Female Survivors Of Intimate Partner Violence Research Articles

Violence Exposure and Disability in Colombian Female Survivors of Intimate Partner Violence: the Mediating Role of Depressive Symptoms

BackgroundViolence is an important public health problem and one of the main causes of deaths worldwide. The mental health consequences of surviving intimate partner violence (IPV) include depression, anxiety and post-traumatic stress disorder. Previous studies have identified that there is a relationship between depression and level of disability in female survivors of IPV. Estimating the direct, indirect or total effect of an exposure on an outcome makes it possible to identify mediating effects between a group of variables. Detecting mediation effects is useful for identifying casual pathways that generate a final outcome and provides a rationale for designing interventions to target the mediator, which in turn positively affects the outcome. The objective was to identify the mediating role of depressive symptoms on the relationship between IPV and disability. MethodsThis was a cross-sectional study of 94 women over the age of 18 who were survivors of IPV by men. They were recruited from two public hospitals in Cali and Tuluá in southwest Colombia. An analysis of casual relationships was performed using structural equation modelling that was made up of: four exogenous observed variables (age, current relationship status [in a relationship or single], level of schooling, and history of an impairment), intermediate endogenous variables (violence and depressive symptoms), and the main endogenous variable (disability). The analyses were carried out in Stata14.2. ResultsThe direct effect of IPV severity on the level of disability was not statistically significant (β=0.09; P=0.63). However, the indirect effect of IPV severity on disability mediated by depressive symptoms was (β=0.39; P<0.01). The total effect of IPV severity on the level of disability was even greater (β=0.48; P=0.01). ConclusionsThis study found a complete mediating role of depressive symptoms on the relationship between the severity of IPV and the level of disability for the female participants in this study. The results of this research contribute to defining strategies to prevent and address intimate partner violence, depressive symptoms and disability in this population.

Exploring help-seeking experiences of Chinese immigrant survivors of intimate partner violence in the U.S.

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).

Intimate Partner Violence: The Relationship between Risk Factors and Symptom Severity

ABSTRACT Several adult and childhood risk factors are associated with an increased likelihood of intimate partner violence (IPV) victimization. Witnessing interparental violence and experiencing abuse as a child are both linked to an increased likelihood of experiencing IPV as an adult. Additionally, relationship factors, including length of IPV relationships, intermittent relationship reinforcement, and having children not related to the perpetrator, are linked to an increased severity of abuse. The primary aim of this study was to investigate the relationship between childhood and adult relationship factors and the severity of emotional and behavioral symptoms associated with IPV. Statistically, the macro PROCESS was employed to evaluate the association of childhood factors to symptom severity with adult relationship factors as the mediator. Results suggest that adult relationship factors partially mediate the relationship between childhood factors and symptom severity. Specifically, these findings demonstrate that the identified childhood factors significantly increased adult relationship factors, which, in turn, increased symptom severity in female IPV survivors. Educating clinicians and medical professionals’ understanding of these risk factors may improve the rates at which these survivors are identified and could lower the risk of continued abuse. Additioanlly, cultivating awareness of these factors and integrating them into assessment and intervention programs may be a step toward protecting IPV survivors against psychologically negative outcomes.

A qualitative study on factors associated with intimate partner violence in Colombia.

Intimate partner violence (IPV) is a human rights violation and a serious global public health problem. This study investigated factors associated with IPV in female survivors in Colombia. Four focus group discussions with female survivors of IPV and 15 key informant interviews with professionals from psychological, social and legal services and community leaders were conducted in Cali and Tuluá. Participant recruitment was via purposive sampling. Transcripts were analysed manually taking a social constructivist standpoint and a content analysis approach. Factors associated with IPV were divided into four themes: cultural beliefs, jealousy, alcohol abuse, and personal history of IPV. The first theme was divided into: patriarchy, gender roles, normalisation of violence, and unawareness of rights, economic dependence, and 'men own women'. The sub-themes were all inter-related and underpinned by patriarchal values. IPV was described as a sociocultural construction formed by patriarchal values ingrained in community and societal norms and individual processes. Therefore, academia, governmental and non-governmental bodies and society are urged to together, create preventative, context specific strategies for individuals, communities and societies.

The Boston Assessment of Traumatic Brain Injury-Lifetime Semistructured Interview for Assessment of TBI and Subconcussive Injury Among Female Survivors of Intimate Partner Violence: Evidence of Research Utility and Validity.

To adapt the Boston Assessment of TBI-Lifetime (BAT-L) interview specifically for female survivors of intimate partner violence (IPV), validate the adapted BAT-L/IPV, and report the prevalence of head injury. The BAT-L is the first validated instrument to diagnose traumatic brain injuries (TBIs) throughout the life span for post-9/11 veterans. The BAT-L/IPV was adapted to target diagnostic issues belonging exclusively to IPV while maintaining its life span approach. Community-dwelling convenience sample of 51 female survivors of IPV with subthreshold (n = 10) or full diagnostic criteria (n = 41) of posttraumatic stress disorder. Standard TBI criteria were evaluated using a semistructured clinical interview. The BAT-L/IPV is compared with the Ohio State University TBI Identification Method (OSU-TBI-ID) scoring approach as the criterion standard. Correspondence between the BAT-L/IPV and the OSU-TBI-ID score was excellent (Cohen κ = 0.86; Kendall τ-b = 0.89). Sensitivity = 89.3% (95% CI, 81.2-97.4); specificity = 98.3% (95% CI, 95.0-100); positive predictive value = 98.0% (95% CI, 94.2-100); and negative predictive value = 90.6% (95% CI, 83.5-97.7). On the BAT-L/IPV, more than one-third (35.3%) of IPV survivors reported TBI secondary to an IPV-related assault, 76.5% reported IPV subconcussive head injury, 31.4% reported attempted strangulation, and 37.3% reported non-IPV TBI. The BAT-L/IPV performed well in diagnosing TBI in female IPV survivors as compared with the criterion standard. The prevalence of TBI was frequent; subconcussive head injury was pervasive. Greater awareness for head injury risk and increased diagnostic specificity of TBI in IPV survivors is needed.

Needs and Support Perceived by Women for Coping with the Experience of Intimate Partner Violence in Andalusia (Spain): A Qualitative Study.

There is a need to improve psychological interventions in women experiencing intimate partner violence (IPV) and reduce its long-term sequelae. The objective of this qualitative study was to explore the needs of female IPV survivors, the support they receive, and their strategies for coping with this experience over the long term. During 2017, 53 female IPV survivors participated in the study, of whom 38 (71.7%) were recruited from women's associations against gender violence from three Andalusia provinces (Southern Spain). In a semi-structured interview, the women responded to four open-ended questions about the effects of IPV on their life and how they coped with this situation. Four main themes were identified: (1) changes after the experience, (2) support during recovery, (3) perceived needs and obstacles, and (4) current situation. The survivors considered formal and informal social support to be critical to their recovery and emotional well-being. They also highlighted the need for continuity in support programs and for specialist interventions to address long-term psychological sequelae. These findings reinforce the need for psychological programs more tailored to the needs of these women.

Predicting changes in PTSD and depression among female intimate partner violence survivors during shelter residency: A longitudinal study.

Posttraumatic stress disorder (PTSD) and depression are comorbid consequences of intimate partner violence (IPV), and models explain this comorbidity via an intrinsic relationship between them. The current study posits that changes in both disorders may provide a clearer picture regarding the interrelations between them. We examined mutual contributions of changes in PTSD and depression to each other. The comorbidity was examined through known risk and protective factors related to both disorders among IPV survivors: perception of danger, helplessness, and peer support. Sample included 146 female IPV survivors residing in 12 shelters in Israel between September 2009 and April 2014. Self-report questionnaires were completed upon entrance to the shelter and before departure. Analysis included 2 regressions, in which the change-score dependent variable of the first appeared as a regressor in the second and vice versa. The regression designed to explore the contribution of changes in depression to PTSD-change explained 48% of the variance, while the regression designed to explore the contribution of changes in PTSD explained 67% of the variance. Changes in both PTSD (β = .14, p = .014) and depression (β = .014, p = .05) contributed similarly to changes in each other, suggesting covariance within IPV-related variables. In addition, the contribution of Arab ethnicity to changes in PTSD was significant. The current study's contribution is in identifying covariance between PTSD and depression along time within the context of variables related to IPV. Clinical implications are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Adaptation of the barriers to help-seeking for trauma (BHS-TR) scale: a cross-cultural cognitive interview study with female intimate partner violence survivors in Iceland

BackgroundEven though traumatization is linked to substantially reduced health-related quality of life, help-seeking and service utilization among trauma survivors are very low. To date, there has not been available in Iceland a culturally attuned, self-reported measure on help-seeking barriers after trauma. This study aimed to translate and cross-culturally adapt the English version of Barriers to Help-Seeking for Trauma (BHS-TR) scale into the Icelandic language and context.MethodsThe BHS-TR was culturally adapted following well-established and rigorous guidelines, including forward-backward translation, expert committee review, and pretesting through cognitive interviews. Two rounds of interviews with 17 female survivors of intimate partner violence were conducted using a think-aloud technique and verbal probing. Data were analyzed using qualitative content analysis, a combination of deductive and inductive approaches.ResultsIssues with the BHS-TR that were uncovered in the study were classified into four categories related to general design, translation, cultural aspects, and post-trauma context. The trauma-specific issues emerged as a new category identified in this study and included concepts specific to trauma experiences. Therefore, modifications were of great importance—resulting in the scale becoming more trauma-informed. Revisions made to address identified issues improved the scale, and the process led to an Icelandic version, which appears to be semantically and conceptually equivalent to the original version; additionally, the results provided evidence of content validity.ConclusionsAs a cognitive interview study, it adds to the growing cognitive interviewing methodology literature. Furthermore, the results provide essential insights into the self-report response process of trauma survivors, highlighting the significance of making health-related research instruments trauma-informed.

A Multi-Method Approach to a Comprehensive Examination of the Psychiatric and Neurological Consequences of Intimate Partner Violence in Women: A Methodology Protocol.

The number of women in the United States that experience blows to the head during assaults by intimate partners is substantial. The number of head blows that result in a traumatic brain injury (TBI) is virtually unknown, but estimates far exceed numbers of TBI in parallel populations (e.g., blast exposure, accidents, sports) combined. Research on the impact of TBI on post-traumatic stress disorder (PTSD) in survivors of intimate partner violence (IPV) is sparse. This methodology paper describes the comprehensive, multi-method approach used by a multi-disciplinary team of investigators from several different fields of expertise to assess the interaction of psychiatric, cognitive, psychological, and physical conditions that result from IPV. Using state-of-the-art instruments, a comprehensive assessment of lifetime trauma exposure, lifetime history of TBI, psychiatric history, and a full assessment of current cognitive, neuropsychological and biomedical function was conducted with 51 female survivors of IPV who screened positive for PTSD. This multi-method assessment included clinician-administered diagnostic interviews modified to specifically assess the sequelae of IPV, standardized self-report surveys, neuropsychological tests, structural, diffusion, and functional neuroimaging and blood-based biomarkers. The specific details and full report of the results of the full study are beyond the scope of this methodology paper. Descriptive characteristics of the complex clinical presentation observed in this unique sample are described. The sample reported high rates of trauma exposure across the lifespan and 80% met full criteria for current PTSD. Women also reported high rates of lifetime subconcussive head injury (88.2%) and TBI (52.9%) from various etiologies (35.3% secondary to IPV). Descriptive findings from the methodological protocol described here have begun to reveal information that will advance our understanding of the impact of subconcussive head injury and TBI on recovery from mental injury among IPV survivors.

Analysis of Effectiveness of Individual and Group Trauma-Focused Interventions for Female Victims of Intimate Partner Violence.

Group psychological programs for intimate partner violence (IPV) survivors would seem particularly useful since they contribute to interrupting women’s isolation and have cost-effectiveness advantage. This study aims to analyze whether the effectiveness of group interventions for female survivors of IPV is equivalent to that of the individual format. A cognitive-behavioral trauma-focused intervention program was applied in eight weekly sessions in Madrid (Spain) to IPV female survivors with significant posttraumatic symptoms that were randomly assigned to the individual (n = 25) or group (n = 28) intervention format. Measures of posttraumatic stress (Severity of Posttraumatic Stress Disorder Symptoms Scale), depression (Beck Depression Inventory), anxiety (Beck Anxiety Inventory), self-esteem (Rosenberg’s Scale) and social support were analyzed at pre-treatment, post-treatment, and 1-, 3-, 6- and 12-months follow-ups. A total of 28.3% of women dropped out, without significant format differences. Intervention (both formats) had significant improvements with large effect sizes in posttraumatic stress (η2p = 0.56), depression (η2p = 0.45), anxiety (η2p = 0.41) and self-esteem (η2p = 0.26) that maintained in follow-ups (p < 0.001), without significant differences between formats. Both intervention formats had different evolutions for depression and anxiety (p < 0.05), with better effects in the individual format at the first post-test measurements, but the differences tended to disappear over time. Intervention was effective in improving social support, with no significant differences between formats. All in all, both formats showed similar effectiveness. The group format could be an alternative when applying psychological interventions for female IPV survivors, since it would maintain good cost-effectiveness balance, mainly in the long-term.

From the uncertainty of violence to life after abuse: Discursive transitions among female survivors of Intimate Partner Violence in online contexts

Intimate Partner Violence (IPV) is undoubtedly one of the most worrying concerns in today’s global societies. Due to the many intertwined factors that explain the persistence of this reality among people from all sorts of backgrounds, finding a uniform strategy to cope with this social issue is far from unproblematic. In this study, I contribute to a growing field of research that examines the discourse of female survivors of IPV in online contexts. The main objective is to identify relevant linguistic patterns used by women to represent themselves and their perpetrators in a publicly-available online forum. More specifically, I seek to ascertain the discursive traits that characterise women in an initial stage in contrast to a final stage within an abusive relationship. To this end, I adopt a Corpus-Assisted Discourse Studies approach in a digital corpus of around 136,000 words, which are analysed with the software tool Sketch Engine. Findings show the most salient discursive traits that characterise IPV online discourse. Additionally, and drawing on verb patterns ascertained in the corpus and their semantic categorisation, I also connect linguistic textual evidence to the power imbalances that sustain this social phenomenon.

Patterns of Help-seeking Strategies in Response to Intimate Partner Violence: A Latent Class Analysis.

Women engage in multiple strategies to cope with the impact of intimate partner violence (IPV). Prior research has focused predominantly on women's service utilization and help seeking as individual acts, yet it is likely that women engage in distinct patterns of multiple help-seeking strategies to achieve safety. As such, the current article examines patterns of service-related help-seeking strategies survivors employ. This article also investigates demographic factors, relationship characteristics, and mental and physical health effects of IPV associated with patterns of help seeking. Using a web-based survey, data were collected from service-engaged adult female IPV survivors (n = 369) in the Southwest region of the United States. Latent class analysis (LCA), a person-centered analytical approach, was used to identify survivors' patterns of help seeking. A 3-class LCA model was determined to be the best fit for the data. Among the sample, 50% of women broadly engaged formal and informal networks, 15% primarily engaged informal networks, and 35% broadly engaged networks but avoided legal systems while seeking other formal services. Findings indicated varying and significant associations between class membership and race/ethnicity, foreign-born status, number of children, IPV severity, and mental health symptoms. The findings reinforce the need for practitioners to be aware of the varied ways women choose or avoid seeking help and explore women's preferences. Comprehensive and collaborative service networks are necessary for early detection and holistic care. Addressing structural factors is imperative for expanding the range of viable support options available to IPV survivors, particularly women of color.

Structural Brain Alterations in Female Survivors of Intimate Partner Violence.

Intimate partner violence (IPV) has been related to brain alterations in female survivors. Nonetheless, few studies have used an exploratory approach, focusing on brain regions that are traditionally studied in other populations with post-traumatic stress. Traumatic brain injury (TBI), strangulation, and childhood trauma are highly prevalent among this population, and have also been associated with brain alterations and functional deterioration. As such, it is difficult to determine how different brain regions are affected by the complex interplay of these factors in female survivors. The aim of this study is to assess (a) brain alterations in female survivors of IPV as compared to non-victim females and (b) the potential causal mechanisms associated with such alterations. We hypothesized that structural brain differences would be found between female survivors of IPV and non-victims, and that these differences would be related to IPV-related TBI, strangulation, IPV severity, depression, post-traumatic stress, generalized anxiety, and childhood adverse experiences. A total of 27 non-victims and 28 survivors completed structural magnetic resonance imaging and questionnaires to measure the potential causal mechanisms for brain alterations. Structural brain differences were found between groups, principally in volumetric analyses. The brain regions in which between-group differences were found were related to attempted strangulation, IPV-related TBI, severity of IPV, adverse childhood experiences, and post-traumatic stress. These results demonstrate that a wider range of brain regions may be impacted by IPV and that various factors are implicated in the structural brain alterations found in female survivors. This study demonstrates the importance of post-traumatic stress, childhood and adult trauma, and physical violence in assessing brain alterations in IPV survivors. Further, it serves as a critical first step in assessing an extensive list of potential causal mechanisms for structural brain alterations, using a more comprehensive a whole-brain structural analysis of IPV female victims, a largely understudied and vulnerable population.

Understanding Forgiveness After Leaving an Abusive Relationship: The Voices of Chinese Female Intimate Partner Violence Survivors.

Forgiveness is known to play an important role in recovery studies of female intimate partner violence (IPV) survivors. However, survivors' understanding of forgiveness remains unclear. This study explored forgiveness through semi-structured interviews with 25 Chinese women. The results indicate that forgiveness is an unintended process that comprises the alleviation of a grudge held against former partners and a reframed understanding of them. It does not involve reconciliation. Moreover, establishment of clear boundaries is a precondition for forgiveness. The findings supplement knowledge on forgiveness and the importance of cognitive reframing, emotion regulation, and establishing clear boundaries in forgiveness and recovery.

Trapped and Resistant Body: Everyday Practices of Women in Taiwan in the Context of Intimate Partner Violence

The extensive literature on intimate partner violence (IPV) against women has focused on the single actors of forces imposed on women. Little is known about the intertwined relationships among the roles of multiple participants in the context of IPV. This study used Michel de Certeau’s concepts of strategies, tactics, and space to explore the power struggle between female survivors and IPV perpetrators, family members, and institutions. This study used data collected in semi-structured interviews between 2016 and 2018 with 24 women (30 to 54 years of age) in Taiwan who experienced IPV from their male partners. Thematic analysis was used to identify and organize themes based on the concepts of strategies, tactics, and spatial actions. Three coders analyzed the data based on the conceptual framework, and inter-rater reliability was evaluated to ensure the quality of the results. Six themes were identified and grouped into two dimensions. Female Taiwanese survivors of IPV confronted not only the strategies of their male partners and families but also strategic mechanisms from the police and nongovernmental organizations. Female survivors found tactical opportunities to evade or resist everyday forms of strategic power. Understanding the quotidian experiences of female survivors has important implications for their protection and support to help them increase their safety and well-being when they are involved in an IPV relationship in particular, and spatial power structures in general.

Screening for Interpersonal Violence: Potential Harm of Modifying Tools

Research ObjectiveHITS, the Hurt Insult Threat Scream tool, was developed to detect intimate partner violence (IPV) in primary care settings. The Center for Medicare and Medicaid Innovation (CMMI) modified the tool to screen more broadly for interpersonal violence—rather than restricting to IPV—and integrated it into a multidomain social risk screening tool in an ongoing national demonstration project. HITS includes four questions: one on physical abuse and three on verbal abuse. The physical abuse question asks: “How often does anyone, including family and friends, physically hurt you?” The three verbal abuse questions ask about being insulted, threatened, or screamed at, respectively. Questions are scored based on frequency of experiencing abuse (1 = “Never”; 5 = “Frequently”). Scores range from 4 to 20. A scoring system for the original tool was validated in adult female survivors of IPV, with a score ≥11 signaling a safety concern. In the current demonstration, CMMI recommends using the original HITS scoring cutoff, despite having broadened the scope of the questions. The objective of this study was to evaluate the use of the original scoring system for detecting rates of reported physical and verbal interpersonal violence.Study DesignCross‐sectional survey design. Descriptive analyses using chi‐square with two‐sided Fisher's exact.Population StudiedA convenience sample of adult English and/or Spanish speaking/reading patients or adult caregivers of pediatric patients at seven primary care clinics and four emergency departments across nine states.Principal FindingsOf 1014 participants, 66 (6.5%) screened positive for any frequency of physical abuse. Using the recommended score cutoff of ≥11, 12/66 (18.2%) screened positive for a safety concern. Of those with scores &lt;11, 3/54 participants (5.6%) reported experiencing physical abuse “fairly often” or “frequently” and 14/54 (25.9%) “sometimes.” 394/1014 participants (38.9%) screened positive for any frequency of verbal abuse; 344/1014 (33.9%) screened positive for verbal abuse without physical abuse. Eighteen of 394 (4.6%) scored ≥11. Three of 394 (7.6%) had total scores &lt;11 and reported “sometimes” or “often” being threatened with harm, while 286/394 (72.6%) reported “rarely” or “sometimes” being insulted or screamed at.ConclusionsUsing the original scoring criteria for the modified HITS, patients reporting physical violence often did not reach the recommended score cutoff to signal a safety concern to the care team. Patient abuse disclosure that lacks adequate follow‐up may result in or exacerbate patient mistrust in the health care system, in addition to being a safety risk for patients. Given that over 30% of patients in this study reported verbal abuse in the absence of physical abuse, and each question is scored with equal weighting, a more nuanced scoring system may be necessary to identify patients at highest risk.Implications for Policy or PracticeScreening for interpersonal violence should at a minimum identify patients experiencing abuse. Identifying patients at risk for abuse can enable interventions to prevent escalation. The scoring system recommended by the original HITS tool for IPV does not allow health systems to reliably identify patients experiencing/at high risk for interpersonal violence. More stakeholder input is needed on how to best score the modified HITS to improve patient safety.Primary Funding SourceThe Commonwealth Fund.

Perceived Executive Functioning among Female Survivors of Intimate Partner Violence

ABSTRACT Current literature demonstrates that female survivors of intimate partner violence (IPV) suffer cognitive impairment. Nonetheless, less is known about how women perceive their cognitive functioning and related factors. The main objective was to assess to what degree abuse severity and mental health are related to perceived cognitive functioning in women who have been exposed to IPV. A group of female IPV survivors (n = 82) were assessed with the Quality of Life Outcomes in Neurological Disorders (Neuro-QOL-EF), Composite Abuse Scale Revised (CASR-SF), the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder Scale (GAD-7). Findings revealed self-reported impairment in concentration, information processing, and attention. Associations were found between self-reported executive function (EF) and posttraumatic stress, abuse severity, and depression. Further, a model including abuse severity and posttraumatic stress explained up to 20.8% of the variance in perceived EF. Findings indicate that female survivors report a high prevalence of difficulties in the domain of EF. Self-reported impairment in EF may be indicative of higher levels of posttraumatic stress (PTSD) and depression, meriting further assessment and possibly treatment. This study opens the way for the potential use of perceived cognitive functioning screening tools with female survivors.

Do You Believe Your Partner is Capable of Killing You? An Examination of Female IPV Survivors' Perceptions of Fatality Risk Indicators.

Advocates in the field of intimate partner violence (IPV) have started to more actively engage survivors around their own perceptions of their lethality risk, as well as assist them in developing strategies for reducing and managing risk related to reassault and intimate partner homicide (IPH). Although research has examined the risk factors most associated with risk and utilized this information in the development and validation of risk assessment tools to be used with survivors, less is known about which indicators survivors most associate with lethality risk. This study aims to fill this gap by examining which risk indicators IPV survivors associate with fatality risk. Classification and regression tree analyses were used to differentiate between women who believed their partners were capable of killing them and those who did not. Data on a sample of 213 survivors of IPV used in this analysis were collected as part of a larger study in which a risk assessment instrument was piloted across four counties within New Jersey in 2016. More than three fourths of participants believed that their abuser was capable of killing them. Alhough the majority of survivors in the study felt as though their abusers were capable of killing them, there was variation in how survivors prioritized risk indicators. Factors associated with fatality risk included: (a) prior homicide threats; (b) whether the abusers had control over survivors' daily activities; (c) abusers' access to a gun; and (d) abusers' drug use. Findings suggest that IPV survivors need targeted intervention strategies around IPH, particularly those at higher perceived risk levels given the presence of risk indicators and their perceptions of lethality threat.

Cardiovascular Risk and Outcomes in Women Who Have Experienced Intimate Partner Violence

Cardiovascular disease (CVD) and intimate partner violence (IPV) are 2 major chronic problems that prevalently affect women's health and quality of life in the United States. However, whether female IPV survivors are at risk for developing adverse cardiovascular outcomes has not been clearly understood. This integrative review was conducted to bridge the literature gap by examining cardiovascular health in female adults with a history of IPV experience. Three electronic databases including PubMed, CINAHL, and Web of Science were used to search for studies published between 1998 and 2019. The search process followed the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Of the 229 records retrieved from the literature, 19 met the criteria for review. All included studies were quantitative research. Although the overall findings showed a mixed relationship between IPV and CVD, women who experienced abuse were more likely to engage in unhealthy behaviors, have higher levels of CVD biomarkers, experience cardiovascular symptoms, and exhibit long-term cardiovascular complications when compared with nonabused women. Intimate partner violence is a stressor that directly and indirectly influences women's cardiovascular health. Therefore, it is essential for healthcare providers to routinely screen IPV status in clinical practice. Targeted interventions, such as assessing women's coping strategies and evaluating their cardiovascular health using a total risk factor approach, are recommended to prevent or reduce the deleterious effects of violence on this large, vulnerable group of women.

Group Compassion-Based Therapy for Female Survivors of Intimate-Partner Violence and Gender-Based Violence: a Pilot Study

Emotional disorders are common in survivors of gender-based violence, especially intimate partner violence (IPV), and are often maintained by shame and self-criticism. Compassion-based therapies target shame and self-criticism but have not been evaluated in this population to date, nor in any low- or middle-income country. Ten Colombian females reporting recent gender-based violence and clinical levels of emotional disorder(s) completed a 5-session group compassion-based therapy intervention. Measures of symptoms and hypothesized mediators were applied 5 weeks before treatment (baseline), pre-treatment, post-treatment and 3-month follow-up. At follow-up, 56 to 89% of cases showed reliable symptom change (depending on the measure). Self-inadequacy, guilt cognitions and experiential avoidance may be important mediators of change. Findings indicate that compassion-based interventions may benefit this population, even for women remaining in relationships with IPV, those with low formal education, and in contexts where gender-based violence is a social norm.