Intimate Partner Violence and Comorbid Mental Health Conditions Among Urban Male Patients

PURPOSE We wanted to explore the associations between intimate partner violence (IPV) and comorbid health conditions, which have received little attention in male patients.     

Risk Factors for Intimate Partner Violence and Associated Injury Among Urban Women

The objective of this study was to identify risk factors for abuse and IPV related injury among an urban population. This study reports an additional analysis of a case-control study conducted from 1994 to 2000 in 11 USA metropolitan cities where of 4746 women, 3637 (76.6%) agreed to participate. Control group women (N = 845) were identified through random digit dialing. Significant risk factors for abuse included women’s young age (adjusted odds ratio (AOR) 2.05 p = .011), being in fair or poor mental health (AOR 2.65 p < .001), and former partner (AOR 3.33 p < .001). Risk factors for partners perpetrating IPV included not being a high school graduate (AOR 2.06 p = .014), being in fair or poor mental health (AOR 6.61 p < .001), having a problem with drug (AOR 1.94 p = .020) or alcohol use (AOR 2.77 p = .001), or pet abuse (AOR 7.59 p = .011). College completion was observed to be protective (AOR 0.60, p < .001). Significant risk factors for injury included partner’s fair or poor mental health (AOR 2.13, p = .008), suicidality (AOR 2.11, p = .020), controlling behavior (AOR 4.31, p < .001), prior domestic violence arrest (AOR 2.66, p = .004), and relationship with victim of more than 1 year (AOR 2.30, p = .026). Through integration of partner related risk factors into routine and/or targeted screening protocols, we may identify more abused women and those at greater risk of abuse and injury.     

Validity of the Brief Inpatient Screen for Intimate Partner Violence Among Adult Women

Background: Identifying intimate partner violence in healthcare settings is becoming the standard of care. The Brief Inpatient Screen was designed to assess recent emotional, physical, and sexual abuse in a general inpatient medical-surgical setting and compared to the Composite Abuse Scale. Methods: Researchers matched “cases” (inpatients screening Brief Inpatient Screen-positive) to up to four “controls” (inpatients screening Brief Inpatient Screen-negative). Forty-six female hospital inpatients ages 18–64 years completed a self-administered survey. The sensitivity and specificity of the Brief Inpatient Screen and its subscales were compared to the Composite Abuse Scale. Researchers examined the performance of the Brief Inpatient Screen when used as a verbal screen versus an anonymous written screen. Results: Twelve of 46 participants (26%) had a positive screen. Compared to the Composite Abuse Scale, the overall sensitivity and specificity of the verbal Brief Inpatient Screen were 52.6% (95% CI 28.9–75.6) and 92.6% (95% CI 75.7–99.1), respectively. The written Brief Inpatient Screen showed improved sensitivity overall (68.4%, 95% CI 43.5–87.4) for the most severe intimate partner violence. Subscale analysis revealed greater sensitivity for emotional and severe combined intimate partner violence. Conclusions: The verbal Brief Inpatient Screen, when compared to the Composite Abuse Scale, was limited in its ability to identify intimate partner violence. An anonymous written format improved sensitivity. Future research should optimize intimate partner violence screening among inpatients.     

Domestic Violence Against Women and Their Mental Health Status in a Colony in Delhi

Background:

Violence against women is a major public health and human rights issue in the world today. This study was conducted to assess the consequences of domestic violence on the mental health of women of reproductive age group.

Materials and Methods:

A community-based, cross-sectional study was conducted in Raj Nagar- I, urban locality in west Delhi near Palam. 350 women of 15-49 years age group residing in the community were selected by stratified random sampling. These women were administered an interview schedule adapted from WHO multi-country study on women’s health and domestic violence. They were assessed for the presence of domestic violence. Mental health status of these women was estimated by using self-reporting questionnaire 20. Data were analyzed using SPSS 12 software. The test applied was chi square test for proportion and binary logistic regression.

Results:

42.8% of the women reported one or the other types of violence. 34.9% of the women reported either physical or sexual violence ever in life. 29.1% of the women reported either physical or sexual violence in past 1 year (current violence). 12% of the women reported mental ill health. Women who had experienced domestic violence were more likely to report mental ill health status and suicidal tendencies as compared to women who had not experienced violence.

Conclusions:

Domestic violence is associated with mental ill health.     

Intimate Partner Violence and Consistent Condom Use Among Drug-Using Heterosexual Women in New York City

The present study examined the associations of relationship factors, partner violence, relationship power, and condom-use related factors with condom use with a main male partner among drug-using women. Over two visits, 244 heterosexual drug-using women completed a cross-sectional survey. Multivariate logistic regression models indicated that women who expected positive outcomes and perceived lower condom-use barriers were more likely to report condom use with their intimate partners. The findings suggest that future interventions aiming at reducing HIV risk among drug-using women should focus on women's subjective appraisals of risks based on key relationship factors in addition to the occurrence of partner violence.     

Intimate Partner Violence of Rural Aging Women*

Abstract: Although reports of intimate partner violence (IPV) decrease with age, a significant number of aging women experience IPV in their relationships. The structure and culture of rural environments may inadvertently conceal violence against aging women and inhibit prevention and treatment efforts. Guided by an ecological community framework, 3 focus groups involving 24 professionals working with victims of IPV in rural Kentucky and in‐depth interviews with 10 aging rural women who had experienced IPV were conducted to examine the trajectory of, and community responses to, violence in late life. Findings revealed multiple interacting influences on IPV of aging women in rural areas including the women’s families and resources, culture and locality, religion, community support, and government entities.     

Risk Factors for Severe Intimate Partner Violence and Violence-Related Injuries Among Women in India

Relying on an ecological framework, we examined risk factors for severe physical intimate partner violence (IPV) and related injuries among a nationally representative sample of women (N = 67,226) in India. Data for this cross-sectional study were derived from the 2005–2006 India National Family Health Survey, a nationally representative household-based health surveillance system. Logistic regression analyses were used to generate the study findings. We found that factors related to severe physical IPV and injuries included low or no education, low socioeconomic status, rural residence, greater number of children, and separated or divorced marital status. Husbands’ problem drinking, jealousy, suspicion, control, and emotionally and sexually abusive behaviors were also related to an increased likelihood of women experiencing severe IPV and injuries. Other factors included women’s exposure to domestic violence in childhood, perpetration of IPV, and adherence to social norms that accept husbands’ violence. Practitioners may use these findings to identify women at high risk of being victimized by severe IPV or injuries for prevention and intervention strategies. Policies and programs that focus on empowering abused women and holding perpetrators accountable may protect women at risk for severe IPV or injuries that may result in death.     

Violence Against Women and Postpartum Depression: The Experience of Chilean Women

This article is based on the findings from a cross-sectional study of women (N = 163) who were at least two weeks postpartum and attending primary care clinics in Arica, Chile. The researcher in this study examined the prevalence of history of violence and its association with postpartum depression. The Women Abuse Screen and the Postpartum Depression Screening Scale–Spanish version were used to assess interpersonal violence and postpartum depression. A history of violence was reported by 64% of the women. Of those who experienced abuse, 44% reported ongoing abuse during their pregnancy. Women who experienced violence screened positive for elevated symptoms categories of postpartum depression such as anxiety/insecurity, emotional lability, and mental confusion compared to women who had not experienced violence. Postpartum depression symptom reporting decreased with increasing number of pregnancies (OR = 0.70, 95% CI 0.54–0.97) and greater social support (OR = 0.64, 95% CI 0.46–0.88). Postpartum depression symptom reporting increased with smoking (OR = 1.71, 95% CI 1.00–2.86), and with reporting history of violence (OR = 1.79, 95% CI 1.24–2.34). Acknowledgment of the strong association between domestic violence and postpartum depression should lead to routine screening during prenatal and postpartum periods as a way to isolate risk for postpartum depression.     

Intersections Between Childhood Abuse and Adult Intimate Partner Violence Among Ecuadorian Women

Objectives Strong linkages exist between childhood abuse and adult intimate partner violence (IPV) among women in developed countries. Few studies examine this pattern in developing nations. This study explores the effect of childhood physical and/or psychological abuse on the likelihood of IPV among a national sample of Ecuadorian women of reproductive age. Methods Secondary data analysis was conducted on a subsample of 9,077 Ecuadorian women, utilizing the 2004 Encuesta Demografía y de Salud Materna e Infantil survey. Cross-tabulations and multivariate logistic regression models were utilized to assess whether women who report childhood abuse had a higher likelihood of reporting sexual, physical or psychological IPV during their lifetimes or within the past year. Results Levels of abuse were high. More than 30% of women reported childhood psychological or physical abuse, and 21% experienced both types of abuse. Forty percent of women reported sexual, physical or psychological IPV during their lifetimes, while 15% reported any form of IPV in the past year. The co-occurrence of childhood psychological and physical abuse was highly predictive of all forms of IPV, with less consistent associations for women who reported only physical or only psychological childhood abuse. Conclusions This study suggests that childhood abuse is an important risk factor for IPV victimization among Ecuadorian women. While this analysis supports findings from developed countries, more cross-cultural research about patterns of violence throughout the life course is needed to develop relevant prevention programs.     

Intimate Partner Violence Associated With Poor Health Outcomes in U.S. South Asian Women

To assess the associations between Intimate Partner Violence (IPV) victimization and health outcomes of South Asian women in Greater Boston. To explore the nature of the health experiences of victimized women in this population. Cross-sectional surveys with a community-based sample of women in relationships with males (n = 208) assessed demographics, IPV history, and health. In-depth interviews were conducted with a separate sample of women with a history of IPV (n = 23). Quantitative data were assessed by logistic regression, qualitative data by a grounded theory approach. Twenty-one percent of the quantitative sample reported IPV in the current relationship. Abused women were significantly more likely than those with no history of IPV in their current relationship to report poor physical health (95% CI = 1.3–12.0), depression (95% CI = 1.8–9.3), anxiety (95% CI = 1.3–6.4), and suicidal ideation (95% CI = 1.9–25.1). Qualitative subjects described how victimization resulted in injury and chronic health concerns and how IPV-induced depression and anxiety affected their sleep, appetite, energy, and wellbeing. Experiences of IPV are related to increased poor health among South Asian women. This elevated risk demands intervention. Healthcare providers should be trained to screen and refer South Asian patients for partner violence. This work was presented as a poster at the Third International Conference on Urban Health, Boston, MA, October 2004. It was awarded Honorable Mention in the Student Abstract Contest (Masters Level). Conflict of Interest: Anita Raj is a volunteer with and advisor to Saheli, the local South Asian CBO of volunteers providing cultural programs in the South Asian community and helping women in crisis. She has provided domestic violence advocacy and community education in the local South Asian community, and she has served as a South Asian Advisor to Asian Task Force Against Domestic Violence (ATFADV), the local Asian domestic violence program in Boston. Both Saheli and ATFADV assisted with recruitment for the current study. Saheli events that were not domestic violence-specific served as venues for recruitment for the cross-sectional study. Saheli and ATFADV cases of domestic violence were referred to the qualitative study.     

Urban Young Women’s Experiences of Discrimination and Community Violence and Intimate Partner Violence

This paper examines the interrelationships between urban young adult women’s experiences of discrimination and community violence and their reports of involvement in intimate partner violence (IPV). We explore whether such experiences are independent risk factors for IPV victimization and perpetration, even when accounting for aggressive behaviors and related risk taking, including drinking and sexual initiation, during early adolescence. We use data from the Reach for Health study, in which a sample of 550 urban African American and Latina women was followed from recruitment in economically distressed middle schools into young adulthood, over approximately 7 years. At the last wave, respondents were 19–20 years old; 28% were raising children. More than 40% reported experiencing at least one form of racial/ethnic discrimination sometimes or often over the past year. About 75% heard guns being shot, saw someone being arrested, or witnessed drug deals within this time period; 66% had seen someone beaten up, 26% had seen someone get killed, and 40% knew someone who was killed. Concurrent reports of lifetime IPV were also high: about a third reported being a victim of physical violence; a similar proportion reported perpetration. Results of multivariate regression analyses indicate that discrimination is significantly associated with physical and emotional IPV victimization and perpetration, controlling for socio-demographic characteristics, including ethnic identity formation, and early adolescent risk behaviors. Community violence is correlated with victimization, but the relationship remains significant only for emotional IPV victimization once early behaviors are controlled. Implications for violence prevention are discussed, including the importance of addressing community health, as well as individual patterns of behavior, associated with multiple forms of violence victimization and perpetration. Stueve is with the Health and Human Development Center, 96 Morton Street, 7th Floor, New York, 10014, New York NY, USA. O`Donnell is with the Health and Human Development, Education Development Center, Newton, MA, USA.     

Intimate Partner Violence and Health Provider Training and Screening in the News

ABSTRACT

Intimate partner violence is a significant women's health issue. Since the news media can play a role in policy development, it is important to understand how newspapers have portrayed training and screening. The purpose of this study was to describe the frequency and nature of print news coverage of health issues related to partner violence, specifically, provider training and screening by health providers. We conducted a content analysis on articles obtained from major city and state capital daily newspapers from 20 states. News articles and editorials mentioning intimate partner violence and provider training and screening were examined for the years 1994 through 2001 (N = 188). Results showed that print news coverage was limited and received low levels of attention, indicating little potential to influence either policy or individual behavior. However, when the issue was covered, little debate or controversy was present, and a broad discussion of the issue was generally provided. News coverage of training and screening could be improved by increasing dissemination of research results, illustrating the policy implications of these issues, and offering resource information to women experiencing violence.     

Preferences for Depression Advice Among Low-Income Women

Maternal and Child Health Journal - Objectives: Because patient reluctance to discuss depression may influence the success of depression interventions, we assessed preferences for the source of...     

An Exploratory Analysis of Intimate Partner Violence and Postpartum Depression in an Impoverished Urban Population

Research on the relationship between intimate partner violence (IPV) and postpartum depression (PPD) is limited. Numerous antecedents and consequences of both IPV and PPD are noted in the literature; however, understanding the mechanisms by which intimate partner violence impacts the postpartum mood are not clearly understood. This study utilized retrospective chart reviews from a pediatric/perinatal social work outreach program to explore urban minority women experiences with IPV and depression both during pregnancy and after. Findings do not suggest a direct relationship between IPV and PPD; however, there was a high co-occurrence of prenatal depression and PPD. The severity of IPV appears to influence the occurrence and acuity of prenatal depression suggesting an indirect relationship. Implications for health and social work practitioners are discussed.     

Police-Reported Intimate Partner Violence During Pregnancy and the Risk of Antenatal Hospitalization

OBJECTIVES: Intimate partner violence (IPV) is a significant public health problem and the abuse of women during pregnancy is of particular concern. Few studies have addressed the relationship between IPV and antenatal hospitalization. This study utilized a novel approach to examine the impact of IPV during pregnancy on antenatal hospitalization not associated with delivery. METHODS: This retrospective cohort study included Seattle women residents 16-49 years of age. Exposed subjects were women with a police-reported IPV incident during pregnancy in the years 1995 through 1998 and who subsequently had a singleton live birth or fetal death. The unexposed group was composed of randomly selected residents with a singleton birth or fetal death and without a police-reported IPV incident during the study period. Linked hospital discharge files and birth records were utilized to determine study outcomes. Logistic regression was used to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI). RESULTS: Women reporting any IPV during pregnancy were twice as likely as unexposed women to experience an antenatal hospitalization not associated with delivery (aAOR 2.39, CI 1.77, 3.24). Women with IPV were more likely to have been hospitalized with a substance abuse-related diagnosis (aOR 2.70, CI 1.52, 4.78) or a mental health-related diagnosis (aOR 1.93, CI 0.96, 3.91). Physical IPV was more strongly associated with antenatal hospitalization than nonphysical IPV or IPV overall. CONCLUSION: This study suggests that women hospitalized during pregnancy, particularly those with substance abuse and mental health-related conditions, may be at high risk for concurrent IPV.     

Recommended Components of Health Care Provider Training Programs on Intimate Partner Violence

Programs that are effective in training health care providers to recognize and meet the needs of victims of intimate partner violence must be identified and replicated. The Centers for Disease Control and Prevention (CDC) has developed criteria for use in developing, enhancing, and evaluating such programs. CDC developed these criteria as a result of continuing efforts to provide useful products for constituents through literature reviews and consultations with experts in the field; evaluations of training programs; creation of an inventory and annotated bibliography of health care provider training programs in the United States and Canada; and development of a framework to assist hospitals and health centers in evaluating their training programs.Training should begin while providers are in professional school and continue in the health care setting. Curricula should be multidisciplinary and should provide information, promote clinical skills, and effectively link providers with resources. Evaluation should assist programs in determining providers’ needs and identifying appropriate materials, trainers, and training strategies. CDC is working to establish scientific evidence that provider training programs are effective and to share successful models with others. Providers have an important role in stopping and ultimately preventing intimate partner violence, but they are not alone in this effort. They need to know how to access the growing network of assistance including women’s advocates, the criminal justice system, and other members of increasingly dynamic community coalitions.