV patterns between service members (n = 2,301) and veterans (n = 1,877). An estimated 37.6% of service members and 47.9% of veterans had any IPV experience; 36.4% of service members and 50.8% of veterans had any IPV use. Veterans had higher rates of IPV experience (adjusted odds ratio [aOR]: 1.43; 95% confidence interval [CI] [1.10, 1.85]) and IPV use (aOR: 1.67; 95% CI [1.29, 2.18]). After adjusting for bidirectionality, veterans had higher rates of bidirectional IPV (aOR: 1.62; 95% CI [1.22, 2.15]) and IPV use (aOR: 2.19; 95% CI [1.29, 3.27]), but not IPV experience. Veterans had an increase in the expected frequency of IPV experience by 47% (adjusted incidence rate ratios [IRR] = 1.47; 95% CI [1.19, 1.81]) and IPV use by 65% (IRR = 1.65, 95% CI [1.35, 2.00]), relative to service members. These findings underscore the value of investment in IPV prevention and treatment upon separation from military service, and the need for targeted programming and resources to address bidirectional IPV among both partners in a dyad.

A Longitudinal Investigation of Intimate Partner Violence Among Mothers With Mental Illness

Severe mental illness, substance use, and intimate partner violence have emerged as major intersecting public health problems that adversely and disproportionately impact the lives of women in the United States. This longitudinal study investigated the demographic and clinical correlates of intimate partner violence in a sample of 324 mothers with severe mental illness. A secondary analysis of longitudinal data was conducted by using multiple logistic regression. Participants were part of a longitudinal, community-based study of mothers with severe mental illness, which was aimed at understanding how these mothers viewed motherhood. The women were interviewed initially at baseline (interviews were conducted between 1995 and 1996) and then about 20 months later at follow-up (interviews were conducted between 1997 and 1998). At follow-up the prevalence rate of intimate partner violence was 19%. Multiple logistic regression analyses showed a significant positive relationship between alcohol and drug misuse at baseline and intimate partner violence at follow-up, indicating that women with a co-occurring diagnosis of a substance use disorder (dual diagnosis) were more likely than women without such a diagnosis to report intimate partner violence. The number of lifetime psychiatric hospitalizations and the number of symptoms related to psychiatric disability exhibited at baseline were positively associated with intimate partner violence at follow-up, and age was inversely associated with intimate partner violence. Mental health professionals serving mothers with mental health problems need to be aware of and prepared to assess the significant correlation between these intersecting public health problems in order to influence successful interventions. Particular attention must be given to the special treatment needs related to dual diagnosis and victimization and the impact of these factors on this vulnerable population.

One-third of women are victimized by intimate partner violence (IPV) in their lifetime; when women are killed, they are often murdered by a previously abusive intimate partner. Risk-informed collaborative interventions, such as domestic violence high risk teams (DVHRTs), use IPV risk assessment to identify and intervene in high-risk IPV cases. This study reports on the development and testing of the Danger Assessment for Law Enforcement (DA-LE), an IPV risk assessment intended for use with DVHRTs. Data were collected through structured telephone interviews from service-seeking survivors of IPV at two time points approximately seven to eight months apart. One sample (n = 570) was used to develop the DA-LE and another (n = 389) was used to test the predictive validity of the instrument using the receiver operating characteristic area under the curve (AUC). The DA-LE predicted near fatal IPV on follow-up with similar or better accuracy than most validated IPV risk assessment instruments (AUC = 0.6864–0.7516). There were no significant differences in predictive validity based on survivor/offender race or ethnicity. The DA-LE has the potential to identify high-risk police-involved IPV cases. Risk-informed collaborative interventions may enhance outcomes for survivors of IPV by holding offenders accountable, increasing help seeking, and reducing future assaults.

Researchers continue to demonstrate the significant physical and mental health consequences to women who experience intimate partner violence (IPV) and children exposed to IPV. However, more research is needed to examine group interventions that support mothers, their children, and the parent-child relationship in the aftermath of IPV. We analyzed data provided by women who participated in a 12-week parent group. The objectives of the parent group were for mothers to better understand their children’s developmental experience of IPV and to break the secret of domestic violence in their family. The sample included 15 women who completed the group and the baseline, midpoint, and endpoint surveys. Eleven of these women also completed a semi-structured interview three months following the group. Survey items and interview topics focused on group process and outcomes. Women reported the group helped them feel less alone in their experience of IPV and they valued having a space to learn and discuss new concepts that related to their experiences and their children’s experiences of IPV. They reported more confidence in identifying their child’s feelings and being a safe person to whom their children could express their anger. Women also reported they developed greater coping and communication tools, and a strengthened mother-child bond, through group participation. Group interventions are an important format for learning and sharing for some mothers who have experienced IPV, though more evaluation is needed on what components of these group interventions are the most supportive of mothers’ healing and growth.

The development of culturally safe intimate partner violence (IPV) services for immigrant and refugee women is strongly tied to understanding how IPV and its concomitants can be different for immigrant and refugee women. A lack of knowledge will contribute to inefficient, inappropriate, and less effective services. This study draws upon the expertise and wisdom of immigrant/refugee IPV survivors who serve on a survivor-only advisory board for IPV programming. The dialog of 35 attendees who participated in immigrant/refugee IPV survivor advisory board meetings was analyzed using reflexive thematic analysis to generate themes that captured their lived experiences of IPV, IPV support (i.e., their journey and recovery process), and their wish list for what they hoped would have been different. Three major themes and nine subthemes were generated (Theme 1: Experience of Intimate Partner Violence Is All-Encompassing; Theme 2: Immigrant and Refugee Survivors Experience Gaps and Therefore Feel Lost When Seeking or Receiving Support; Theme 3: Empowerment Is a Core Need). This study’s results study contribute to a more nuanced understanding of IPV for immigrant and refugee women (including how they tend to experience and navigate IPV differently than locally born ethnic/racial minoritized individuals) and provide valuable information that could help service providers and policy-makers develop and implement more culturally safe and effective intervention and prevention strategies.

“There's no place like home”: Examining the associations between state eviction defense protections and indicators of biopsychosocial stress among survivors of intimate partner violence

Survivors of intimate partner violence (IPV) and sexual assault (SA) faced increased violence, new safety risks, and reduced services access in the face of the COVID-19 pandemic. IPV and SA service providers have a critical role in safety planning and advocacy with survivors; however their patterns of working were dramatically impacted by changes brought on by the pandemic. Little is known about safety planning strategies and service adaptations employed in this context. Through semi-structured interviews with 33 service providers from across the United States, this study explores the experiences and perspectives of victim service agency staff with IPV and SA survivor safety and safety planning from March to December 2020. Qualitative data were analyzed using conventional content analysis. Four overarching themes related to survivor safety and safety planning emerged, including (1) "The violence is more severe, it's more escalated," describing an increase in the severity and frequency of violence; (2) "Perpetrating the violence through [technology]," describing a specific surge in technology based abuse (TBA) as the world shifted to virtual communication to facilitate social distancing; (3) "COVID-19 is now a tool in their toolbox," describing the emergence of the COVID-19 pandemic and health guidance as a life generated risk that abusive partners used to further control and isolate their partner; and (4) "You just get real crafty," highlighting the wide range of "work-arounds" and safety planning adaptations employed by victim service professionals trying to maintain services in a disrupted environment and in the face of evolving safety risks and increasing violence severity. These findings highlight the safety and safety planning challenges encountered as the COVID-19 pandemic unfolded and the many creative strategies employed by service providers to adapt in the moment.

Nonfatal strangulation is a prevalent, underreported, and dangerous form of intimate partner violence (IPV). It is particularly important to assess for strangulation among abused women as this form of violence may not leave visible injury. The most severe negative physical and mental health consequences of strangulation appear to be dose-related, with those strangled multiple times or to the point of altered consciousness at higher risk of negative sequelae. This research examines the relationship between multiple strangulation, loss of consciousness due to strangulation, and risk of future near-fatal violence to modify the Danger Assessment (DA) and the Danger Assessment for Immigrant women (DA-I), IPV risk assessments intended to predict near-fatal and fatal violence in intimate relationships. Data from one study (n = 619) were used to modify the DA to include an item on multiple strangulation or loss of consciousness due to strangulation. Data from an independent validation sample (n = 389) were then used to examine the predictive validity of the updated DA and DA-I. The updated version of the DA predicts near-fatal violence at 7-8 months follow-up significantly better than the original DA. Adding multiple strangulation or loss of consciousness to the DA-I increased the predictive validity slightly, but not significantly. The DA and DA-I are intended to be used as a collaboration between IPV survivors and advocates as tools for education and intervention. Whether or not an IPV survivor has been strangled, she should be educated about the dangerous nature of strangulation and the need for medical intervention should her partner use strangulation against her. This evidence-based adaptation of the DA and DA-I may assist practitioners to assess for and intervene in dangerous IPV cases.

The association between emotional and physical intimate partner violence and COVID-19 vaccine uptake in a community-based U.S. Cohort