Using pre-existing poetry in understanding women exposed to intimate partner violence

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.

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.

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

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

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.

Evidence suggests an overlap between intimate partner violence (IPV) experience and perpetration. However, few studies in sub-Saharan Africa have investigated experience and perpetration of IPV among women and men within the same community. This study reports prevalence of past-year IPV experience and perpetration among women and men living in an informal settlement in Nairobi, Kenya, and factors associated with IPV. Data analyzed for this study involved a geographically distributed random sample of 273 women and 429 men who participated in a community survey. We approximated prevalence of IPV experience and perpetration and used logistic regression for estimating associations between individual-level factors and IPV. Women and men experienced similar levels of IPV, but a significantly higher proportion of men reported physical and sexual IPV perpetration. Witnessing violence between parents in childhood was associated with women's physical and sexual, and men's sexual IPV experience; and with women perpetrating emotional, and men perpetrating sexual IPV. Less equitable gender attitudes were associated with men's perpetration of physical IPV. More equitable gender knowledge was associated with women's experience of sexual IPV, and with men perpetrating IPV. Perceived skills to challenge gender inequitable practices were negatively associated with men perpetrating sexual IPV. In conclusion, we found IPV experience and perpetration were highly correlated, and that, contrary to commonly reported gender gaps, men and women experienced similar rates of IPV. We make suggestions for future research, including on IPV prevention interventions in areas with such IPV prevalence that would be beneficial for women and men and future generations.

Women presenting for care within a suburban Department of Veterans Affairs Hospital (VA) were screened for intimate partner violence (IPV). This study aimed to explore the feasibility of screening for IPV within a VA women’s health clinic, assess how well the screening measure captured women veterans’ experiences of IPV, and compare clinical correlates of IPV in women veterans who have and have not experienced IPV. Of 96 eligible women, 93 (97 %) answered a self-report question regarding experience of lifetime IPV and 72 (75 %) participated in a standardized screening. Among participants, 42 (47 %) reported experiencing past or current IPV, and of those, 11 (25 %) reported that they were currently experiencing IPV, and 31 (70 %) reported that they had experienced IPV in their past. Screening for IPV among women veterans in a women’s health clinic is feasible and identifies women who experience IPV, offering opportunities for referral and intervention.

22: Intimate partner violence and pregnancy: Narratives of pregnant and parenting teens

Intimate partner violence (IPV) can comprise physical, sexual, and emotional abuse, and is a widespread public health concern. Despite increasing recognition that women experience different types of IPV, the majority of research has focused on physical IPV. The present study aims to examine associations between different types of IPV (physical, emotional, physical, and emotional) and women's mental, physical, and sexual health by analyzing longitudinal data from a prospective pregnancy cohort of 1,507 first-time mothers in Melbourne, Australia. Questionnaires included validated measures of physical and mental health (Short Form Health Survey, Edinburgh Postnatal Depression Scale) and IPV (Composite Abuse Scale). Emotional IPV alone was the most commonly reported type of IPV (n = 128, 9.5%), followed by both physical and emotional IPV (n = 76, 5.7%), and then physical IPV alone (n = 30, 2.2%). Women reporting emotional IPV or physical and emotional IPV had increased odds of poor health compared with women reporting no IPV. Experience of physical and emotional IPV was most strongly associated with mental health issues, including depressive symptoms (adjusted odds ratio [OR] 4.6, 95% confidence interval [CI] = [2.9, 7.1]) and self-reported anxiety (adjusted OR 2.9, 95% CI = [1.9, 4.4]). Experience of emotional IPV alone was associated with poor mental health as well as physical factors, including poor general physical health (adjusted OR 1.9, 95% CI = [1.2, 3.1]), and pain during sex (adjusted OR 1.8, 95% CI = [1.2, 2.7]). Increased odds of poor body image were also observed for women reporting emotional IPV alone and physical and emotional IPV. These findings highlight the need for greater awareness of the diversity in women's experiences of IPV among health care providers. This includes understanding the prevalence of emotional IPV among new mothers, and the range of health problems that are more common for women experiencing IPV.

The Intimate Partner Violence Stigmatization Model posits that internalized stigma and centrality of experiences of intimate partner violence (IPV) to one's self‐concept are two intrapersonal factors that influence concealment of IPV. However, research has yet to empirically examine these relationships. The current study examines whether internalized stigma, centrality, and their interaction are related to how out people are about IPV to others. Participants were 57 men and women who were recruited from a predominately urban Northeast community and indicated that they were concealing experiences of physical IPV from others. Results of a hierarchical multiple regression analysis revealed a significant internalized stigma x centrality interaction on general outness about one's experiences of IPV. Centrality was associated with more outness about experiences of IPV when internalized stigma was low, but had no association with general outness when internalized stigma was high. In other words, people low in internalized stigma were more out to others when IPV centrality was high and less out to others when IPV centrality was low. However, people high in internalized stigma were less out to others about their IPV victimization regardless of the centrality of IPV. We did not find evidence that internalized stigma and centrality predict disclosure to specific close others such as one's parents or siblings. Women were more likely than men to be out about experiences of IPV to their mother and closest friend. Findings have implications for understanding when and why people victimized by IPV reveal or conceal their experiences to others.

BackgroundIntimate partner violence (IPV) against women is a global public health concern. While community-level gender norms and attitudes to IPV are recognised drivers of IPV risk, there is little evidence on how interventions might tackle these drivers to prevent IPV at the community-level. This secondary analysis of data from the SASA! study explores the pathways through which SASA!, a community mobilisation intervention to prevent violence against women, achieved community-wide reductions in physical IPV.MethodsFrom 2007 to 2012 a cluster randomised controlled trial (CRT) was conducted in eight communities in Kampala, Uganda. Cross-sectional surveys of a random sample of community members, aged 18–49, were undertaken at baseline (n = 1583) and 4 years post intervention implementation (n = 2532). We used cluster-level intention to treat analysis to estimate SASA!’s community-level impact on women’s past year experience of physical IPV and men’s past year perpetration of IPV. The mediating roles of community-, relationship- and individual-level factors in intervention effect on past year physical IPV experience (women)/perpetration (men) were explored using modified Poisson regression models.ResultsSASA! was associated with reductions in women’s past year experience of physical IPV (0.48, 95 % CI 0.16–1.39), as well as men’s perpetration of IPV (0.39, 95 % CI 0.20–0.73). Community-level normative attitudes were the most important mediators of intervention impact on physical IPV risk, with norms around the acceptability of IPV explaining 70 % of the intervention effect on women’s experience of IPV and 95 % of the effect on men’s perpetration. The strongest relationship-level mediators were men’s reduced suspicion of partner infidelity (explaining 22 % of effect on men’s perpetration), and improved communication around sex (explaining 16 % of effect on women’s experience). Reduced acceptability of IPV among men was the most important individual-level mediator (explaining 42 % of effect on men’s perpetration).ConclusionsThese results highlight the important role of community-level norm-change in achieving community-wide reductions in IPV risk. They lend strong support for the more widespread adoption of community-level approaches to preventing violence.Trial registrationClinicalTrials.gov, NCT00790959. Registered 13th November 2008.The study protocol is available at: http://www.trialsjournal.com/content/13/1/96Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3018-9) contains supplementary material, which is available to authorized users.

Neighborhood Effects and Intimate Partner and Sexual Violence: Latest Results

BackgroundLittle is known about women veterans’ intimate partner violence (IPV) experiences during the COVID-19 pandemic or the impacts of pandemic-related stress on their mental and physical health.ObjectivesTo identify IPV experiences among women veterans prior to and during the pandemic, pandemic-related stressors, and examine their respective contributions to mental and physical health.DesignNational sample of women veterans drawn from a larger web-based longitudinal study. Relationships between recent IPV and pandemic-related stressors were tested with linear regressions, controlling for pre-pandemic IPV and mental and physical health symptoms, demographic, and military-related covariates.ParticipantsOne hundred forty-two women veterans (Mage=58.8 years).Main MeasuresWe assessed IPV (CTS-2), PTSD (PCL-5), depression (CESD), anxiety (DASS-A), physical health (PHQ-15), and physical health–related quality of life (SF-12) prior to the pandemic (June 2016–December 2016/January 2017) and during the pandemic study period (March 2020–December 2020/January 2021). We assessed pandemic-related stressors (EPII) during the pandemic study period.Key ResultsOver a third (38.7%) of participants experienced IPV during the pandemic study period (psychological: 35.9%, physical: 9.9%, sexual: 4.2%). Overall rates, frequency, and severity of IPV experience did not significantly differ between the pre-pandemic and pandemic study periods. Few participants tested positive for COVID-19 (4.2%); however, most participants reported experiencing pandemic-related stressors across life domains (e.g., social activities: 88%, physical health: 80.3%, emotional health: 68.3%). IPV during the pandemic and pandemic-related stressors were both associated with greater PTSD and depressive symptoms. Pandemic-related stressors were associated with worse anxiety and physical health symptoms. Neither IPV during the pandemic nor pandemic-related stressors were associated with physical health–related quality of life.ConclusionsIPV experiences during the pandemic were common among women veterans, as were pandemic-related stressors. Although IPV did not increase in the context of COVID-19, IPV experiences during the pandemic and pandemic-related stressors were linked with poorer mental and physical health.

The concept of intimate partner violence (IPV) implies gender-neutrality in the experiences of violence. Gender symmetry in IPV implies similar numbers of men and women victims. Data from the 2014 Canadian General Social Survey (Victimization) indicate that 262,267 men and 159,829 women were victims of self-reported spousal violence over the past 5 years. Despite the prevailing notion that IPV predominantly affects female victims, these data suggest that men too are victims of IPV, especially in heterosexual relationships. However, very few qualitative studies have shed light on heterosexual male victims' experiences of IPV. This article describes some of these experiences and also seeks to understand the effects of IPV on male victims. Qualitative data collected through semi-structured interviews with 16 male victims of IPV were used to explore their experience of physical IPV and psychological IPV, as well as the consequences of such abuse. Results revealed common themes pertaining to the type of abuses (i.e., physical, controlling and threatening behaviours, and verbal abuse) male victims experienced and the subsequent physical and psychological impacts. This study identifies the need to distinguish between physically and psychologically abused male victims of IPV.

Intimate partner violence (IPV) can involve patterns of physical, sexual and emotional abuse. Women typically experience physical IPV in combination with emotional IPV, while emotional IPV is often experienced in the absence of other types of IPV. There is very little known about women's experiences of these different types of IPV over time. The primary aim of this paper is to describe patterns in women's individual experiences of physical and/or emotional IPV across the first 10years of motherhood. Data were drawn from a prospective pregnancy cohort of 1507 first-time mothers in Melbourne, Australia. Emotional, physical, and combined physical and emotional IPV were reported in the first, fourth and tenth year of motherhood using the Composite Abuse Scale. The overall prevalence of each type of IPV remained consistent across the three time-points, with emotional IPV alone being the most prevalent. There was substantial variability in women's experiences of IPV over time and there was no common progression from one type of IPV to another. Women were more likely to report IPV at more than one time-point if they experienced combined physical and emotional IPV, while for women who reported emotional or physical IPV alone this was more likely to be at a single time-point. A number of socio-demographic characteristics in early pregnancy were associated with a higher risk of reporting IPV at all three time-points, including being unemployed (RRR = 3.6; 95% CI: 2.1, 6.2) and being aged 18-24years (RRR = 3.1; 95% CI: 1.8, 5.4). Knowledge of the variability and persistence of IPV in the first 10years of motherhood, and factors associated with these experiences, can help tailor effective health and social service responses.