Past Intimate Partner Violence Research Articles

Frequency of intimate partner violence history in gynecologic and breast cancers

OBJECTIVES: Intimate partner violence (IPV) has been linked to cancer-related well-being. Frequency of IPV and sexual violence among women with cancer by specific cancer site has not been well characterized. Here the frequency of self-reported current and lifetime IPV was estimated among women diagnosed with cancer by primary site and the potential impact of IPV on delaying detection measured as stage at diagnosis. Methods: Women, ages 18 to 79 years, with an incident, primary, biopsy-confirmed cancer were recruited from 2 state cancer registries (Kentucky and North Carolina) within 12 months of their diagnosis (2009-2015). In a phone interview, consenting women reported current and past IPV experiences, current partner interfering behavior (PIB), sociodemographics, and cancer-related well-being indicators. Cancer registries provided stage, site, date of diagnosis, and age. Multivariable logistic regression analyses were used to determine whether women experiencing lifetime or current IPV or PIB were more likely to present (1) at a later stage at diagnosis, or (2) with specific cancer sites: cervical/vulvar, endometrial, and ovarian cancer relative to breast cancer. Results: A total of 2,320 women were included in the analysis. Of these, 1,981 had breast cancer, 158 had endometrial cancer, 84 had ovarian cancer, and 97 had cervical or vulvar cancer. Of women with cervical or vulvar cancer, 57.3% disclosed IPV or PIB, which was significantly higher than seen in the breast cancer group (37.2%, P Conclusions: Cervical and vulvar cancer are associated with an increased likelihood of lifetime IPV compared with other gynecologic cancer or breast cancer patients. IPV history is correlated with cancer-related well-being and may be an important determinant of quality of life. Copyright © 2015 Published by Elsevier Inc. Language: en

Intimate Partner Violence Screening in a Women Veterans’ Health Clinic: Assessing Feasibility

Women presenting for care within a suburban Department of Veterans Affairs Hospital (VA) were screened for intimate partner violence (IPV). This study aimed to explore the feasibility of screening for IPV within a VA women’s health clinic, assess how well the screening measure captured women veterans’ experiences of IPV, and compare clinical correlates of IPV in women veterans who have and have not experienced IPV. Of 96 eligible women, 93 (97 %) answered a self-report question regarding experience of lifetime IPV and 72 (75 %) participated in a standardized screening. Among participants, 42 (47 %) reported experiencing past or current IPV, and of those, 11 (25 %) reported that they were currently experiencing IPV, and 31 (70 %) reported that they had experienced IPV in their past. Screening for IPV among women veterans in a women’s health clinic is feasible and identifies women who experience IPV, offering opportunities for referral and intervention.

High-frequency intimate partner violence during pregnancy, postnatal depression and suicidal tendencies in Harare, Zimbabwe

Intimate partner violence (IPV) is a common form of violence experienced by pregnant women and is believed to have adverse mental health effects postnatally. This study investigated the association of postnatal depression (PND) and suicidal ideation with emotional, physical and sexual IPV experienced by women during pregnancy. Data were collected from 842 women interviewed postnatally in six postnatal clinics in Harare, Zimbabwe. We used the World Health Organization versions of IPV and Centre for Epidemiological Studies - Depression Scale measures to assess IPV and PND respectively. We derived a violence severity variable and combined forms of IPV variables from IPV questions. Logistic regression was used to analyse data whilst controlling for past mental health and IPV experiences. One in five women [21.4% (95% CI 18.6-24.2)] met the diagnostic criteria for PND symptomatology whilst 21.6% (95% CI 18.8-24.4) reported postpartum suicide thoughts and 4% (95% CI 2.7-5.4) reported suicide attempts. Two thirds (65.4%) reported any form of IPV. Although individual forms of severe IPV were associated with PND, stronger associations were found between PND and severe emotional IPV or severe combined forms of IPV. Suicidal ideation was associated with emotional IPV. Other forms of IPV, except when combined with emotional IPV, were not individually associated with suicidal ideation. Emotional IPV during pregnancy negatively affects women's mental health in the postnatal period. Clinicians and researchers should include it in their conceptualisation of violence and health. Further research must look at possible indirect relationships between sexual and physical IPV on mental health.

Overcoming Abuse: A Phenomenological Investigation of the Journey to Recovery From Past Intimate Partner Violence.

To date, minimal research has focused on the recovery process for survivors of intimate partner violence (IPV). This study utilized a phenomenological methodology to understand the lived experiences of survivors of IPV ( N = 123) who had overcome abusive relationships and created violence-free and meaningful lives. The researchers aimed to understand key factors involved in their recovery processes. Results indicated two main processes in the IPV recovery process: intrapersonal processes and interpersonal processes. Intrapersonal processes included (a) regaining and recreating one's identity, (b) embracing the freedom and power to direct one's own life, (c) healing from the mental and physical health symptoms of the abuse, (d) fostering acceptance and forgiveness with self and abuser, (e) education and examination of abusive relationships, (f) determining whether and how to enter new intimate relationships, and (g) acknowledging the long-term process of overcoming abuse. Interpersonal processes included themes of (a) building positive social support and relationships and (b) using ones' experiences with abuse to help others. Results of the present study are presented, and implications for practitioners are discussed.

Intimate Partner Violence and Communication of HIV Diagnosis in Rakai, Uganda

Individuals who communicate their HIV diagnosis to sexual partners may be at increased risk of intimate partner violence (IPV). The authors examined past year self-reported IPV associated with communication of HIV diagnosis and other factors, in a sample of 679 sexually active; HIV-positive individuals age 18 to 49, who received HIV results and posttest counselling 12 months or more prior to the survey in Rakai, Uganda, using log-binomial multivariable regression. The rates of verbal and physical abuse among married individuals were significantly higher compared to unmarried persons, respectively. Physical abuse was significantly higher among women compared to men. IPV was not significantly associated with communication of HIV diagnosis. Interventions to prevent IPV among married HIV-positive individuals particularly women, at the community level, are needed.

Intimate partner violence and repeat induced abortion in Italy: A cross sectional study

Objective To investigate the impact of intimate partner violence (IPV) on the risk of repeat induced abortion (RIA), we compared IPV history among women with and without previous induced abortion (IA).Methods All consecutive women aged 18 years or more requiring IA in 12 Italian abortion clinics were eligible for inclusion in the study. They were asked to fill in an anonymous, self-developed questionnaire assessing sociodemographic data and their history of different types of violence and related risk factors.Results The analysis included 1030 women, 624 (60.6%) of whom reported a previous IA. Past or current IPV was reported by 19.3%: 7.0% reported sexual violence, 11.3% physical abuse and 12.1% psychological abuse. Past or current IPV was reported by 22.3% of women with RIA and 14.8% of those undergoing their first IA (adjusted odds ratio 1.57, 95% confidence interval 1.07–2.30; p = 0.02). When we considered sexual, psychological and physical abuse separately, we found that any kind of abuse was more frequent in women with RIA than in women with no previous IA.Conclusion This study underlines the impact of IPV on the risk of RIA and suggests the need for screening for IPV among women requiring abortion, in order to identify women at risk of RIA and to improve their general and reproductive health.Chinese 摘要：目的：为了研究亲密伴侣暴力对反复人工流产的影响，我们比较了既往有亲密伴侣暴力病人有无反复流产史。方法：在意大利12所堕胎诊所需要行人工流产术的所有的18周岁及以上的妇女符合此研究的纳入标准，她们需要填写一份匿名的、自主研发的问卷，调查研究社会人口数据和既往的暴力性质及与此相关的影响因素。结果：共有1030人纳入研究，其中的624（60.6%）既往有过人工流产史。目前的研究表明亲密伴侣暴力的发生率为19.3%，其中7.0%为性暴力，11.3%躯体虐待，12.1%为心理暴力。目前的研究提出，既往有过人工流产史的妇女中发生亲密伴侣暴力的概率是22.3%，第一次行人工流产的妇女中亲密伴侣暴力的发生率是14.8%（调整后OR=1.57,95%CI 1.07-2.30,P=0.02）。当我们将性、躯体、心理的虐待分开来考虑，发现不同形式的虐待在既往有人工流产史的妇女中的发生频率均高于在初次行人工流产的妇女的发生频率。结论：这项研究强调了亲密伴侣暴力对反复人工流产的影响，建议在妇女需要行人工流产时调查有无亲密伴侣暴力的存在，从而识别有无反复人工流产的危险因素，并提高妇女的健康及生殖健康。关键词：亲密伴侣暴力，人工流产， 流行病学，危险因素，性虐待

Exploring Risk and Protective Factors for Recent and Past Intimate Partner Violence Against New Zealand Women.

The purpose of this investigation was to identify risk and protective factors associated with intimate partner violence (IPV) in a high-income country (New Zealand) and to identify those factors that distinguish between current versus previous exposure to IPV. Data were drawn from the New Zealand replication of the World Health Organization's Multi-Country Study on Women's Health and Domestic Violence. Logistic regression was conducted to identify those variables associated with experience of IPV. Problem drinking, a partner who has concurrent sexual relationships, and a partner who is violent outside the home were associated with increased likelihood of current as opposed to previous experience of IPV. Increased household income and both the respondent and her partner being employed were associated with reduced likelihood that women would experience current as opposed to prior IPV. The findings point toward the need for comprehensive approaches to reduce all forms of violence and to contribute to the primary prevention of IPV. Strategies that address early exposure to violence, problematic alcohol consumption, gender transformative approaches to working with boys and men, and economic empowerment for women may all hold promise.

Intimate partner violence after disclosure of HIV test results among pregnant women in Harare, Zimbabwe.

BackgroundHIV status disclosure is a central strategy in HIV prevention and treatment but in high prevalence settings women test disproportionately and most often during pregnancy. This study reports intimate partner violence (IPV) following disclosure of HIV test results by pregnant women.MethodsIn this cross sectional study we interviewed 1951 postnatal women who tested positive and negative for HIV about IPV experiences following HIV test disclosure, using an adapted WHO questionnaire. Multivariate regression models assessed factors associated with IPV after disclosure and controlled for factors such as previous IPV and other known behavioural factors associated with IPV.ResultsOver 93% (1817) disclosed the HIV results to their partners (96.5% HIV− vs. 89.3% HIV+, p<0.0001). Overall HIV prevalence was 15.3%, (95%CI:13.7–16.9), 35.2% among non-disclosers and 14.3% among disclosers. Overall 32.8% reported IPV (40.5% HIV+; 31.5% HIV− women, p = 0.004). HIV status was associated with IPV (partially adjusted 1.43: (95%CI:1.00–2.05 as well as reporting negative reactions by male partners immediately after disclosure (adjusted OR 5.83, 95%CI:4.31–7.80). Factors associated with IPV were gender inequity, past IPV, risky sexual behaviours and living with relatives. IPV after HIV disclosure in pregnancy is high but lower than and is strongly related with IPV before pregnancy (adjusted OR 6.18, 95%CI: 3.84–9.93).ConclusionThe study demonstrates the interconnectedness of IPV, HIV status and its disclosure with IPV which was a common experience post disclosure of both an HIV positive and HIV negative result. Health services must give attention to the gendered nature and consequences of HIV disclosure such as enskilling women on how to determine and respond to the risks associated with disclosure. Efforts to involve men in antenatal care must also be strengthened.

Acceptance of wife beating and its association with physical violence towards women in Nepal: a cross-sectional study using couple's data.

BackgroundIntimate partner violence (IPV) is a serious global public health issue. Acceptance of wife beating is known to be associated with IPV, but few studies have analysed the acceptance of wife beating from both women and men’s points of view. The objective of this study was to examine whether acceptance of wife beating among couples is associated with lifetime and past one-year physical IPV perpetration towards wives in Nepal.MethodsA cross-sectional study was conducted from August to September 2011, with 717 randomly selected couples with wives aged 18 to 49 years old from the Kirtipur municipality and Bhaktapur district of Nepal. Wives’ and husbands’ acceptance of wife beating was measured by six scale items, while physical IPV experience among wives was measured by seven physical assault scale items. To assess the association between acceptance of wife beating and physical IPV, multiple logistic regression analysis was used.ResultsNearly 30% of wives and husbands indicated that beating of wives is acceptable under certain circumstances. Statistically, no significant difference was detected between wives’ and husbands’ level of acceptance of wife beating. However, husbands’ acceptance of wife beating was positively associated with lifetime and past one-year perpetration of physical IPV, whereas wives’ acceptance of wife beating was neither associated with lifetime nor past one-year victimization of physical IPV. The positive association for husbands remained even after controlling for their partner’s factors.ConclusionsAcceptance of wife beating is an important risk factor, which must be considered to prevent perpetration of physical IPV towards wives in Nepal. Future studies should include men to better understand the structure and dynamics of IPV in Nepal, and prevention programs should also target men to change their attitudes or to identify which couples are at more risk of physical IPV occurring toward wives.

Documentation of Intimate Partner Violence in Women Veterans’ Medical Records: An In-Depth Analysis

National guidelines for identifying and addressing intimate partner violence (IPV) in the health care setting recommend that health care practitioners screen for IPV experiences and document disclosure and response in patients’ medical records. Women veterans are a growing population with particular risk of lifetime IPV victimization, yet we know little about how IPV presents and is addressed within the Veterans Health Administration (VHA). The purpose of this study was to examine documentation of women veterans’ disclosed experiences of IPV victimization in electronic medical records to identify how IPV presents in the VHA and to compare IPV screening, assessment, and response at a VHA medical center to nationally recognized best practices. We reviewed medical records for a five-year period (2005 to 2009) of 533 women veteran patients receiving care at an urban Veterans Affairs (VA) medical center and analyzed documentation of IPV disclosure and clinician response for patients with any documentation of IPV (N = 126). Women veterans presented with both acute and chronic IPV victimization experiences, as well as long-term effects of past IPV. Documentation of screening and response revealed opportunities for improvement to meet best practices.

Patterns of Resource Utilization and Mental Health Symptoms Among Women Exposed to Multiple Types of Victimization

Although the value of resources aimed to support women who experience intimate partner violence (IPV) is clear, few studies have investigated how exposure to multiple types of victimization influences women's resource utilization. We applied latent class analysis (LCA) to a sample of 412 women who used IPV in their current relationships to test whether women's resource utilization is associated with different patterns of victimization, including current IPV victimization, past IPV victimization, and childhood victimization. Three classes of women were identified: the Low Cumulative IPV class (n = 121) included women with a low prevalence of past IPV victimization and low severity of current IPV victimization; The High Past/ Low Current IPV class (n = 258) included women with a high prevalence of past IPV victimization but low severity of current IPV victimization; and the High Cumulative IPV class (n = 33) included women with a high prevalence of past IPV victimization and severe current IPV victimization. Multiple types of childhood victimization were highly prevalent among women in all three classes. Women in the High Cumulative IPV class used a greater variety of resources, experienced a greater number of posttraumatic stress and depression symptoms, drug problems, and used more severe IPV aggression compared to women in other classes. These findings highlight the heterogeneity of resource utilization among women in relationships characterized by bidirectional IPV and underscore the potential clinical utility of adapting services to meet the specific needs of women with unique profiles of victimization.

Association of Intimate Partner Violence and Childhood Sexual Abuse with Cancer-Related Well-Being in Women

Limited evidence suggests that intimate partner violence (IPV) may be associated with poorer cancer outcomes. We hypothesized that timing and type of IPV as well as childhood sexual abuse (CSA) may negatively affect depression, perceived stress, and cancer-related well-being. This was a cross-sectional study of women diagnosed with either breast, cervical, or colorectal cancer in the prior 12 months included in the Kentucky Cancer Registry. Consenting women were interviewed by phone (n=553). Multivariate analysis of covariance (MANCOVA) was used to determine the association between IPV (37% lifetime prevalence) and type, timing, and the range of correlated cancer-related well-being indicators, adjusting for confounding factors. IPV (p=0.002) and CSA (p=0.03) were associated with the six correlated well-being indicators. Specifically, lifetime and current IPV were associated with lower Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B) (p=0.006) and Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale (FACIT-SP) (p=0.03) scores, higher perceived stress at diagnosis (p=0.006), and depressive symptom scores at diagnosis (p<0.0001), whereas CSA was associated with lower FACT-B (p=0.02), increased number of comorbid conditions (p=0.03), and higher current stress levels (p=0.04). Current and past IPV, as well as psychologic abuse, were associated with poorer well-being among women with a recent cancer diagnosis. Our results provide evidence that both IPV and CSA negatively influence cancer-related well-being indicators. These data suggest that identification of lifetime IPV and other stressors may provide information that healthcare providers can use to best support and potentially improve the well-being of female cancer patients.

Temporal Relationship Between Intimate Partner Violence and Postpartum Depression in a Sample of Low Income Women

To estimate whether there is a temporal association between Postpartum Depression (PPD) and intimate partner violence (IPV), and to assess the potential role of social support on this relationship. A cross-sectional study was conducted between January 2006 and March 2007 with 701 low income women who received prenatal and postpartum care in primary health care units of the public sector in São Paulo, Brazil. The Self-Report Questionnaire (SRQ-20) was used to assess the presence of PPD. Structured standardized questionnaires were used to assess IPV and social support. The prevalence of PPD was estimated with a 95% confidence interval. Crude and adjusted prevalence ratios were calculated using Poisson regression to examine the association between PPD and exposure variables. Values of p<0.05 were considered statistically significant. The prevalence of PPD was 27.9% (95%CI 24.6:31.2). The prevalence of psychological IPV was 38.6%, physical IPV 23.4%, and sexual IPV 7.1%. The multivariate analysis showed that PPD was strongly associated with current psychological and physical/sexual violence, after controlling for confounding factors, and less so with past (prenatal or lifetime) IPV. Presence of social support was an independent protective factor for PPD. Identifying and addressing intimate partner violence, including psychological violence, in the postpartum period should be considered as part of a comprehensive approach to caring for new mothers.

Rethinking Social Support and Conflict: Lessons from a Study of Women Who Have Separated from Abusive Partners

Relationships have both positive and negative dimensions, yet most research in the area of intimate partner violence (IPV) has focused on social support, and not on social conflict. Based on the data from 309 English-speaking Canadian women who experienced IPV in the past 3 years and were no longer living with the abuser, we tested four hypotheses examining the relationships among severity of past IPV and women's social support, social conflict, and health. We found that the severity of past IPV exerted direct negative effects on women's health. Similarly, both social support and social conflict directly influenced women's health. Social conflict, but not social support, mediated the relationships between IPV severity and health. Finally, social conflict moderated the relationships between social support and women's health, such that the positive effects of social support were attenuated in the presence of high levels of social conflict. These findings highlight that routine assessments of social support and social conflict and the use of strategies to help women enhance support and reduce conflict in their relationships are essential aspects of nursing care.

Markers of Inflammation in Midlife Women with Intimate Partner Violence Histories

Lifetime occurrence of intimate partner violence (IPV) in women has been associated with increased prevalence of aging-related chronic diseases, including those with a pathophysiology involving inflammation. To begin to identify potential biologic mediators of this relationship, this cross-sectional study examined associations between past IPV and circulating levels of C-reactive protein (CRP) and interleukin-6 (IL-6)-measures linked with emergence of aging-related diseases-along with in vitro IL-6 production by peripheral blood mononuclear cells (PBMC) stimulated with either phytohemagglutinin A (PHA) or lipopolysaccharide (LPS). Apparently healthy, midlife women with divorce histories were recruited from the community. Histories of intimate partner psychological aggression, physical assault, sexual coercion, and stalking were assessed, along with current depression, posttraumatic stress symptoms, and health-related characteristics. At two visits, blood was drawn for assessment of biologic measures; measures were averaged across visits. In this sample (n=68), a history of being stalked was significantly positively correlated with CRP levels; in a multiple regression analysis that included body mass index (BMI) and current symptoms, this association was attenuated by adjusting for BMI. Physical assault history was significantly negatively correlated with PHA-stimulated IL-6 production. This was most apparent for severe assault and was not accounted for by BMI or symptoms. IPV histories remitted for an average of 10 years were associated with biologic mediators of inflammation. The profile was not uniformly proinflammatory, suggesting that in situations of traumatic or chronic stress, different aspects of the inflammatory response are differentially regulated and subjected to diverse compensatory mechanisms.

Intimate Partner Violence Exposure Predicts PTSD Treatment Engagement and Outcome in Cognitive Processing Therapy

Intimate partner violence (IPV) exposure was examined as a predictor of treatment engagement (i.e., starting and completing therapy) and treatment outcome in 150 women taking part in a dismantling study of cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD; Resick et al., 2008). Results indicate that women in a current intimate relationship with recent IPV (i.e., past year) were less likely to begin treatment relative to women who reported past IPV only or no history of IPV. For women who began treatment, IPV exposure was not predictive of whether or not they completed treatment. Among women who began treatment, the frequency of IPV was associated with treatment outcome such that women who experienced more frequent IPV exhibited larger reductions in PTSD and depression symptoms over the course of treatment, but experienced similar levels of PTSD and depression severity at the 6-month follow-up. Findings highlight the importance of targeting treatment engagement among women who report recent IPV and suggest that women who have experienced frequent IPV respond well to CPT treatment in spite of their IPV experiences.

Correlations among inflammatory markers in plasma, saliva and oral mucosal transudate in post-menopausal women with past intimate partner violence

The relationship between psychosocial factors and an increased risk for disease has been related to a heightened pro-inflammatory status reflected in increased circulating levels of pro-inflammatory cytokines and/or C-reactive protein (CRP). Routinely, epidemiological studies rely on measurements of inflammatory markers in serum or plasma, but the use of biological fluids such as saliva or oral mucosal transudate (OMT) may offer potential advantages. This study investigated correlations among plasma CRP and levels of IL-6 and soluble IL-6 receptor (sIL-6R) in plasma, saliva and OMT in a population of middle aged women with histories of past intimate partner violence (IPV). A total of 67 women without existing chronic diseases participated in the study, which included two visits each in which psychological tests were administered, and blood, saliva and OMT samples were collected. Although significantly higher plasma CRP levels were found in past IPV sufferers compared to controls, there were no significant differences in IL-6 or sIL-6R levels in plasma, saliva or OMT between the two groups. There were only relatively modest correlations between IL-6 levels in plasma and those in saliva or OMT and between plasma IL-6 and CRP levels. A significant correlation between IL-6 and sIL-6R levels in both saliva and OMT, but not in plasma, was also detected. No significant correlations were found between levels of IL-6 in saliva or OMT and periodontal health measures. Results indicate that IL-6 and sIL-6R levels in saliva or OMT do not closely reflect those in plasma, and therefore are not a good surrogate for systemic levels.

Impact of Current and Past Intimate Partner Violence on Maternal Mental Health and Behaviour at 2 Years After Childbirth: Evidence from the Pacific Islands Families Study

The present study examined the association between maternal intimate partner violence (IPV) at 6 weeks and 24 months postpartum and maternal health problems in a cohort of Pacific families with 2-year-old children in New Zealand. Data were gathered from the Pacific Islands Families Study. Mothers of a cohort of Pacific infants born in Auckland, New Zealand during 2000 were interviewed when the children were 6 weeks and 24 months of age. There were 828 mothers cohabiting in married or de facto partnerships who completed measures of IPV, mental health, and health-related behaviour such as smoking and high-risk alcohol use at both data points. The main statistical method used was logistic regression analysis. Compared to mothers who did not experience physical violence at either data point, the odds of reporting psychological distress were 2.42 (95% confidence interval (CI) = 1.07-5.44) for those experiencing physical violence at 6 weeks only, 3.47 (95%CI = 1.75-6.86) for those experiencing physical violence at 24 months only, and 3.84 (95%CI = 1.78-8.30) for those experiencing physical violence at both data points after controlling for sociodemographic factors. Mothers experiencing verbal aggression or physical violence at both data points were more likely to report smoking or high-risk alcohol use at 24 months than those who did not, but the associations were no longer significant after controlling for sociodemographic factors. Being a victim of intimate partner physical violence at any time (past, recent and repeated) may contribute to an increase in maternal psychological distress. Health-related behaviours such as smoking and high-risk alcohol use at 24 months postpartum may to some degree be attributable to repeated victimization of physical violence and verbal aggression, but the relationships are not convincing and deserve further research in longitudinal studies.

Modelling the effects of intimate partner violence and access to resources on women's health in the early years after leaving an abusive partner

Although the negative health effects of intimate partner violence (IPV) are well documented, little is known about the mechanisms or determinants of health outcomes for women who had left their abusive partners. Using data collected from a community sample of 309 Canadian women who left an abusive partner, we examined whether women's personal, social and economic resources mediate the relationships between the severity of past IPV and current health using structural equation modelling. A good fit was found between the model and data for hypothesized models of mental and physical health. In the mental health model, both the direct and total indirect effects of IPV were significant. In the physical health model, the direct effect of IPV on physical health was about four times as large as the total indirect effects. In both models, more severe past IPV was associated with lower health and women's personal, social, and economic resources, when combined, mediated the relationship between IPV and health. These findings demonstrate that the health outcomes of IPV for women who have left an abusive partner must be understood in context of women's resources.

Sex-Symmetric Effects of Coercive Behaviors on Mental Health?

The present study tested a section of the model of coercion in intimate partner violence (IPV) by investigating the relationships among coercion, IPV and mental health symptoms. The study's sample consisted of 573 culturally diverse university students (age M = 21.4) who completed a survey that measured past IPV victimization, coercive behaviors, and mental health symptoms. Structural equation modeling analyses revealed that coercion was a stronger predictor of adverse mental health symptoms than was IPV victimization. In addition, the study found that the adverse effect of coercive behaviors on mental health symptoms was stronger among female victims of IPV than among male IPV victims. The results have implications for theory building, future research, and mental health professionals who work with female and male victims of IPV.