Intimate Partner Violence Assessment Research Articles

Preparing to Intervene in Intimate Partner Violence: An Interprofessional Safety Planning and Assessment Simulation

ABSTRACT Within the healthcare system, identification and intervention for intimate partner violence (IPV) are critical, yet often hindered by siloed operations among healthcare workers. Effective interprofessional collaboration is pivotal for timely and appropriate interventions. This article describes an interprofessional educational simulation involving nursing and social work students. Pairs engaged in risk assessment and safety planning for IPV. In the pilot run with 140 nursing and 137 social work students, post-simulation results increased confidence (t = 5.25, p = .001) and positive evaluation of IPV knowledge (t = 63.22, p = .001). Focus groups underscored team synergy, communication skills, and prior experiences as critical elements. Future projects should expand simulation scopes to address diverse situations and include additional professions interacting with survivors.

Implications of intimate partner physical violence and substance misuse for parenting

AbstractApproximately 35%–45% of young married adults engage in intimate partner violence (IPV), and it is possible to reliably distinguish between general IPV and clinically significant IPV in a manner accepted both by DSM‐V & ICD‐11. IPV and alcohol misuse have been associated in many research designs, and experts now argue that alcohol misuse causes IPV. While less research exists on other substances like marijuana, there is clearly a moderate association between marijuana use and IPV, and that association appears to be dose‐dependent. Both IPV and substance use disorders (SUD), especially alcohol misuse, have been associated with a host of both internalizing and externalizing problems of children and adolescents. Research on the co‐morbid effects of IPV and substance misuse is relatively new but there are documented cumulative effects of IPV, problematic alcohol use, problematic drug use, and depressive symptoms on aggressive and neglectful parental disciplinary practices. Fortunately, research on the effects of both alcohol misuse and IPV shows that while both can have deleterious effects on children, the majority of children exposed to either IPV or alcohol misuse do not grow up to have diagnoses of emotional or behavioral problems. Support from one parent, a teacher, or extended family members, as well as the ability to maintain family rituals, serve as protective factors for children. Recommendations are made regarding reviews of assessment of IPV and substance misuse as well as a guide for conceptualizing and completing forensic evaluations involving IPV and substance misuse.

"Everything That Is Here, I Have Lived": A Triangulated Analysis of an Intimate Partner Violence Assessment Tool in Curitiba, Brazil.

Using a mixed-methods triangulation approach we piloted the Composite Abuse Scale-Brazilian version (CAS-Brazil) at the House of the Brazilian Woman of Curitiba among 62 survivors of intimate partner violence and four professionals serving survivors to assess its feasibility for use. Quantitative data were tabulated using descriptive statistics while qualitative data were recorded, coded, and thematically analyzed. Four qualitative domains emerged: (a) conceptual understanding; (b) item definitions; (c) women's experiences; and (d) professionals' perspectives. Comprehension of the CAS-Brazil appeared high across participants from diverse backgrounds. Professionals viewed it as highly feasible for use in Brazilian cross-sectoral services to support survivor decision-making.

Interpartner Agreement on Intimate Partner Violence Reports: Evidence From a Community Sample of Different-Sex Couples.

An accurate assessment of intimate partner violence (IPV) is crucial to guide public policy and intervention. The Conflict Tactic Scales Revised (CTS-2) is one of the most widely used instruments to do so. Despite its good psychometric properties, research on interpartner agreement has pointed to low-to-moderate estimates, which generated some concerns about the validity of the results obtained through single-partner reports. This cross-sectional study introduces indexes that have not previously been used to assess interpartner agreement. Both partners' reports on perpetration and victimization were analyzed in a community sample of 268 different-sex couples. Our results generally pointed to better agreement levels on IPV occurrence than frequency, suggesting that the proxy method (i.e., using a single-partner report) could be a reliable method for assessing IPV occurrence but not its frequency in this population. Findings are discussed as well as the advantages and constraints of different IPV assessment practices.

The Effects of Race and Gender When Predicting Intimate Partner Violence Recidivism in Police Reports Using the Ontario Domestic Assault Risk Assessment

Despite a growth in risk assessment for intimate partner violence (IPV), validation research has focused on men’s violence against women leading to a dearth of research among other genders and racialized populations. We examined validity of an IPV risk assessment tool in 448 Black and White men and women identified as IPV perpetrators by a United States urban police service. The Ontario Domestic Assault Risk Assessment (ODARA) predicted new police reports of IPV in a fixed 2-year follow up (baserate = 33%, AUC = 0.59). Predictive effects were mostly small, with few significant differences between groups. Further research should examine the benefits and potential harms of IPV risk assessment to individuals who identify within minority race and gender groups.

Removing Biases in Communication of Severity Assessments of Intimate Partner Violence: Model Development and Evaluation

To support a victim of violence and establish the correct penalty for the perpetrator, it is crucial to correctly evaluate and communicate the severity of the violence. Recent data have shown these communications to be biased. However, computational language models provide opportunities for automated evaluation of the severity to mitigate the biases. We investigated whether these biases can be removed with computational algorithms trained to measure the severity of violence described. In phase 1 (P1), participants (N=71) were instructed to write some text and type 5 keywords describing an event where they experienced physical violence and 1 keyword describing an event where they experienced psychological violence in an intimate partner relationship. They were also asked to rate the severity. In phase 2 (P2), another set of participants (N=40) read the texts and rated them for severity of violence on the same scale as in P1. We also quantified the text data to word embeddings. Machine learning was used to train a model to predict the severity ratings. For physical violence, there was a greater accuracy bias for humans (r2=0.22) compared to the computational model (r2=0.31; t38=-2.37, P=.023). For psychological violence, the accuracy bias was greater for humans (r2=0.058) than for the computational model (r2=0.35; t38=-14.58, P<.001). Participants in P1 experienced psychological violence as more severe (mean 6.46, SD 1.69) than participants rating the same events in P2 (mean 5.84, SD 2.80; t86=-2.22, P=.029<.05), whereas no calibration bias was found for the computational model (t134=1.30, P=.195). However, no calibration bias was found for physical violence for humans between P1 (mean 6.59, SD 1.81) and P2 (mean 7.54, SD 2.62; t86=1.32, P=.19) or for the computational model (t134=0.62, P=.534). There was no difference in the severity ratings between psychological and physical violence in P1. However, the bias (ie, the ratings in P2 minus the ratings in P1) was highly negatively correlated with the severity ratings in P1 (r2=0.29) and in P2 (r2=0.37), whereas the ratings in P1 and P2 were somewhat less correlated (r2=0.11) using the psychological and physical data combined. The results show that the computational model mitigates accuracy bias and removes calibration biases. These results suggest that computational models can be used for debiasing the severity evaluations of violence. These findings may have application in a legal context, prioritizing resources in society and how violent events are presented in the media.

Measuring Violence Behaviours in the Context of Romantic Relationships during Adolescence: New Evidence about the Modified Conflict Tactics Scale

The main purpose of the present study was to analyze the psychometric properties of the Spanish version of the Modified Conflict Tactics Scale (M-CTS) in adolescents. The M-CTS is a questionnaire that screens for intimate partner violence. Additionally, we studied the association between the M-CTS and attitudes towards violence. The study included a sample of 1248 students in a cross-sectional survey. The M-CTS and the Attitudes Towards Violence (EAV) scale were used. The analysis of the internal structure of the M-CTS revealed that a four-factor structure was the best fitting solution. The M-CTS scores revealed evidence of structural equivalence by gender and age. The McDonald's Omega indices were adequate for both victims and perpetrators models. Moreover, attitudes towards violence were positively correlated with measures of violence manifestations. Results found in the present study confirm the psychometric adequacy of the M-CTS scores and gather new evidence about its internal structure and measurement equivalence for its use in samples of adolescent and young students. The assessment of intimate partner violence may contribute to detect adolescents at risk for different forms of violence in the future.

Association between childhood trauma, intimate partner violence, and perceived parental competence among women abusing amphetamine-type stimulant.

This cross-sectional study examines the correlation between childhood trauma, intimate partner violence (IPV), and parenting self-efficacy among women who reported using amphetamine-type stimulants (ATS) in an institutional drug rehabilitation center. A total of 106 participants were recruited by purposive sampling, of which 88 were mothers. Questionnaires were used to collect sociodemographic data and study variables. Most of these women had experienced emotional abuse, sexual abuse, and physical neglect in their childhood. IPV assessments revealed that 70.5% (n = 74) and 30.5% (n = 32) had experienced physical and sexual violence, respectively. In terms of parenting competency, they scored 79.5% for self-efficacy and 54.4% for parenting satisfaction. Childhood emotional abuse significantly increases the odds of individuals experiencing sexual violence by 20.9%. We found that childhood trauma and IPV did not have a significant relationship with parenting efficacy. Conversely, childhood emotional abuse and physical abuse were negatively correlated to parenting satisfaction. It is imperative that any form of childhood abuse be recognized and stopped early to reduce the harm it brings to women later in life.

Improvements to Screening for Intimate Partner Violence During a Pandemic

During the COVID-19 pandemic, screening deferral for intimate partner violence (IPV) became common practice due to the partner remaining at the bedside (due to COVID-19–related visitor restrictions) in women admitted for birth. However, pregnancy is a time of increased vulnerability and risk for violence. Screening deferral and incompletion of IPV assessment leave potential victims unidentified and at risk for poor maternal and fetal outcomes, including preterm birth and miscarriage.

"The Average Counsellor Wouldn't Know": Exploring How General Health Practitioners Understand and Respond to Domestic Violence.

Individuals experiencing and perpetrating intimate partner violence (IPV) are frequently in contact with general health and mental health services. Health service providers, including nurses, thus have a key role in identifying and responding to initial indicators of IPV risk. The present study provides descriptive information about current assessment and intervention practices of health and mental health service providers when patients are presenting with concerns about IPV. A secondary data analysis of interviews with general health practitioners (n = 17) were coded and dominant themes analyzed through thematic analysis. The present study uncovered ways in which IPV-related risks are, and are not, recognized and responded to. A metaphorical visual display in the form of a "domestic violence supply room" depicts the level of access and degree of competency described by practitioners in respective areas of practice. Within reach for all practitioners is the knowledge of factors that increase risk and vulnerability to IPV. Out of reach is a comprehensive understanding of the needs of children and perpetrators as well as the consistent ability to consider intersectionality and be reflexive when working with culturally and linguistically diverse populations. The step ladder to improved IPV response, including formal supports such as training and procedures, is frequently described as lacking. A consistent and empirically supported approach to IPV assessment and response is rare to find across generalist service provision. Although service providers possess basic knowledge of risk factors, organizational direction is needed to allow providers to address IPV confidently and effectively.

Agreement Between Mother and Father Reports of IPV in a Sample of Child Protection Referred Coparents.

Accurate assessment of intimate partner violence (IPV) using standardized measures can be a challenge as there is often discrepancy between partner reports, with previous research indicating very poor concordance between partners using the Conflict Tactics Scale. This study examines agreement between coparent reports of IPV using the Abusive Behavior Inventory (ABI) from 282 coparent dyads referred for Fathers for Change, an IPV intervention by the Department of Children and Families (DCF). Differences in partner concordance using intraclass correlations were examined based on type of violence, marital status/cohabitation, race/ethnicity and substance misuse problems. Intraclass correlations were also calculated for eight power and control items unique to the ABI. Overall agreement between coparents was poor. However, there was greater concordance about mothers' who have used IPV toward fathers than fathers' use of IPV toward mothers. There was lower agreement between reports of physical than psychological IPV especially for white coparents. All types of coparent relationships showed low levels of agreement, but cohabiting coparents showed the highest levels of agreement when reporting fathers' IPV. In cases with one parent exhibiting substance misuse, concordance between reports of IPV increased. Results are consistent with prior findings that women report higher IPV than fathers even when assessments are done in the context of a DCF IPV treatment referral.

Intimate partner violence and pregnancy during the COVID-19 pandemic

ABSTRACT The COVID-19 pandemic has resulted in psychological sequelae in different populations, especially female victims of intimate partner violence (IPV) who are pregnant. Nonetheless, little is known about how IPV events and pregnancy are related to mental health outcomes for pregnant women during the pandemic, when this research took place. 155 pregnant women (82 primigravidas and 73 multigravidas women) were assessed using questionnaires for mental health status and IPV events. The results showed that primigravida women were less likely to experience intimate partner violence than multigravida women. Further, first time pregnancy was not related to symptoms of psychopathology nor perceived stress, even after controlling for the potential effect of IPV. In contrast, IPV was related to all measures of psychopathology, except for pregnancy-specific stress. The results provide information about the relationship of IPV, pregnancy and psychopathology during the COVID-19 pandemic. However, due to the study design (part of awider study), it is not yet possible to examine how IPV patterns with respect to pregnancy may have changed in response to the pandemic. In light of the relationship between IPV and mental health during the pandemic, assessment of IPV appears to be an important component in health assessments of pregnant women.

Awareness, Knowledge, and Screening for Intimate Partner Violence Among Orthopedic Surgeons in Israel.

This study examines factors associated with screening of female patients for intimate partner violence (IPV) by orthosurgeons in a sample of 100 Israeli orthosurgeons. Findings reveal positive attitudes toward screening female patients but a significant lack of knowledge. Arab orthosurgeons held slightly more negative attitudes toward screening for IPV and had a more prominent lack of knowledge regarding screening for IPV, compared to their Jewish counterparts. Nationality and feeling uncomfortable asking female patients about IPV predicted screening for IPV. The importance of training orthosurgeons on the assessment and treatment of IPV cannot be overemphasized, especially among Arab orthosurgeons.

Reproductive endocrinologists’ knowledge and attitudes in the identification of intimate partner violence

To assess reproductive endocrinologists' attitudes, beliefs, knowledge, and experiences with intimate partner violence (IPV). Cross-sectional survey of US reproductive endocrinologists. The survey was disseminated via both direct mail and e-mail to a voluntary, semirandomized US national sample of reproductive endocrinologists. We randomly selected a maximum of six clinics per state using the Centers for Disease Control and Prevention Fertility Clinic Success Rates Report. None. None. Clinician perceptions and knowledge regarding IPV and its relevance to the infertility setting. A total of 95 reproductive endocrinology and infertility physicians practicing in either academic or private clinics in the United States completed the survey with an overall response rate of 46% (95/200). General knowledge of IPV was good among respondents. Intimate partner violence assessment was very relevant among 39% (37/95) of respondents and possibly relevant among 56% (53/95) of respondents. A history of IPV awareness training was associated with a decreased frequency of reported barriers, including fewer perceived time constraints, decreased knowledge regarding IPV community resources, and less discomfort asking about IPV. Most respondents estimated the prevalence of IPV in their practice to be rare (≤1%). However, 33% (31/95) reported identifying between one and five active victims of IPV over the prior year, and 63% (60/95) reported identifying a victim of IPV throughout their careers. Only 17% (16/95) of respondents were certain that their clinic had guidelines for detection or management of IPV. Reproductive endocrinology and infertility physicians would benefit from education and training in IPV to enable them to better identify and assist patients who are victims of IPV.

Intimate Partner Violence Standardized Patient Simulation for Nurse Practitioner Students.

Intimate partner violence (IPV) is a serious public health threat in the United States, affecting millions of individuals and families. The American Association of Colleges of Nursing recommends that nursing programs, both baccalaureate and graduate, provide students didactic training and clinical experience in the assessment and management of IPV. Our goal was to expose Psychiatric Mental Health Nurse Practitioner (PMHNP) students and Family Nurse Practitioner (FNP) students to a simulated IPV scenario so they are prepared to respond appropriately to a survivor's disclosure of IPV when they begin clinical practice. We integrated a patient simulation scenario into our PMHNP and FNP curriculum. A combined group of PMHNP and FNP students participated in a simulation in which the standardized patient provided an unlikely explanation for her injuries. If students inquired about abuse, the patient revealed that she had experienced IPV. A pre- and posttest survey was used to evaluate student knowledge gain before and after the participating in the scenario. A Related Samples Wilcoxon Signed Rank Test was used to evaluate the results. Compared with pretest scores, students demonstrated improved confidence in screening for IPV as well as responding to a disclosure of IPV. Simulation provides a method to enhance student knowledge of incidence, risk, and best practices in relation to the screening, assessment and management of IPV.

Evaluating the Relationship Between Intimate Partner Violence-Related Training and Mental Health Professionals' Assessment of Relationship Problems.

Intimate partner violence (IPV) is a serious public health problem associated with increased risk of developing mental health conditions. Assessment of IPV in mental health settings is important for appropriate treatment planning and referral; however, lack of training in how to identify and respond to IPV presents a significant barrier to assessment. To address this issue, the World Health Organization (WHO) advanced a series of evidence-based recommendations for IPV-related training programs. This study examines the relationship between mental health professionals’ experiences of IPV-related training, including the degree to which their training resembles WHO training recommendations, and their accuracy in correctly identifying relationship problems. Participants were psychologists and psychiatrists (N = 321) from 24 countries who agreed to participate in an online survey in French, Japanese, or Spanish. They responded to questions regarding their IPV-related training (i.e., components and hours of training) and rated the presence or absence of clinically significant relationship problems and maltreatment (RPM) and mental disorders across four case vignettes. Participants who received IPV-related training, and whose training was more recent and more closely resembled WHO training recommendations, were more likely than those without training to accurately identify RPM when it was present. Clinicians regardless of IPV-related training were equally likely to misclassify normative couple issues as clinically significant RPM. Findings suggest that IPV-related training assists clinicians in making more accurate assessments of patients presenting with clinically significant relationship problems, including IPV. These data inform recommendations for IPV-related training programs and suggest that training should be repeated, multicomponent, and include experiential training exercises, and guidelines for distinguishing normative relationship problems from clinically significant RPM.

The intersection of intimate partner violence and substance use among women with opioid use disorder

Background Women with opioid use disorder (OUD) report high rates of intimate partner violence (IPV) and there is limited understanding of how IPV influences substance use behaviors among women with OUD. Methods: Semi-structured qualitative interviews were conducted with a sample of 40 women with OUD participating in an ongoing clinical trial evaluating postpartum contraceptive utilization patterns for this population. Interviews were audio-recorded, transcribed verbatim and lasted approximately 45 min. Interview questions focused on women’s perceptions and experiences with IPV and how these experiences impacted their substance use behaviors. Transcripts were coded independently in Atlas.ti and qualitatively analyzed using a general qualitative inquiry approach for emerging themes. Results: Participants were aged 24–29, and the majority were white, single, unemployed, had Medicaid insurance and a high school degree. Although personal IPV experiences were not necessary to be selected for this qualitative sub-study, all participants reported some lifetime experience with IPV. Four overarching themes emerged: (1) women attributed physical IPV to their partner’s substance use; (2) emotional abuse prevented women from fully engaging in their recovery; (3) financial abuse prevented women from gaining independence from abusive partners; and (4) women coped with IPV experiences through substance use. Conclusions: IPV had a significant influence on women’s substance use behaviors including their perceived risk of relapse and treatment discontinuation. These findings demonstrate the need to integrate assessment, evaluation and management of IPV into substance use treatment settings.

15215 Female sex worker experiences with intimate partner violence screening by health care providers

ABSTRACT IMPACT: This work will inform the need for more trauma-informed approaches to violence screenings among marginalized populations by health care providers. OBJECTIVES/GOALS: Female sex workers (FSW) experience high rates of intimate partner violence (IPV) which may have negative reproductive health consequences. Routine IPV screening by healthcare providers (HCP) is recommended. This study examines how FSW experience IPV assessments by HCP. METHODS/STUDY POPULATION: This qualitative descriptive study is nested within EMERALD, a longitudinal cohort study of street-based FSW. EMERALD assesses a structural community-level intervention on HIV and STI risks among FSW. Participants were recruited for EMERALD using time-location sampling to identify a sampling frame of venues and times where sex work is likely to occur. Inclusion criteria for this qualitative study include: participating in EMERALD, age 18-49, and willingness to participate in one phone interview. Twenty-two semi-structured individual qualitative interviews were conducted. Two coders, using thematic analysis, applied deductive codes and inductive coding to identify themes. RESULTS/ANTICIPATED RESULTS: Three themes emerged from participant interviews regarding IPV screening. Inconsistent screening practices: Despite frequent reproductive health visits among participants, many women did not recall IPV screening by a HCP. Stigma as a barrier to disclosure: Women described feeling judged by HCP regarding their frequency of visits for reproductive concerns, sex work, and substance use and did not trust disclosing violence to HCP. Transactional health encounters: During visits, HCP were focused on addressing women’s immediate concerns; if the HCP did ask about IPV women felt the questions were asked part of a required protocol and not driven by a concern to deeply understand their lives. DISCUSSION/SIGNIFICANCE OF FINDINGS: FSW described inconsistent IPV screening practices by HPC. Participants expressed feeling stigmatized by HCP and that encounters with HCP did not foster trust for women to disclose IPV experiences. There is a need for HPC training in universal IPV screening focused on relationship and trust building to facilitate disclosure.

Family Planning Providers' Assessment of Intimate Partner Violence and Substance Use.

Background: Intimate partner violence (IPV) and substance use are intersecting health problems that adversely impact sexual and reproductive health outcomes for women seeking care at family planning (FP) clinics. We aimed to characterize whether and how FP clinic providers (1) assessed for IPV and substance use and (2) combined IPV and substance use assessments. Methods: Providers and patients (female, 18-29 years old, English speaking) at four FP clinics participating in a larger randomized controlled trial on provider communication skills were eligible. Providers received training on universal education, a research-informed IPV assessment approach. Visits were audio recorded, transcribed verbatim, and coded by two independent coders. We used inductive and deductive coding to assess providers' communication approaches and examined codes for patterns and categories. We then converted these approaches into variables to calculate frequencies among recorded visits. Results: Ninety-eight patient-provider encounters were analyzed. In almost all encounters (90/98), providers assessed for IPV. Many providers adopted best practice IPV assessment techniques, such as universal education (68/98) and normalizing/framing statements (45/98). Tobacco use screening was common (70/98), but alcohol (17/98) and other drug use screening (17/98) were rare. In only one encounter did a provider discuss IPV and substance use as intersecting health problems. Conclusion: This study provides insight on how FP clinicians, as key providers for millions of women in the United States, assess patients for IPV and substance use. Results show providers' willingness to adopt IPV universal education messaging and demonstrate room for improvement in substance use assessments and integrated discussions of IPV and substance use. Trial Registration Number: NCT01459458.

Toward a Contextually Valid Assessment of Partner Violence: Development and Psycho-Sociometric Evaluation of the Gendered Violence in Partnerships Scale (GVPS).

This article presents a new measure for intimate partner violence (IPV), the Gendered Violence in Partnerships Scale (GVPS). The scale was developed in the Middle East with the aim to contribute to the global perspective on IPV by providing a contextual assessment tool for partner violence against women in violent-torn settings embedded in a patriarchal social structure. In an effort to generate a scale including IPV items relevant to the women of the population, a pragmatic step-wise procedure, with focus group discussions and expert panels, was performed. The study’s analyses resulted in an 18-item checklist featuring four subscales of the GVPS that are based on a new typology of male-to-female partner violence presenting an alternative to the commonly used classification by type of abuse (i.e., physical, psychological, sexual acts). Therein, dominating behaviors, existential threats, impulsive aggression, and aggravated physical assault were identified as reflective of the lived realities of women in the war-torn Middle East, which was confirmed in factor analysis. The scale’s psychometric properties were assessed with data from 1,009 displaced women in Iraq, and associations with measures of psychopathology were determined. Implications for IPV assessment and prevention possibilities in humanitarian contexts and beyond are discussed.