Intimate Partner Violence Outcomes Research Articles

Employment Maintenance and Intimate Partner Violence.

Intimate partner violence (IPV) is a major public health problem in the United States. Negative outcomes of IPV affect women's attainment and maintenance of employment. The purpose of this study was to develop a theoretical framework that described and explained the process by which women who have experienced IPV attain and maintain employment. Grounded theory methodology was used to analyze interviews of 34 women who had experienced IPV. Analysis suggested that women who had experienced IPV could attain employment; however, they had difficulty maintaining employment. Entanglement of work and IPV was experienced by all 34 participants because of the perpetrator controlling their appearance, sabotaging their work, interfering with their work, or controlling their finances. Some women described ways in which they disentangled work from IPV through a dynamic unraveling process, with periods of re-entanglement, resulting in job security and satisfaction.

BSAFER: A Web-based intervention for drug use and intimate partner violence demonstrates feasibility and acceptability among women in the emergency department

ABSTRACTBackground: Addressing violence along with drug use change goals is critical for women with coexisting intimate partner violence (IPV) and substance use disorders (SUDs). Methods: This was an acceptability and feasibility study of BSAFER, a brief Web-based program and booster phone call addressing violence and drug use. A screening survey identified women with recent drug use and IPV in the emergency department (ED). Participants were randomized to BSAFER or a Web-based control program and booster call providing education about home fire safety. Program completion, usability, satisfaction, and motivational interviewing (MI) adherence were primary outcomes. Drug use and IPV outcomes were measured at baseline, 1 month, and 3 months. Results: Forty women were enrolled (21 BSAFER, 19 control); 50% were nonwhite and mean age was 30 years. The most commonly used drugs were marijuana (88%) and cocaine (30%); 45% reported physical abuse, and 33% reported severe combined physical and sexual abuse. Thirty-nine (98%) completed the Web program, 30 (75%) completed the booster, and 29 (73%) completed the 3-month follow-up. Mean System Usability Scale (SUS) for the BSAFER Web program was 84 (95% confidence interval [CI]: 78–89) of 100; mean Client Satisfaction Questionnaire (CSQ-8) was 28 (95% CI: 26–29) of 32. MI adherence scores were high and similar for both the Web program and the booster. Both intervention and control groups had small mean decreases in weekly drug use days (0.7 vs. 1.5 days); participants using drugs other than marijuana demonstrated greater average reductions in drug use than those using marijuana only. Conclusions: An ED Web-based intervention for SUDs and IPV in women demonstrated feasibility and acceptability. Future studies will examine efficacy of the BSAFER program and investigate whether specific subgroups of drug using women may be most responsive to ED-based Web interventions.

Continued Intimate Partner Violence During Pregnancy and After Birth and Its Effect on Child Functioning

ObjectiveTo investigate the effect of intimate partner violence (IPV) during pregnancy with continued IPV up to 6 months after birth and its effect on child functioning. DesignNonexperimental descriptive design. SettingSafe shelters and the District Attorney's office in a large urban community in the United States. ParticipantsAbused women (N = 284) who reported IPV and reached out for services. MethodsAbused women who reported IPV answered a questionnaire on the effects of abuse during pregnancy and continued abuse after birth and child behaviors. Women who continued to experience abuse during pregnancy were compared with women who did not report abuse during pregnancy and after birth. The Achenback Child Behavior Checklist was used to evaluate child behavior. Research questions were analyzed through the use of nonparametric analyses. ResultsBetween the two groups, the relationship between IPV during pregnancy and IPV during the first 6 months after birth was significant (p < .001). The relation between women who reported abuse during pregnancy and conception rape was significant (p < .001). Most abused women (76%) were not screened for IPV during pregnancy (p = .025). Significant findings related to child behaviors and IPV during pregnancy were found for internalizing behaviors (p < .009), externalizing behaviors (p < .001), and total behavioral problems (p < .001). ConclusionIntimate partner violence during pregnancy increases the risk of IPV 6 months after birth. These findings also indicated a negative intergenerational effect of IPV during pregnancy on child behavior. Screening for IPV during pregnancy is vital to interrupt ongoing IPV and possible negative outcomes for mother and child.

Efficacy of a Computerized Intervention on HIV and Intimate Partner Violence Among Substance-Using Women in Community Corrections: A Randomized Controlled Trial.

To test the efficacy of a computerized, group-based HIV and intimate partner violence (IPV) intervention on reducing IPV victimization among substance-using women mandated to community corrections. Between November 2009 and January 2012, we randomly allocated 306 women from community corrections in New York City to 3 study arms of a computerized HIV and IPV prevention trial: (1) 4 group sessions intervention with computerized self-paced IPV prevention modules (Computerized Women on the Road to Health [WORTH]), (2) traditional HIV and IPV prevention intervention group covering the same HIV and IPV content as Computerized WORTH without computers (Traditional WORTH), and (3) a Wellness Promotion control group. Primary outcomes were physical, injurious, and sexual IPV victimization in the previous 6 months at 12-month follow-up. Computerized WORTH participants reported significantly lower risk of physical IPV victimization, severe injurious IPV victimization, and severe sexual IPV victimization at 12-month follow-up when compared with control participants. No significant differences were seen between Traditional WORTH and control participants for any IPV outcomes. The efficacy of Computerized WORTH across multiple IPV outcomes highlights the promise of integrating computerized, self-paced IPV prevention modules in HIV prevention groups.

Intimate partner violence during pregnancy and the risk for adverse infant outcomes: a systematic review and meta-analysis.

Intimate partner violence (IPV) is of particular concern during pregnancy when not one, but two lives are at risk. Previous meta-analyses have suggested an association between IPV and adverse birth outcomes; however, many large studies have since been published, illustrating the need for updated pooled effect estimates. To evaluate the relationship between IPV during pregnancy and the risk of preterm birth (PTB), low-birthweight (LBW), and small-for-gestational-age (SGA) infants. We searched PubMed and SCOPUS (from inception until May2015), and the reference lists of the relevant studies. Observational studies comparing the rates of at least one adverse birth outcome (SGA, LBW, or PTB) in women who experienced IPV during pregnancy and those who did not. Data extracted from 50 studies were pooled and pooled odds ratios were calculated using random-effects models. Intimate partner violence (IPV) was significantly associated with PTB (OR1.91, 95%CI 1.60-2.29) and LBW (OR2.11, 95%CI 1.68-2.65), although a large level of heterogeneity was present for both (I(2) =84 and 91%, respectively). The association with SGA was less pronouncedandmarginally significant (OR1.37, 95%CI 1.02-1.84), althoughfewer studies were available for meta-analysis (n=7). Our meta-analysis indicates that women who experienced IPV during pregnancy are at increased risk ofhaving a PTB, and an LBW or an SGA infant. More studiesexamining the association between IPV and SGA are needed. Meta-analysis of IPV during pregnancy finds increased risk for preterm birth, LBW and SGA infants.

Risks and Targeted Interventions: Firearms in Intimate Partner Violence.

The use of firearms in intimate partner violence (IPV) is widely recognized as an important public health threat. However, what we know about the risks of firearm access on IPV outcomes is limited. Therefore, we conducted a systematic review to determine the state of knowledge on 1) the risks of firearm access and use in IPV and 2) the effectiveness of interventions designed specifically to reduce firearm violence in intimate relationships. Only studies published in English in peer-reviewed journals from 1990 through 2014 were included. Results of the review suggest that, when violent intimates have access to firearms, IPV increases in severity and deadliness; however, increases in severity may not be due to firearm use. Additionally, statutes prohibiting persons under domestic violence restraining orders from accessing firearms are associated with reductions in intimate partner homicide, but certain provisions of these laws and their enforcement may impact their effectiveness. Future research should focus on elucidating the link between firearm access and increased IPV severity and on investigating whether and which specific provisions of domestic violence restraining order laws impact the laws' effectiveness. Additionally, more evaluations of initiatives designed to improve the enforcement of domestic violence restraining order firearm prohibitions are needed.

Severe and Less Severe Intimate Partner Violence: From Characterization to Prediction.

Intimate partner homicide/attempted homicide are the most serious outcome of intimate partner violence. Thus, in this study, conducted in Portugal, we sought to compare perpetrators of severe violence with those who perpetrate less severe acts of violence as well as to identify predictors for severe violence. Sample was constituted by 50 men convicted for marital homicide or attempted homicide and 137 men convicted for domestic violence. Results show that although both perpetrators of severe and less severe violence share some characteristics, significant differences were found among them. The use of weapons, separation/break-up, and high socioeconomic status (SES) significantly increased the likelihood of a man to commit severe violence. Prior violence, aggression, and medium SES decreased significantly the probability of an individual to perpetrate severe violence. These findings reinforce the assumption that severe and less severe forms of violence can be discrete phenomena and underscore the importance of conducting accurate risk assessments.

Intimate Partner Violence and Current Mental Health Needs Among Female Veterans.

The Veterans Health Administration (VHA) recommends screening female patients for intimate partner violence (IPV), yet few studies inform IPV screening efforts among this population. This study examined the proportion of women who experienced IPV within the past year and the associations between IPV and depression, post-traumatic stress disorder (PTSD), alcohol dependence, mental health multimorbidity (ie, 2 or 3 of these conditions), and military sexual trauma (MST) among female veterans. A cross-sectional mail survey of 160 female VHA patients with an intimate partner within the past year was conducted in 2012 in New England. Self-reported IPV was assessed using the Hurt, Insult, Threaten, Scream screening tool. The survey also included validated screening measures of depression (Center for Epidemiologic Studies Depression Scale), PTSD (PTSD Checklist-Civilian), alcohol misuse (10-item Alcohol Use Disorders Identification Test), and MST. Approximately 37% of women reported IPV within the past year on the Hurt, Insult, Threaten, Scream tool. Odds ratios for the associations between reporting IPV and mental health outcomes ranged between 2.75 and 3.67. With the exception of alcohol dependence, IPV remained strongly associated with mental health conditions when adjusting for MST. These findings can increase provider knowledge of the strong connection between past-year IPV and mental health conditions among female veterans. This may encourage IPV screening and facilitate appropriate referrals, treatment conceptualization, and planning within the VHA and other health care settings.

Mediating Effects of Existential and Religious Well-Being Among Abused, Suicidal African American Women

Intimate partner violence (IPV), an international public health matter, is linked to psychological distress including suicidal behavior. Despite the noted sequelae associated with IPV, many individuals display resilience in the face of IPV exposure. This study examines two potential protective factors in the IPV-suicidal ideation link, namely existential and religious well-being, in a sample of African American women. Low-income, African American, female suicide attempters who were abused by a partner within the previous year (N = 111) were administered the Conflicts Tactics Scale-2, Spiritual Well-Being Scale, and Beck Scale for Suicide Ideation. Mediational models testing indirect effects through the bootstrapping method revealed that the total effect of IPV on suicidal ideation was positive and significant, confirming suicidal ideation as a consequential outcome of IPV among African American women. This effect was mediated by existential well-being; however, religious well-being was not a significant mediator, suggesting that existential well-being serves a unique protective role in the IPV-suicidal ideation relation. The results provide additional support for the well-known positive effects of existential well-being on mental health among African American samples. Culturally-informed, meaning-making interventions to enhance existential well-being appear to be effective in reducing suicidal ideation in this population.

Intimate Partner Violence Perpetration and Victimization Among YMSM: The P18 Cohort Study.

Research indicates that experiences of intimate partner violence (IPV) are common among young gay, bisexual, and other young men who have sex with men (YMSM). Yet, there is little understanding of the individual, mental health, and psychosocial variables associated with IPV in this population. The aim of this study is to assess the prevalence and correlates of IPV among a new generation of racially/ethnically diverse YMSM. Baseline data from a longitudinal cohort study of YMSM (N = 598) from New York City informed lifetime experiences of IPV victimization, perpetration, and mutual IPV (those reporting both victimization and perpetration). Multivariate logistic regression models were constructed to examine associations between IPV and individual, mental health, and psychosocial factors. Among YMSM, 39% reported IPV victimization, 31% reported perpetration, and 25% reported mutual IPV. Victimization and perpetration were highly correlated. Childhood mistreatment was related to all three IPV outcomes. With regard to psychosocial states, impulsivity was the only variable strongly related to all three IPV outcomes. PTSD was significantly related to IPV victimization but not IPV perpetration. In addition, personal gay-related stigma was associated with IPV victimization, whereas public gay-related stigma was associated with IPV perpetration. Findings extend previous research by identifying psychosocial and mental health variables associated with IPV, while controlling for childhood mistreatment. We recommend more systematic screening for IPV in healthcare settings that serve YMSM (e.g., HIV testing sites). Moreover, we suggest that IPV may be part of a larger syndemic disproportionately burdening YMSM.

The Effects of Social Capital and Neighborhood Characteristics on Intimate Partner Violence: A Consideration of Social Resources and Risks

Intimate partner violence (IPV) is a growing public health problem, and gaps exist in knowledge with respect to appropriate prevention and treatment strategies. A growing body of research evidence suggests that beyond individual factors (e.g., socio-economic status, psychological processes, substance abuse problems), neighborhood characteristics, such as neighborhood economic disadvantage, high crime rates, high unemployment and social disorder, are associated with increased risk for IPV. However, existing research in this area has focused primarily on risk factors inherent in neighborhoods, and has failed to adequately examine resources within social networks and neighborhoods that may buffer or prevent the occurrence of IPV. This study examines the effects of neighborhood characteristics, such as economic disadvantage and disorder, and individual and neighborhood resources, such as social capital, on IPV among a representative sample of 2412 residents of Toronto, Ontario, Canada. Using a population based sample of 2412 randomly selected Toronto adults with comprehensive neighborhood level data on a broad set of characteristics, we conducted multi-level modeling to examine the effects of individual- and neighborhood-level effects on IPV outcomes. We also examined protective factors through a comprehensive operationalization of the concept of social capital, involving neighborhood collective efficacy, community group participation, social network structure and social support. Findings show that residents who were involved in one or more community groups in the last 12 months and had high perceived neighborhood problems were more likely to have experienced physical IPV. Residents who had high perceived social support and low perceived neighborhood problems were less likely to experience non-physical IPV. These relationships did not differ by neighborhood income or gender. Findings suggest interesting contextual effects of social capital on IPV. Consistent with previous research, higher levels of perceived neighborhood problems can reflect disadvantaged environments that are more challenged in promoting health and regulating disorder, and can create stressors in which IPV is more likely to occur. Such analyses will be helpful to further understanding of the complex, multi-level pathways related to IPV and to inform the development of effective programs and policies with which to address and prevent this serious public health issue.

Estimating the effect of intimate partner violence on women's use of contraception: a systematic review and meta-analysis.

BackgroundIntimate partner violence (IPV) is an important global public health problem. While there is a growing literature on the association between IPV and women’s reproductive health (RH) outcomes, most studies are cross-sectional—which weakens inference about the causal effect of IPV on women’s RH. This systematic review synthesizes existing evidence from the strongest study designs to estimate the impact of IPV on women’s use of contraception.MethodsWe searched 11 electronic databases from January of 1980 to 3 December 2013 and reviewed reference lists from systematic reviews for studies examining IPV and contraceptive use. To be able to infer causality, we limited our review to studies that had longitudinal measures of either IPV or women’s use of contraception.ResultsOf the 1,574 articles identified by the search, we included 179 articles in the full text review and extracted data from 12 studies that met our inclusion criteria. We limited the meta-analysis to seven studies that could be classified as subject to low or moderate levels of bias. Women’s experience of IPV was associated with a significant reduction in the odds of using contraception (n = 14,866; OR: 0.47; 95% CI: 0.25, 0.85; I2 = 92%; 95% CII2: 87%, 96%). Restricting to studies that measured the effect of IPV on women’s use of partner dependent contraceptive methods was associated with a reduction in the heterogeneity of the overall estimate. In the three studies that examined women’s likelihood of using male condoms with their partners, experience of IPV was associated with a significant decrease in condom use (OR: 0.48; 95% CIOR: 0.32, 0.72; I2 = 51%; 95% CII2: 0%, 86%).ConclusionsIPV is associated with a reduction in women’s use of contraception; women who experience IPV are less likely to report using condoms with their male partners. Family planning and HIV prevention programs should consider women’s experiences of IPV.

Intimate partner violence against women in slums in India.

Intimate partner violence against women in slums in India.

The Role of Alcohol Policies in Preventing Intimate Partner Violence: A Review of the Literature

This article summarizes existing research on the relationship between alcohol policies and intimate partner violence (IPV). Because alcohol use represents an important risk factor for IPV, interventions and policies aimed at decreasing problem drinking may also lead to reductions in IPV. Electronic databases were searched to identify relevant peer-reviewed journal articles on alcohol policies and IPV, as well as reference sections of appropriate articles. Only policies that have been studied specifically for their impact on IPV were included. Three alcohol policy areas (outlet density, hours and days of sale, and pricing/taxation) have been studied in relation to IPV outcomes. Research on outlet density has the most consistent findings, with most studies indicating that higher densities of alcohol outlets are associated with higher rates of IPV. Fewer studies have been conducted on pricing policies and policies restricting hours/days of sale, with most studies suggesting no impact on IPV rates. A higher density of alcohol outlets appears to be associated with greater rates of IPV. However, there is limited evidence suggesting that alcohol pricing policies and restrictions on hours and days of sale are associated with IPV outcomes. Knowledge about the impact of alcohol-related policies on IPV and violence in general is limited by several significant research gaps. Additional research is needed to assess the impact of alcohol policies on IPV and other forms of violence.

The Effect of Gender and Perpetrator-Victim Role on Mental Health Outcomes and Risk Behaviors Associated With Intimate Partner Violence.

Intimate partner violence (IPV) is a major public health concern. Previous studies have consistently shown that IPV is tied by to a variety of detrimental consequences for affected individuals, including negative mental health outcomes. However, the differential impact of gender and perpetrator-victim role (i.e., whether an individual is the perpetrator or victim of violence or both) remains largely understudied in the academic literature. Thus, the purpose of the present study was to describe a variety of mental health outcomes and risk behaviors among men and women experiencing no violence, perpetration-only, victimization-only, and bidirectional violence. Data from Waves 3 and 4 of the National Longitudinal Study of Adolescent Health (N = 7,187) were used. Participants provided information on their perpetrator-victim role and on a variety of factors related to mental health (depression, suicidality, alcohol use, illegal drug use, and relationship satisfaction). For all outcomes, prevalence and severity generally tended to be highest among individuals affected by bidirectional IPV and lowest among individuals not affected by any violence (independent of gender). The present findings highlight that IPV and negative mental health outcomes and risk behaviors should be addressed as co-occurring problems in research, prevention, and treatment. In addition, all gender-role combinations should be addressed to better understand and address all potential effects of IPV. According to the present findings, couples affected by bidirectional violence are at particularly high risk of developing mental health disorders. Thus, policy makers and clinicians should predominantly target couples as well as individuals who are not only the victims but also the perpetrators of IPV and pay particular attention to potential signs of mental health distress these individuals might exhibit.

Intimate partner violence during pregnancy and adverse neonatal outcomes in low-income women.

Intimate partner violence (IPV) affects an estimated 1.5 million U.S. women annually. IPV impacts maternal and neonatal health with higher rates of depression and low birth weight (LBW). Less studied is experiencing IPV and delivering a small for gestational age (SGA) baby. SGA neonates are at increased risk of developmental and behavioral problems. The negative sequelae persist into adulthood with increased rates of diabetes mellitus and coronary heart disease. In a sample of 239 pregnant women experiencing IPV, in urban and rural settings, we examined cross-sectional associations of severity of IPV and neonatal outcomes (i.e., birth weight and gestational age). Severity of IPV was measured by the Conflict Tactics Scale 2 and neonatal outcomes were collected at the time of delivery. Outcomes were collected on 194 neonates; 14.9% (n=29) were classified as LBW, 19.1% (n=37) classified as SGA, and 9.8% (n=19) as LBW and SGA. Women reporting higher severity of IPV during pregnancy had a greater likelihood of delivering an SGA neonate (odds ratio [OR] 4.81; 95% confidence interval [95% CI] 1.86-12.47), and LBW neonate (OR 4.20; 95% CI 1.46-12.10). In a sample of pregnant women experiencing perinatal IPV, women experiencing greater severities of IPV were more likely to deliver a neonate with an adverse outcome. Early recognition and intervention of IPV is essential to reduce disparities in birth outcomes and long-term health outcomes for these neonates.

Marital infidelity and intimate partner violence in rural Malawi: a dyadic investigation.

Extramarital sexual partnerships are a common reason for intimate partner violence (IPV) in sub-Saharan Africa. Despite the fact that IPV requires an interaction between two partners, the majority of the research focuses on individuals rather than the broader relationship context where such violence takes place. Using a sample of 422 married couples from rural Malawi, this study examined the dyadic environment of marital infidelity and two types of IPV victimization: sexual coercion and physical abuse. We considered both self-reported marital infidelity and perceived partner infidelity to assess how well partners knew each other and to compare their respective associations with IPV. Logistic regression was used to test for associations between self-reported marital infidelity and IPV. Multilevel logistic regression was used to examine actor and partner effects of perceived partner infidelity on an individual's and their partner's experience of IPV. The results show that self-reported marital infidelity was not significantly associated with IPV for men or women. However, the perception of a partner's infidelity was significantly associated with both an individual's and their partner's risk for sexual coercion and physical abuse. Contrary to the "sexual double standard" hypothesis, women were not significantly more likely than men to report being physically abused when their partners suspected infidelity. Future studies should continue to explore the relationship context of IPV in sub-Saharan Africa in order to understand how spouses mutually shape each other's experience of IPV and subsequent health outcomes.

Maternal outcomes of intimate partner violence during pregnancy: study in Iran

ObjectivesTo investigate the prevalence of intimate partner violence (IPV) against pregnant women and its relationship with adverse maternal outcomes, including preterm labour, abortion, caesarean section, antenatal hospitalization and vaginal bleeding, in the West Azerbaijan, Iran. Study designCross-sectional design. MethodsIn total, 1300 pregnant women, aged 18–39 years, who were referred to hospitals in the Iranian cities of Miandoab and Mahabad in the province of West Azerbaijan in 2009–2010 were recruited for this study by a convenience sampling method. Participants were asked to share their experiences of IPV during pregnancy and adverse maternal outcomes. ResultsOf these pregnant women, 945 (72.8%) reported that they had experienced IPV during their last pregnancy. A significant association was found between IPV and preterm labour [adjusted odds ratio (adjOR) 1.54, 95% confidence interval (CI) 1.16–2.03], caesarean section (adjOR 11.84, 95% CI 6.37–22.02), antenatal hospitalization (adjOR 6.34, 95% CI 3.82–10.52) and vaginal bleeding (adjOR 1.51, 95% CI 0.9–2.3). DiscussionThis study demonstrated a high prevalence of IPV during pregnancy, and found that IPV was associated with adverse maternal outcomes including preterm labour, caesarean section, antenatal hospitalization and vaginal bleeding. This adds to the existing literature and can be used to inform healthcare practices in developing countries. Medical, health and surgical services for pregnant women should consider screening for IPV, and providers should be aware that IPV victims are at increased risk for adverse outcomes. Services should also develop links with the Battered Women's Movement; such programmes now exist in many countries.

Endometriosis: the bloggers’ tales

<h3>Background:</h3> The Veterans Health Administration (VHA) recommends screening female patients for intimate partner violence (IPV), yet few studies inform IPV screening efforts among this population. This study examined the proportion...

Intimate Partner Violence and HIV: A Review

Intimate partner violence (IPV) is a common and negative social determinant of health. IPV also increases vulnerability to risks associated with HIV transmission and contributes to HIV transmission. IPV is therefore predictably common among people living with HIV. It is increasingly being recognized as an important predictor of poor outcomes for those living with HIV by affecting retention to care, mental health, adherence to therapy, frequency of follow-up; all of which lead to more hospitalizations and progression to AIDS. HIV care providers can safely and effectively screen all HIV patients for IPV. Screening offers the opportunity to identify those at risk for poor outcomes and mitigate its effects. Further research is required in further defining the risk factors and outcomes of IPV and optimizing interventions. We review the association between HIV infection and IPV and make recommendations for IPV screening of HIV-positive individuals and those at high risk for HIV.