Lifetime Domestic Violence Research Articles

Risk factors for involvement in care proceedings for mothers receiving treatment for substance use: A cohort study using linked and administrative data in South London

BackgroundMaternal substance use is considered a significant risk for child maltreatment and neglect, and thus, a common feature in care proceedings (Family Courts). It is important to better understand how the complex needs of these mothers impact on care proceedings’ outcomes. The present study explored individual and clinical characteristics of mothers receiving treatment for substance use to describe who the mothers involved in care proceedings are, and explore what factors are associated with out-of-home placement of their children. MethodsData were extracted from electronic health records (EHRs) of 1587 mothers of dependent children (age < 18 years old) who attended South London and Maudsley (SLaM) National Health Services (NHS) Foundation Trust addiction services between 2007 and 2019. Clinical service records of 480 mothers (30 %) were linked to family court records. ResultsThe number of care proceeding cases decreased during the study period. Most mothers involved in care proceedings (79 %) were known to SLaM before care proceedings began. Compared to mothers who were not involved in care proceedings, mothers who were involved, were more likely to be younger, from a non-white background, to be socially deprived, to experience housing problems, to be pregnant, to have a longer duration of treatment for substance use, to use opioids and/or crack-cocaine and to report lifetime domestic violence victimisation, be at risk of suicide, and report poorer quality of life and psychological health. The median length of care proceeding cases was 37 weeks. Eighty-two percent of mothers had care for their child terminated by the court. Mothers’ younger age, housing problems, use of opiate and/or cocaine/crack-cocaine and poorer quality of life increased the odds of out-of-home placement of the children. The participation of the child’s father in the proceedings was a protective factor for maintaining care of the child for those mothers that were receiving substance use treatment at the time of the proceedings. Attending treatment for substance use during the proceedings was not associated with the child placement outcome. ConclusionFindings highlight that current substance use treatment services are not designed to support mothers retain the care of their children. Understanding and addressing the range of needs of these mothers has implications for both substance use treatment and child welfare.

The characteristics of husbands and violence against women in Wuhan, China: a cross-sectional study

ObjectiveTo explore the prevalence and correlation between husbands and lifetime domestic violence (DV) among women in Wuhan, China.MethodsA cross-sectional study was conducted in a community health center in Wuhan from June 2015 to December 2015. A total of 1015 women who came to the center for gynecological examination were selected through a random sampling. They were assessed using the WHO Violence Against Women Instrument to evaluate the prevalence of DV. The chi-square test, the Wilcoxon rank test, and unadjusted and adjusted logistic regression analyses were used to analyze the possible risk or protective factors for DV.ResultsThe lifetime prevalence of DV was 29.36% (298/1015). The risk factors included heavy physical labor (OR 3.54, 95% CI 1.63–7.77), long-term drinking (OR 1.60, 95% CI 1.19–2.14), overweight or obesity (OR 1.36, 95% CI 1.01–1.88) and long-term smoking (OR 1.03, 95% CI 1.01–1.04). Higher education was a protective factor (OR 0.80, 95% CI 0.66–0.96).ConclusionWomen whose husbands had lower education, performed heavy physical labor, were long-term alcohol consumers, had overweight or obesity, and were long-term smokers were vulnerable to lifetime DV.

Parental status and characteristics of women in substance use treatment services: Analysis of electronic patient records

BackgroundMany women receiving substance use treatment services are mothers. Despite this, research has not proved whether substance use treatment services are addressing the specific needs of mothers. This study explored differences in sociodemographic, psychological, patterns of substance use, and treatment characteristics between mothers and women without children, and between mothers whose children were in alternative care. MethodThe study extracted data from electronic patient records (EPRs) of women who attended South London and Maudsley (SLaM) National Health Services (NHS) Foundation Trust addiction services between 2013 and 2020 (N = 4370). ResultsThe study identified 1730 participants (39.6%) as mothers, of whom 1340 (77.4%) had dependent children. The average number of births was 1.83 (SD = 1.0). Of the participants, 54.3% of mothers did not disclose whether their dependent child(ren) was under their care and 37.5% of mothers indicated that at least one of their child(ren) was in alternative care. Alcohol was the most reported type of substance used in the past 28 days. Mothers also highly reported suicide attempts and hospitalization due to mental health problems. Compared to women without children, mothers were more likely to be young, experience housing problems, use opioids and/or crack-cocaine in the past 28 days and experience lifetime domestic violence victimizations. Mothers were also less likely to have alcohol-related problems, experience overdose, and social isolation than women without children. ConclusionThe study highlights the need for substance use services to invest in approaches to improve mothers' disclosure of parenting and childcare issues. It also demonstrates that EPRs can identify key characteristics of mothers.

Domestic violence victimisation and its association with mental distress: a cross-sectional study of the Yangon Region, Myanmar

ObjectivesTo estimate the prevalence of domestic violence, with subgroups of physical, sexual and emotional violence, among men and women and to assess the association between any lifetime domestic violence (DV)...

Domestic violence victims in a hospital setting: prevalence, health impact and patients’ preferences – results from a cross-sectional study

ABSTRACT Background: Domestic violence (DV) is a widespread yet commonly underdetected problem with severe impact on physical and mental health. To date, only limited information is available on prevalence and detection-rates of victims of DV in hospital settings. Objective: The aim of this study was (a) to assess the prevalence and impact of DV on physical and mental health as well as risk-factors associated with it, (b) to determine how many patients had been asked directly about DV in the hospital and (c) to investigate patients’ preferences about being asked about DV in a hospital setting. Methods: Adult inpatients and outpatients at seven somatic departments at the University Hospital Innsbruck (Austria) were included consecutively in this ad-hoc, cross-sectional paper-and-pencil questionnaire-based study. In total, n = 2,031 patients were assessed regarding their experiences with DV. They also reported on whether they had been asked about DV at the hospital and whether they would mind being asked about it. To evaluate the impact of DV on patients’ self-reported physical and mental health, odds ratios were calculated using binary logistic regression. Results: DV was reported by 17.4% of patients, with 4.0% indicating current DV exposure. Lifetime DV exposure was associated with a significant risk for both physical and mental health-problems. Only 4.8% of patients with DV exposure had ever been asked about it by hospital staff. While patients with a history of DV were more open to being asked about DV than patients without DV (78.2% vs. 72.9%), overall acceptance was still high (74%). Conclusion: DV is a frequently overlooked problem with detrimental effects on physical and mental health. While high acceptance of DV assessment was found, only a small proportion of affected patients had indeed been assessed for DV. Screening for DV in hospitals may thus increase the number of identified patients.

Maternal Experience of Domestic Violence, Associations with Children's Lipid Biomarkers at 10 Years: Findings from MINIMat Study in Rural Bangladesh.

The consequences of maternal experience of Domestic Violence (DV) on their children’s cardio-metabolic risk factors are unclear. We aimed to assess if maternal exposure to any or a specific form of DV (i.e., physical, sexual, emotional and controlling behaviors) before and after childbirth was associated with their children’s lipid biomarkers at the age of 10 years. A current observational sub-study of a larger MINIMat trial included a cohort of 1167 mothers and their children. The conflict tactic scale was used to record women’s experience of lifetime DV before and after childbirth at week 30 of pregnancy and at a 10-year follow up, respectively. Five ml of fasting blood sample was collected from the children to evaluate their lipid profile. Children of women who experienced any DV before childbirth had lower Apo A (βadj −0.04; 95% CI: −0.08, −0.01). Women who experienced physical DV both before and after childbirth had children with higher triglycerides (βadj 0.07; 95% CI: 0.01, 0.14). Children whose mother experienced sexual DV before birth had lower Apo A (βadj −0.05; 95% CI: −0.08, −0.01) and High Density Lipoprotein (HDL) (βadj −0.05; 95% CI: −0.10, −0.01) as well as higher Low Density Lipoprotein (LDL) (βadj 0.17; 95% CI: 0.05, 0.29) and LDL/HDL (β 0.24; 95% CI: 0.11, 0.38). However, levels of LDL (βadj −0.17; 95% CI: −0.28, −0.06), LDL/HDL (βadj −0.12; 95% CI: −0.25, −0.00) and cholesterol (βadj −0.13; 95% CI: −0.25, −0.02) were lower among the children of mothers who experienced controlling behavior after childbirth. Results from the current study suggest that maternal experience of physical or sexual DV might negatively affect their children’s lipid profile at the age of 10 years.

Customary practices, domestic violence, and psychosomatic pain among adolescent mothers in Turkey.

Adolescent motherhood is present in many societies worldwide, including Turkey. We aimed to determine the demographical and cultural characteristics of adolescent mothers, lifetime domestic violence and history of miscarriage, and whether they suffer from any kind of medically unexplained (psychosomatic) pain in a study in south-eastern Turkey. We included 501 mothers in this case-control study. The study group comprised 228 mothers who gave their first deliveries at or before 19 years of age, and the control group consisted of 273 mothers who first delivered after 19 years of age. The case-control study was conducted between February and April 2013 in Diyarbakir, Turkey. Adolescent mothers marry more frequently with their relatives. They have a higher prevalence of culture-bound customary applications such as bride price. They are less likely to be asked for their consent to marry and tend to have more children. They are more frequently victims of domestic violence and more often report medically unexplained psychosomatic pain. Adolescent motherhood is still a public health problem that seems to be related to certain culture-bound customary practices, continuing domestic violence across generations, increased number of children, and more prevalent psychosomatic pain.

Breast-feeding counselling mitigates the negative association of domestic violence on exclusive breast-feeding duration in rural Bangladesh. The MINIMat randomized trial.

To determine if exclusive breast-feeding counselling modifies the association of experience of any lifetime or specific forms of domestic violence (DV) on duration of exclusive breast-feeding (EBF). In the MINIMat trial pregnant women were randomized to receive either usual health messages (UHM) or usual health messages with breast-feeding counselling (BFC) in eight visits. During pregnancy (30 weeks), lifetime experience of any or specific forms of DV was measured. Infant feeding practice information was collected from 0 to 6 months at 15 d intervals. Matlab, Bangladesh. Pregnant and postpartum women (n 3186) and their infants. Among women in the UHM group, those who had experienced any lifetime DV exclusively breast-fed for a shorter duration than women who did not experience any lifetime DV (P=0·02). There was no difference, however, in duration of EBF among women in the BFC group based on their experience of any lifetime DV exposure (P=0·48). Using Cox regression analysis, there was an interaction of exposure to any lifetime DV, sexual violence and controlling behaviour, and counselling group with duration of breast-feeding at or before 6 months (P-interaction≤0·08). Among the UHM group, experience of any lifetime DV, sexual violence or controlling behaviour was associated with fewer days of EBF (P<0·05). In contrast, among the BFC group, experience of DV was not associated with duration of EBF. The experience of DV compromises EBF and the support of breast-feeding counselling programmes could assist this vulnerable group towards better infant feeding practices.

Domestic violence and its associated factors among married women of a village development committee of rural Nepal.

BackgroundViolence against women is a global public health problem occurring in multitude of contexts and domestic violence is considered to be the most pervasive one. Poor enforcement of policies, limitation of researches and expertise in this field largely accounts for persistence of this problem and nature of domestic violence and its associated factors are poorly understood.ObjectivesThis research aimed to estimate the magnitude of different forms of domestic violence and identify its associated factors.MethodsCommunity based cross sectional study was conducted among 355 married women of reproductive age group of Kusheshwor, Sindhuli, Nepal. The questionnaire adapted from the World Health Organization Multi-Country Study was used for the face to face interviews. Occurrence of current domestic violence was used as outcome variable in logistic regression. Descriptive and multivariate analysis were performed in order to assess the magnitude of domestic violence and to identify its associated factors respectively.ResultsSelf-reported lifetime prevalence of physical violence was 29.6 % and past year prevalence was 15.2 %, while corresponding figures for sexual violence were 6.8 and 2.3 %, and for psychological violence were 31.0 and 18.3 %. Lifetime domestic violence was 38.6 % while in past 12 months, prevalence was 23.1 %. Furthermore, 12.4 % of women were experiencing all forms of violence concurrently. Women with controlling husband and having poor mental health were found to be at higher risk of domestic violence.ConclusionsDomestic violence is still rampant in our society with several forms of violence occurring together. In a country like Nepal, differentials power in relationship and poor mental health was found to be positively associated with violent episodes. This study highlights the infringement of women rights which can be the cause for serious public health consequences.

Variation in the Prevalence of Domestic Violence between Neighboring Areas.

Domestic violence against women is an important health issue, but few studies have focused on city of residence and ethnic differences. To estimate the prevalence of various forms of domestic violence and certain related factors, with a specific focus on city of residence and ethnicity, we studied 1820 married women attending public health centers in 4 large cities in Khuzestan Province, southwestern Islamic Republic of Iran. We used an interviewer-administered questionnaire for data collection. The prevalence of some forms of lifetime domestic violence against women was 47.3%. The prevalence of physical, psychological, and any form of lifetime violence was the highest in Dezful (25.7%, 54.8%, and 57.7%, resp.). For sexual violence, the highest prevalence was reported in Ahvaz (17.7%). The highest prevalence of physical and sexual violence during any point of life was reported by Arab women (25.1% and 16.7%). The experience of all forms of violence was significantly associated with city of residence. Results of regression logistic analysis revealed that all of the forms of violence except psychological violence were statistically significantly associated with ethnicity (P < 0.05).

Factors associated with the anonymous reporting of lifetime domestic violence in a genitourinary medicine clinic: a patient self-reported questionnaire study

Domestic violence (DV) occurs frequently within the UK, with one in four women and one in six men experiencing DV during their life. DV is the leading cause of morbidity for women aged 19-44 years and is associated with sexual health problems. However, few data exist on the prevalence of DV in UK genitourinary (GU) medicine settings. An anonymous questionnaire was self-completed by patients (n = 476/500) attending Bournemouth GU medicine clinic during July 2009 to explore associations between lifetime DV and sociodemographic, sexual and behavioural factors. Overall, 21% (98/472) reported that they had ever been abused by a partner (12% [27/229] of men and 29% [71/243] of women). Logistic regression highlighted that being female, having children/dependants and use of illicit drugs were the most important factors associated with lifetime DV. Regular staff training on DV is recommended to increase awareness and signposting to relevant services.

829 – Domestic violence and mental disorders

Background There is little known about the extent to which men and women with mental disorders are at increased risk of being a victim of domestic violence. We therefore aimed to estimate the prevalence and risk of domestic violence victimisation among men and women with depressive and anxiety disorders, post-traumatic stress disorder, eating disorders, psychotic disorders, and among psychiatric service users. Methods We searched 18 biomedical and social sciences databases (including MEDLINE, EMBASE and PsycINFO) and supplemented the search by hand searching of key journals and reference lists of included articles, citation tracking, expert recommendations, and updating a systematic review on victimisation among people with mental disorders. We included cross sectional, cohort and experimental studies that reported on the prevalence and/or risk of adulthood domestic violence victimisation among people meeting either ICD or DSM diagnostic criteria for a mental disorder. Two reviewers independently extracted data and appraised study quality. Random effects meta-analysis was used to pool data where possible. Findings High quality papers reported a median prevalence of adult lifetime domestic violence in mental health service users of 30% (IQR 26% - 39%) in female inpatients and 33% (IQR 31%-53%) in female outpatients. There was an increased risk of experiencing domestic violence in all diagnostic groups and in men and women but there were few high quality studies for men. Interpretation Mental disorder is associated with a high prevalence and increased risk of being a victim of domestic violence in both men and women.

Domestic Violence Against Women: Systematic Review of Prevalence Studies

To systematically review the worldwide evidence on the prevalence of domestic violence against women, to evaluate the quality of studies, and to account for variation in prevalence between studies, using consistent definitions and explicit, rigorous methods. Systematic review of prevalence studies on domestic violence against women. Literature searches of 6 databases were undertaken for the period 1995 to 2006. Medline, Embase, Cinahl, ASSIA, ISI, and International Bibliography of the Social Sciences were searched, supplemented by hand searching of the reference lists from studies retrieved and specialized interdisciplinary journals on violence. A total of 134 studies in English on the prevalence of domestic violence against women, including women aged 18 to 65 years, but excluding women with specific disabilities or diseases, containing primary, empirical research data, were included in the systematic review. Studies were scored on eight pre-determined criteria and stratified according to the total quality score. The majority of the sudies were conducted in North America (41%), followed by Europe (20%). 56% of studies were population-based, and 17% were carried out either in primary or community health care settings. There was considerable heterogeneity both between and within geographical locations, health care settings, and study quality The prevalence of lifetime domestic violence varies from 1.9% in Washington, US, to 70% in Hispanic Latinas in Southeast US. Only 12% scored a maximum of 8 on our quality criteria, with 27% studies scored 7, and 17% scored 6. The mean lifetime prevalence of all types of violence was found to be highest in studies conducted in psychiatric and obstetric/gynecology clinics. Results of this review emphasize that violence against women has reached epidemic proportions in many societies. Accurate measurement of the prevalence of domestic violence remains problematic and further culturally sensitive research is required to develop more effective preventive policies and programs.

Violence and depressive symptoms during pregnancy: a primary care study in Brazil

To estimate the prevalence of violence, depressive symptoms, and associated factors during pregnancy in women attending antenatal care in Brazil. Violence was assessed using a modified version of the abuse assessment screen (ASS), and depressive symptoms were evaluated using the primary care evaluation of mental disorders (PRIME-MD). Participants were pregnant women attending 18 primary care units in Rio Grande do Sul, Brazil, between June 2006 and April 2007. A total of 712 pregnant women participated, but only 627 of them responded the ASS. Experience of any lifetime violence was reported by 273 (43.4%) women and 114 (18.2%) reported violence during the current pregnancy. One-third of them (n=211) reported lifetime domestic violence and 100 (15.9%) women reported this type of violence during the current pregnancy. Experience of domestic violence during pregnancy was more common in unemployed women, among those with two or more children, with a higher consumption of alcohol, and who had not planned their current pregnancy. Of the total of sample (n=712), 198 (27.8%) women reported six or more depressive symptoms. The presence of depressive symptoms during pregnancy was associated with low educational levels, living in a household with five or more people, and with higher consumption of alcohol during pregnancy. Pregnant women attending primary care are exposed to high rates of domestic violence, and many have clinically relevant depressive symptoms. Appropriate interventions to avoid or minimize the effects of violence and mental disorders to the well-being of the mothers and their babies are urgently required. Primary care services play an important role in identifying and supporting women at risk.

Detection of Domestic Violence by a Domestic Violence Advocate in the ED

Background: The current domestic violence (DV) literature has evaluated the incidence and prevalence of DV via written surveys and verbal questioning performed by a variety of health care professionals. Objectives: We sought to examine the prevalence of DV as obtained by a full-time, trained DV advocacy coordinator using direct patient interviewing in our emergency department (ED), and to compare our results with the published literature. Methods: The DV advocacy coordinator randomly selected and interviewed female patients presenting to the ED with various complaints during daytime hours. Participation was voluntary, and patients were excluded if they were too ill or injured to answer questions. We performed a retrospective review of data obtained through our DV advocacy coordinator's screening interviews of female patients presenting to the ED over a period of 1 year. Acute incidence and lifetime prevalence of DV was determined and compared to results reported in the literature. Results: The domestic violence advocacy coordinator screened a total of 1550 patients over the study period. Domestic violence incidence and lifetime prevalence as detected by the coordinator was determined to be 4.8% (95% confidence interval [CI] 3.9–6.0%) and 27.5% (95% CI 25.3–29.8%), respectively. Conclusions: Although the lifetime DV prevalence of 27.5% uncovered by our trained DV advocacy coordinator is similar to other reports, the acute incidence of 4.8% is higher than most other reported results using personal interviews. The use of a trained DV coordinator may improve detection rates of domestic violence in the ED.

Domestic abuse in the emergency department: can a risk profile be defined?

The main purpose of this study was to determine whether any clinical or demographic characteristics could identify adult female patients presenting to the emergency department (ED) with a history of domestic abuse. A second objective was to describe the frequency, types, and severity of this abuse. This study was a crosssectional survey of 611 women conducted in an academically-affiliated, urban ED. Domestic abuse was described as "recent" (within the preceding 12 months) or "lifetime" (recent or past). This included emotional, physical, and sexual abuse. Recent (7.9%, n = 48) and lifetime (38%, n = 232) domestic abuse was reported. For recently abused women, violence had been severe (87.5%, n = 42) and was associated with 1) trauma (OR 5.4, 95% CI = 2.6 to 11.6), 2) obstetrical and gynecological syndromes (OR 5.6, 95% CI = 2.4 to 13.2), and 3) psychiatric symptoms and substance use (OR 7.3, 95% CI = 2.4 to 22.0). The sensitivities and positive predictive values of these risk factors individually (<27.1% and <25.0%, respectively) and in aggregate (56.3% and 20.9%, respectively) were low. These indicators predicted only 27 (56.3%) of recently abused women. Lifetime domestic violence was more likely in homeless women (OR 5.8, 95% CI = 2.2 to 15.0), although less likely in immigrants (OR 0.4, 95% CI = 0.3 to 0.7). Clinical presentations and demographic characteristics of women presenting to the ED may not be sensitive or predictive indicators of domestic abuse. In the absence of typical clinical or demographic findings, asking all women in the ED about domestic abuse remains a necessary priority.