Experiences Of Coercion Research Articles

“He Was Afraid I Wouldn’t Come Back”: Experiences of Transportation Coercion Among Survivors of Intimate Partner Violence in the United States

“He Was Afraid I Wouldn’t Come Back”: Experiences of Transportation Coercion Among Survivors of Intimate Partner Violence in the United States

Users' Experience of Treatment and Coercion in an Inpatient Medium-Stay Psychiatric Rehabilitation Unit: A Mixed Methods Study.

Coercion influences mental health services users' experience of care and can hinder their recovery process, so it is essential to understand how it is perceived in rehabilitation settings oriented towards recovery. To describe and measure users' experience of coercion and explore their perception of the treatment received in an inpatient medium-stay psychiatric rehabilitation unit (IMSPRU). This study, in which 75 service users participated, used a mixed methods approach. Twenty participants were administered a semistructured interview and completed quantitative measures for coercion and 55 additional service users completed the quantitative measurements only. The perception of coercion was measured using the Coercion Experience Scale. The content analysis of qualitative data resulted in two main themes: treatment received and experience of coercion in the IMSPRU. The participants made a distinction between good treatment and mistreatment or unfair treatment. Experience of coercion in the IMSPRU included the feeling of freedom or lack thereof in the unit, forms of formal and informal coercion, and the positive or negative impact of rules on the unit. The quantitative data revealed a low perception of formal coercion among the users. Individuals had different views of what it meant to be treated well, but all agreed on the importance of communication and the need to feel respected. Informal coercion was the most frequent type of coercion identified, but users were often unaware of its existence. Knowledge of how IMSPRU users experience the treatment received from nursing staff and how they perceive coercive situations will help to lay the foundations of a system of care oriented towards good treatment and noncoercive practices.

Reproductive Coercion: Prevalence and Risk Factors Related to Relationship Health Knowledge and Skills.

Reproductive coercion is any behavior that limits a person's reproductive decision-making and can lead to negative health and safety outcomes. Previous research has explored reproductive coercion prevalence rates in clinical samples, as well as demographic risk factors for experiencing reproductive coercion. The purpose of this study is to assess the prevalence rates of two specific forms of reproductive coercion, pregnancy coercion and condom manipulation, in an ethnically and racially diverse sample of young females. We also explore the association between relationship health knowledge and skills with reproductive coercion. We used a sample of 143 females with previous sexual activity. Participants were diverse in terms of race, ethnicity, sexual orientation, and family immigration status. Descriptive statistics and logistic regression analyses were used to determine prevalence rates of pregnancy coercion and condom manipulation and the likelihood of experiencing reproductive coercion based on participants' knowledge and skills related to relationship health. Results revealed that 16.1% of the sample had experienced reproductive coercion, with all participants in this group reporting lifetime experiences of pregnancy coercion. Lifetime experiences of condom manipulation were reported by 6.3% of the sample. The most common form of reproductive coercion experienced by participants was being told by a partner not to use any birth control. Furthermore, results indicate that higher relationship health knowledge may be a protective factor for pregnancy coercion and condom manipulation. Likewise, higher decision-making skills in relationships and higher confidence in relationships may also protect against condom manipulation. Results from this study suggest implications for sexual and relationship health programming that expands education around consent, choice, decision-making, and communication around the use of contraception.

Gender Differences in Sexual Violence Victimization Experiences and Validity of Victimization Reports: A Think-Aloud Study

ABSTRACT This study compared the qualitative nature of women and men’s sexual violence (SV) victimization, the types of experiences captured and missed on the Sexual Experiences Survey-Short Form Victimization (SES-SFV) across genders, and common interpretations of the SES-SFV items. Fifty-four university students (31 women, 21 cis men, 2 trans men) who had recent unwanted (but not necessarily nonconsensual) sexual experiences thought out loud while privately completing the SES-SFV. They also typed descriptions of experiences reported on SES-SFV items or similar experiences when nothing was reported on an item. Results indicated that women’s victimization was more frequent and severe than cis men’s, except when men were victimized by men. Although verbal coercion was common across genders, event descriptions indicated that women’s verbal coercion experiences were more often harsh and part of a partner’s ongoing SV or coercive control. The findings suggest that quantitative measurement can mask important gender differences in victimization and (based on analysis of false positives and negatives) may underestimate rape and attempted rape experiences, especially women’s. Findings suggested that responding to the SES-SFV was not traumatic or distressing. However, participants sometimes expressed confusion about the items and interpreted them in unintended ways.

Obstetric violence and consent during pregnancy and childbirth: the Eighth Amendment and its impact on the Irish maternity system

ABSTRACT In the run up to the referendum on abortion in Ireland in 2018, women shared experiences of being denied abortion care through social media. The ‘In Her Shoes’ dataset is a collection of archived Facebook posts in which women shared their experiences of obstetric coercion, lack of information and lack of consent to medical procedures during pregnancy and childbirth. Using women’s testimonies from the In Her Shoes database (https://repository.dri.ie/catalog/wm11nd02p), this research will critically analyse these stories. The paper will analyse women’s experiences in maternity care pre-2018 before the constitutional change. The article includes experiences of being denied treatment because of their pregnancy, being forced to continue the pregnancy when there was a risk to the woman’s health, as well as a lack of information and lack of consent to medical procedures. The article puts women’s experiences at the forefront of the research and analyses their experiences within a medical narrative framework. It argues that the Eighth Amendment, not just denied abortion care, but contributed towards a medical culture in which the patient’s experience was not central to that care. Since the removal of the Eighth Amendment, we should move towards a patient-centered care approach to maternity care in Ireland.

Coercion in Psychiatry: Exploring the Subjective Experience of Coercion Among Patients in Five Portuguese Psychiatric Departments.

The subjective experience of coercion may have a more significant impact on clinical outcomes than formal coercive measures. This study aimed to investigate the subjective experience of coercion among patients on admission in Portuguese psychiatric departments by assessing their perceived coercion, procedural justice, and negative pressures during admission. The study also investigated whether this subjective experience of coercion changed with time during admission, and the predictors of this change. Validated instruments, including the McArthur Admission Experience Survey (AES) and the Client Assessment of Treatment Scale, were used to collect information from 208 adults admitted to five public psychiatric inpatient departments in rural and urban regions of Portugal. About a third (32.24%, n = 49) of the sample had a legal involuntary admission status, while more than a third of them perceived their admission to be involuntary (40.13%, n = 61). The subjective experience of coercion was significantly higher among people who perceived their admission to be involuntary compared to people who perceived their admission to be voluntary (Median = 10, IQR = 5.5 vs. Median = 3, IQR = 6; p < 0.001). Satisfaction with their care was significantly inversely correlated with the subjective experience of coercion (p < 0.01). The changes in the subjective experience of coercion at the second assessment were predicted by the perceived admission status rather than the legal admission status, and the initial procedural justice (p < 0.05). The study findings highlight the importance of improving procedural justice in psychiatric admissions, regardless of the legal status of admission.

A Latent Class Analysis of Reproductive Coercion Experiences Based on Victim-Survivors' Acknowledgment and Disclosure Patterns.

Reproductive coercion (RC) is a form of violence involving behavior that interferes with an individual's contraceptive and reproductive decisions. Like other forms of violence perpetrated by intimate partners, victims of RC do not necessarily identify it as such. Similarly, victim-survivors do not readily disclose their experiences or seek support and treatment. This study identifies patterns of acknowledgment and formal and informal disclosure of RC experiences in a community sample of 317 participants. Latent classes are then compared with respect to characteristics of victims/survivors, RC consequences, and associated contexts. Participants completed measures to assess experiences of RC and violence perpetuated by intimate partners as well as social support, posttraumatic stress symptoms, and consequences for psychological and sexual health. Latent class analysis was performed to identify acknowledgment and disclosure patterns. An optimal three-class solution was selected: High unacknowledgment with ambivalence, High disclosure (41%); High acknowledgment, High disclosure (30%); and Hesitant acknowledgment, No disclosure (29%). Classes were identified according to the presence of social support, living with a disability, victimization experiences, and mental and sexual health consequences. Future studies should explore the relationship between RC acknowledgment and disclosure, which can influence victims' search trajectories for support and services.

Assessing the impact of CHARM2, a family planning program on gender attitudes, intimate partner violence, reproductive coercion, and marital quality in India.

Using a two-armed cluster randomised controlled trial, CHARM2 (Counselling Husbands to Achieve Reproductive health and Marital equity), a 5-session gender equity and family planning intervention for couples in rural India, showed an impact on family planning outcomes in primary trial analyses. This study examines its effects on gender-equitable attitudes, intimate partner violence, reproductive coercion, and marital quality. We used multilevel mixed-effects models to assess the intervention impact on each outcome. Both male (aIRR at 9 months: 0.64, C.I.: 0.45,0.90; aIRR at 18 months: 0.25, C.I.: 0.18,0.39) and female (aIRR at 9 months: 0.57, C.I.: 0.46,0.71; aIRR at 18 months: 0.38, C.I.: 0.23,0.61) intervention participants were less likely than corresponding control participants to endorse attitudes accepting physical IPV at 9- and 18-month follow-ups. Men in the intervention, compared to those in the control condition, reported more gender-equitable attitudes at 9- and 18 months (ß at 9 months: 0.13, C.I.: 0.06,0.20; ß at 18 months: 0.26, C.I.: 0.19,0.34) and higher marital quality at the 18-month follow-up (ß: 0.03, C.I.: 0.01,0.05). However, we found no effects on women's experiences of IPV, reproductive coercion, or marital quality. CHARM2 shows promise in improving men's and women's attitudes towards gender equality and male perceptions of marital quality. Still, IPV and reproductive coercion reductions may require more intensive programming than that provided within this 5-session model focused on family planning.

An examination of sexual coercion experiences among Latinx female college students

ABSTRACT The current study examined sexual coercion among Latinx female college students in New York City. It identified frequently reported sexual coercion tactics and disclosure behaviours, delineating these experiences by race and cultural values. Latinx women (N = 158) from several public colleges were surveyed, and 49.4% (n = 78) experienced sexual coercion – with most reporting helplessness tactics (39.2%; n = 62). No differences were found among race, although this sample of Black Latinx students endorsed coercion more often than non-Black students. Most participants sought informal support, and specifically disclosed to a female friend (82.9%, n = 34). Lastly, attitudes toward familism and religiosity did not affect disclosure in this sample. These findings highlight the nuances of young Latinx women’s sexual experiences and have implications for sexual violence education for Latinx youth. It also has implications for college mental health professionals working with Latinx students with histories of sexual coercion. PRACTICE IMPACT STATEMENT Due to the nature of negative sexual experiences experienced among youth, sexual education curriculum and prevention training in educational institutions must emphasise the importance of sexual consent and identifying appropriate and inappropriate sexual advances. Curriculum must be tailored towards the demographics and respective potential cultural contexts of school district populations. College mental health professionals should be properly trained on how sexual coercion manifests in college-age relationships in addition to current training on identifying sexual harassment, sexual assault, and alcohol/drug induced rape.

Women's access to family planning and experiences of reproductive coercion during the COVID-19 lockdown in two districts of Uganda

BackgroundIn March 2020, Uganda enforced country-wide restrictions to control the spread of SARS-CoV-2, categorizing some health services, including family planning (FP), as non-essential. Globally, similar COVID-19 restrictions have been associated with increased vulnerability to reproductive coercion (RC) among women, due to changes in FP service availability and restricted access by partners. This study aims to investigate these dynamics in Uganda, specifically examining the impact of the COVID-19 lockdown on women's access to FP, their experiences of RC, and the relationship between RC and intimate partner violence (IPV). MethodsWe conducted a cross-sectional analysis of data from 960 women participating in the AMBSO Population Health Surveillance Study (APHS) between August 2020 and March 2021 across Wakiso (N = 164) and Hoima (N = 796) districts in Uganda. Our analysis focused on women who were sexually active in the past month, using bivariate analyses to explore the associations between RC and recent experiences of sexual, physical, and verbal IPV. FindingsThe most commonly reported FP methods were injectables (36.8 %) and implants (16 %). Despite the COVID-19 lockdown, less than one percent of participants reported an inability to access their preferred FP method. Notably, 3 % of the women experienced RC in the past 12 months. There was a significant association between RC and sexual IPV (p < 0.0001), as well as physical IPV (p < 0.0001). Instances of verbal IPV were observed to have tripled during the lockdown period. InterpretationAn increase in verbal IPV was found among women during the COVID-19 lockdown. Additionally, a notable association emerged between other forms of IPV and an increased risk of RC. Despite the lockdown, access to FP remained high, which could be attributed to the prevalent use of long-acting FP methods.

Microcredit, gender norms, and women’s experiences of economic coercion and agency in Matlab, Bangladesh

Microfinance organizations in Bangladesh often direct microloans to women, due in part to women’s high repayment rates. Questions remain about how microfinance institutions are addressing – or enabling – economic coercion of women taking out loans. In-depth interviews with 25 men and 24 women examined how the structure of microcredit programs, and men’s reactions to such structures, enabled or challenged women’s economic agency. We found that loan access and control was gendered, that loans were socially disruptive and engendered shame among men and women, and that this social disruption and shame was managed through practices of concealment. Interviews revealed that inequitable gender structures governing microloan administration are impeding gender transformative experiences with microloans. The results of this study illustrate the importance of considering structural and normative elements of gender systems to understand women’s experiences of economic agency and coercion around microloans.

Everyday violence and care: insights from fictive kin relations between madams and sex workers in India

ABSTRACT This article intervenes in the globally polarised terrain of debates on violence and agency in sex work. With a critical eye on how developmentalism governs these debates, the article explores fictive kin relations between women in Sonagachi, a prominent red-light area in Eastern India. Through an analysis of ethnographic observations and life-history interviews among madams and sex workers across three brothel households, this article argues that the configuration of ‘family-like’ relationships needs to be understood against a backdrop of what ‘family’ implies for socio-economically marginalised women who sell sex in urban India. Specifically, experiences of choice and coercion within these relationships are predicated on how madams and sex workers respond to kosto, a vernacularised articulation of everyday violence in each other’s lives, through jotno or care. Through this, the article sheds light on everyday forms of harm and solidarity between women in a red-light area, challenging institutionalised exceptionalisms of violence within sex work.

A pragmatic randomised controlled non-inferiority trial of open-door policy versus treatment as usual in urban psychiatric inpatient wards

IntroductionOpen-door policy (ODP) is an approach to reduce coercion in psychiatric wards recommended by the World Health Organization and the Council of Europe. Observational studies from Switzerland and Germany have shown promising results in reducing coercion, but no RCTs have been conducted. Skeptics have been concerned the observational evidence could mask that ODP could increase risks and harms and / or increase the use of coercive measures staff use to assist patients with psychoses, while proponents have argued that de-escalation and alliance-building will result in no such increase.ObjectivesTo evaluate open-door policy in an openly randomised, ethical-board approved trial of all patients referred to ward care at the Lovisenberg Diaconal Hospital in Oslo, Norway.MethodsA 12-month pragmatic, randomised-controlled non-inferiority trial comparing two ODP and three TAU acute psychiatric wards. The trial was pre-registered (ISRCTN16876467) and conformed to CONSORT. Ethical committee exemption enabled waiver of consent rules for the study, meaning all regular patients were included. Patients were randomly assigned (2:3 ratio) by a clinical admissions team using an open list. The non-inferiority margin was 15 % on the primary outcome: the proportion of patient stays with one or more coercive measures, including involuntary medication, isolation/seclusion, and physical and mechanical restraints. Primary and safety analyses were based on intention-to-treat. Safety analyses included suicides and violent events against staff. Secondary outcomes were individual coercive measures, intensive care, resource use, and patient feedback.ResultsN=556 patients were included and randomised and were similar on all pre-admission demographics: Around 75% of patients were diagnosed with a psychotic disorder and were involuntarily admitted. Primary outcome: Use of coercive measures was within the non-inferiority margin (see table 1). Safety outcomes: No suicides occurred during ward care in any group. Violence against staff did not differ between study wards. Secondary outcomes: Use of intensive care (‘skjerming’) and number of days admitted was significantly less on open-door policy wards. Patients on open-door policy wards rated their experience of coercion and ward atmosphere better than patients on control wards.Table 1.Absolute and relative risk of being subjected to coercion on open-door policy or usual-treatment wards.Number (%) Main outcome Absolute Risk ODP wards (n=245) Absolute Risk TAU wards (n=311) Relative Risk (95% CI) Risk Difference (95% CI) Primary hypothesis confirmedOne or more coercive measures during the admission65 (26.5%)104 (33.4%)1.3 (0.97 to 1.6)6.9% (-0.7 to 14.5)YesConclusionsThis first RCT found open-door policy does not increase use of coercion or resource use. It does not harm staff or patients and is experienced as better by patients.Disclosure of InterestNone Declared

Development of Human Rights-Based Practices in Psychiatry FromPeople Living With Mental Health Problems Lived Experiences DuringInvoluntary Hospitalization or Treatment

This article presents the research protocol of an interpretative phenomenological study that aims to understand the lived experiences of coercion and human rights-based practices in psychiatry from the perspectives of people living with mental health problems during involuntary hospitalization or treatment. This qualitative study used an interpretative phenomenological analysis design. In-depth, one-on-one interviews along with a socio-demographic questionnaire were conducted with approximately 10 participants. Data analysis was followed by an iterative and hermeneutic emergence coding process. By centering human rights-based practices on the lived experiences of people living with mental health problems who encountered coercion, this study highlighted the contributing and limiting factors to the recognition of human rights in nursing practices. This study also promoted the development of nursing knowledge and practices that can significantly contribute to an individual’s recovery process.

Factors Associated with Transgender and Gender Diverse People's Experience of Sexual Coercion, and Help-Seeking and Wellbeing Among Victims/Survivors: Results of the First Australian Trans and Gender Diverse Sexual Health Survey.

Purpose: Our study examined factors associated with transgender and gender diverse ("trans") people's experience of sexual coercion, as well as the factors associated with help-seeking and wellbeing among victims/survivors. Methods: We analyzed cross-sectional data from the first Australian Trans and Gender Diverse Sexual Health Survey, conducted in 2018. Logistic regressions were undertaken to identify factors associated with sexual coercion, help-seeking, and wellbeing. Results: Of the sample of 1448 participants, 53.4% had been sexually coerced, which was associated with older age, Aboriginal or Torres Strait Islander descent, nonbinary gender, being presumed female gender at birth, currently living publicly some or all the time as their affirmed gender, having regular sex, and use of drugs to enhance or alter sexual experiences. Protective factors included having a higher income and access to gender affirming care. Help-seeking was reported among 49.5% of victims/survivors and was associated with having more trans friends. Wellbeing among victims/survivors was associated with being older, residing in regional/remote areas, having higher levels of education and annual income, being presumed female gender at birth, having stronger satisfaction with one's sex life, and good health care access. Wellbeing was not associated with help-seeking. Conclusion: Sexual coercion was prevalent among participants, but help-seeking behavior was low. Protective factors identified underscore the importance of socioeconomic supports, access to health and gender affirming care, and peers. Accessible peer-led and culturally safe preventive and trauma-focused supports should also be considered for trans people who experience sexual coercion.

Women’s Experiences of Reproductive Coercion: Mental Health Outcomes

Women’s Experiences of Reproductive Coercion: Mental Health Outcomes

Revisiting the psychometric properties of the McArthur admission experience survey: Validating the Portuguese version using a bifactor approach

Cultural factors play a significant role in shaping the perception of coercion during psychiatric admissions. The present study aimed to assess the psychometric properties of the Portuguese Admission Experience Survey(P-AES).The study employed a cross-sectional approach in five psychiatric departments in three regions of Portugal. A total of 208 patients participated in the survey. Reliability was assessed through internal consistency and test-retest procedures. Internal validity was analyzed using a two-parameter logistic item response model, exploring three models, including a bifactor model. Convergent validity was determined by correlating AES scores with the Coercion Ladder (CL), Client Assessment of Satisfaction (CAT), and Global Assessment of Functioning (GAF) scale. Discriminatory power was assessed by comparing scores between patients with voluntary and involuntary admission status.The P-AES demonstrated satisfactory internal consistency and test-retest reliability. The bifactor model exhibited superior fit compared to the one-factor and three-factor models. Correlations between P-AES and CL, as well as CAT scores, indicated good convergent validity. Additionally, P-AES scores were notably higher in patients with compulsory psychiatric hospital admission compared to those admitted voluntarily, confirming its discriminatory power.The bifactor model suggests that all three domains of the AES should be used to measure the subjective experience of coercion.

A qualitative exploration of reproductive coercion experiences and perceptions in four geo-culturally diverse sub-Saharan African settings

Reproductive coercion (RC) is any intentional behavior that interferes with another’s reproductive decision-making or pregnancy outcome. This study aims to qualitatively examine RC experiences and perceptions among women and men in Ethiopia, Nigeria (Kano and Anambra States), and Uganda. This is a secondary analysis utilizing qualitative data from the Women’s and Girls’ Empowerment in Sexual and Reproductive Health study. Across sites, focus group discussions (38 groups; n=320 participants) and in-depth interviews (n=120) were conducted, recorded, and transcribed. Transcripts were loaded into Atlas.ti, and quotes describing experiences of reproductive control or abuse were coded as “reproductive coercion.” RC quotes were input into a matrix for thematic analysis. Emergent RC themes included indirect reproductive pressures, direct family planning interference, concurrent experiences of violence, and responses to RC. Indirect reproductive pressures included tactics to both promote and prevent pregnancy, while direct interference centered on pregnancy promotion. Women who were not compliant with their partners’ reproductive demands were often subjected to violence from multiple actors (i.e., parents, in-laws, community members) in addition to their partners. Despite concurrent forms of violence, women across sites resisted RC by using contraceptives covertly, choosing to abort, or leaving their abusive partnerships. Women and men across sites indicated that men were highly influential in fertility. RC behaviors were a mechanism of control over desired reproductive outcomes, which were often rooted in perceptions of childbearing as social status. Findings indicate a need for more nuanced community interventions targeting social norms, as well as improved RC screening and response within health services.

“Too weak to fight, too scared to scream”: Understanding experiences of sexual coercion of Black female adolescents through digital storytelling

Black female adolescents are less frequently viewed as victims of violence or as agents of resistance. This study analyzed the experiences of sexual coercion of Black female adolescents on the South Side of Chicago through narrative scripts used to create digital stories. Using Sexual Script Theory and applying an intersectional lens, we analyzed a collection of 46 narrative transcripts from Black female youth, living on the South Side of Chicago, five of which specifically focused on the theme of sexual coercion. Under the broader theme of sexual coercion, the following subthemes were identified: (1) broken expectations of romance, (2) sex as a means of seeking attention from a male partner, (3) sex as a means of maintaining a partner, and (4) rape. By better understanding the social context of relationships for Black adolescent girls in heterosexual relationships, we may be able to better design sexual and reproductive health interventions for young women of color.

Women’s Lived Experiences of Reproductive Coercion and Abuse

Abstract Purpose Reproductive coercion and abuse (RCA) refers to the use of physical, psychological or sexual violence or coercive behaviours to control a woman’s reproductive choices. Perpetrators use various forms of RCA such as controlling the outcome of a pregnancy, contraceptive sabotage and pregnancy coercion. Current research has focused primarily on quantitative data and health interventions, yet there is limited qualitative research on the overall experience of RCA. To address this gap, this study aimed to investigate the question: “What are women’s lived experiences of RCA?”. Methods Twenty women who had experienced RCA were recruited to participate in qualitative in-depth interviews. Data were analysed using interpretive phenomenological analysis. Results Three themes were developed that describe women’s lived experiences of RCA: I didn’t have a way out, where women described how their partners threatened them both with direct violence or indirectly through manipulation; I still feel guilty which centered around women’s overwhelming feelings of guilt and self blame and I don’t feel worthy, that outlined how RCA eroded women’s self-concept, particularly in relation to motherhood. Conclusions Our findings foreground the profound impacts of RCA on women’s mental health, identity and wellbeing which can linger for many years after the experience. It is vital that practitioners working with women who have experienced RCA consider these impacts and how to address and respond to them effectively.