Prevalence and correlates of physical,psychological, and sexual intimate partner violence in Bolivia

Despite increasing awareness that domestic violence is a major public health problem, existing studies focus on physical and sexual violence and give little attention to psychological violence. This study uses data from the 2008 Bolivia Demographic and Health Surveys (BDHS) to examine the prevalence and correlates of physical, sexual, and psychological intimate partner violence in Bolivia. The results show that psychological intimate partner violence is extremely common (affecting nearly one in two women) and often occurs in addition to physical violence. While physical, psychological and sexual intimate partner violence have several common predictors, there are factors that only affect some types of violence. Common risk factors include urban residence, respondent's employment status and having witnessed interparental violence in childhood. Although marital status is not a risk factor for physical violence, unmarried cohabitation is a strong risk factor for psychological intimate partner violence. Our findings highlight the need for research to assess the potential consequences of psychological intimate partner violence, particularly for women's mental health.     

Physical health consequences of physical and psychological intimate partner violence

BACKGROUND: Past studies that have addressed the health effects of intimate partner violence (IPV) have defined IPV as violence based on physical blows that frequently cause injuries. To our knowledge, no epidemiologic research has assessed the physical health consequences of psychological forms of IPV. OBJECTIVE: To estimate IPV prevalence by type and associated physical health consequences among women seeking primary health care. DESIGN: Cross-sectional survey. SETTING AND PARTICIPANTS: A total of 1152 women, aged 18 to 65 years, recruited from family practice clinics from February 1997 through January 1999 and screened for IPV during a brief in-clinic interview; health history and current status were assessed in a follow-up interview. RESULTS: Of 1152 women surveyed, 53.6% ever experienced any type of partner violence; 13.6% experienced psychological IPV without physical IPV. Women experiencing psychological IPV were significantly more likely to report poor physical and mental health (adjusted relative risk [RR], 1.69 for physical health and 1.74 for mental health). Psychological IPV was associated with a number of adverse health outcomes, including a disability preventing work (adjusted RR, 1.49), arthritis (adjusted RR, 1.67), chronic pain (adjusted RR, 1.91), migraine (adjusted RR, 1.54) and other frequent headaches (adjusted RR, 1.41), stammering (adjusted RR, 2.31), sexually transmitted infections (adjusted RR, 1.82), chronic pelvic pain (adjusted RR, 1.62), stomach ulcers (adjusted RR, 1.72), spastic colon (adjusted RR, 3.62), and frequent indigestion, diarrhea, or constipation (adjusted RR, 1.30). Psychological IPV was as strongly associated with the majority of adverse health outcomes as was physical IPV. CONCLUSIONS: Psychological IPV has significant physical health consequences. To reduce the range of health consequences associated with IPV, clinicians should screen for psychological forms of IPV as well as physical and sexual IPV.     

Sociodemographic associations of physical, emotional, and sexual intimate partner violence in Spanish women

PURPOSE: To measure the lifetime prevalence of physical, emotional, and sexual Intimate Partner Violence (IPV) in women attending general practice in Spain and to assess sociodemographic factors associated with the different types of abuse. METHODS: The sample included 1402 randomly selected women, aged 18 to 65 years, attending general practice in three Spanish regions. A self-administered structured questionnaire specifically developed for the study was used. Given the overlap between the different types of lifetime abuse, various categories were created by combining the different types. Multiple logistic regression models were developed to identify the sociodemographic factors independently associated with the different categories of abuse. RESULTS: Lifetime prevalence of IPV was 32%, and 14.4% referred having experienced emotional abuse alone. Factors independently associated with all categories of abuse included being separated/divorced/widowed, having three or more children, and lacking social support. Increasing age was protective for physical and emotional abuse (odds ratio = 0.96; 95% confidence interval = 0.93-0.99). Women with the lowest monthly family income (< 600 euro) (1 euro = 1.32 euro) were most likely to experience all IPV categories, except for emotional abuse alone. CONCLUSIONS: IPV is a common problem in general practice. The identification of factors associated with this public health problem is essential for its prevention and treatment.     

Physical and sexual intimate partner violence and reported serious psychological distress in the 2007 BRFSS

Objectives:  

We sought to determine the relationship between intimate partner violence (IPV) and serious psychological distress (SPD) as measured by the Kessler-6 (K6) among U.S. adults. We used data from the 2007 Behavioral Risk Factor Surveillance System (BRFSS) to determine whether individuals who reported multiple forms of IPV also reported higher prevalences of SPD compared with those who reported: 1) no physical or sexual IPV; 2) physical or sexual IPV only; and 3) threatened or attempted physical IPV. We also obtained adjusted prevalences for lifetime physical or sexual IPV.     

Patterns of intimate partner violence and their associations with physical health, psychological distress, and substance use

OBJECTIVES: The purpose of this work is to formally model patterns of intimate partner violence (IPV) separately for males and females and to assess the unique contributions of different types of violence exposure to health related outcomes. METHODS: Using data from the National Violence Against Women Survey--a national probability sample of U.S. men and women--latent class analyses produced a map of the underlying structure of IPV for both males and females that is defined by specific types of violent acts. Multivariable logistic regression analyses assessed the differential physical health, mental health, and substance use consequences of exposure to IPV by gender. RESULTS: Women and men experience similar types of IPV, although the prevalence of the different types of violence is much greater for women than men. Second, exposure to IPV for both women and men is associated with a range of negative health outcomes including increased odds of poor physical health and physical disability, psychological distress and mental illness, and heightened recreational and non-recreational substance use. Finally, there is some evidence that experiences with IPV have stronger and broader associations with negative health outcomes among women, likely reflecting differences in the severity of violence experienced by men and women. CONCLUSIONS: More attention to the ways in which interpersonal violence is conceptualized, measured, and screened for is crucial. Specifically, while women have greater exposure to IPV, and subsequently a greater range of health problems, the effects on men should not be ignored.     

Community-level correlates of intimate partner violence against women globally: a systematic review

Intimate partner violence (IPV) against women is a problem facing women around the world, one that has implications for women's health and well-being. The relationship between communities and the occurrence of IPV is an expanding area of research. Although a large number of community characteristics have been examined in relation to IPV, the research as a whole lacks a coherent theoretical focus or perspective. In this systematic review, we provide a comprehensive synthesis of the evidence regarding the community-level correlates of IPV against women. In our review of peer-reviewed research published between January 1, 1990 and January 31, 2011, we identify key community-level correlates, detect gaps, and offer recommendations for future research. Recognizing a difference in approach between U.S. and non-U.S. based research and an over-reliance on a primarily urban, U.S.-based perspective on communities and IPV, we advocate for a global perspective that better reflects the social and economic fabric of communities around the world. Specifically, future research should focus on the most promising, but currently under-studied, community-level correlates of IPV against women, namely gender inequality, gender norms, and adapted measures of collective efficacy/social cohesion.     

Child maltreatment, youth violence, and intimate partner violence: developmental relationships

BACKGROUND: Understanding the cycle of violence, from victimization to perpetration across the life span, is critical for designing successful prevention interventions. This study uses a nationally representative sample to examine the developmental relationships among three forms of child maltreatment, youth violence perpetration or victimization, and young adult intimate partner violence (IPV) perpetration or victimization. METHODS: Data describing self-reported youth violence perpetration (or victimization) from Wave I of the National Longitudinal Study of Adolescent Health (1994-1995) were matched with self-reported IPV perpetration (or victimization) in young adult sexual relationships and retrospective reports of child maltreatment collected during Wave III (2001-2002). Bivariate probit regression models were used to analyze the developmental relationships between child maltreatment, youth violence, and IPV. Analyses were completed in September 2006. RESULTS: Compared to nonvictims of child maltreatment, victims of child maltreatment are more likely to perpetrate youth violence (a likelihood increase ranging from -1.2% to 6.6% for females and 3.7% to 11.9% for males) and young adult IPV (an increase from 8.7% to 10.4% for females and from 1.3% to 17.2% for males), although the direct and indirect effects vary by type of child maltreatment experienced. Gender differences exist in the links between child maltreatment, youth violence and IPV, and in the effects of socioeconomic factors on youth violence and IPV. CONCLUSIONS: Results suggest that it may be important to account for gender differences when designing violence prevention programs, and an integrative approach is critical for stopping the developmental trajectory of violence.     

Reproductive health and intimate partner violence

The article examines the relationship between reproductive health and intimate partner violence. Through the conference conducted by the Centers for Disease Control and Prevention, along with other government agencies and private organizations, it has been demonstrated that while there is an increased awareness of intimate partner violence as a public health issue, there has been limited research on the potential association of violence to women's reproductive health. Furthermore, there are few consistent findings that can be used to aid in the development and evaluation of effective interventions to reduce intimate partner violence as part of an overall strategy of improving women's reproductive health. Most recent information suggests potential associations between violence and a variety of reproductive health indicators, such as sexually transmitted diseases and HIV, birth outcomes, and unintended pregnancies. However, the nature of these associations remains unclear and requires further investigation.     

Prevalence of intimate partner violence and injuries--Washington, 1998

Approximately 20% of emergency department visits for trauma and 25% of homicides of women involve intimate partner violence (IPV) (1,2). To assess IPV prevalence in Washington, the Washington State Department of Health added questions from the Conflict Tactics Scale (3) and the Revised Conflict Tactics Scale (4) to its 1998 Behavioral Risk Factor Surveillance System (BRFSS) survey. This report describes an analysis of responses to the questions, which indicated that women were more likely than men to experience IPV in their lifetime, and more than three times more likely than men to experience injuries from IPV.     

Pregnancy coercion, intimate partner violence and unintended pregnancy

Background

Reproductive control including pregnancy coercion (coercion by male partners to become pregnant) and birth control sabotage (partner interference with contraception) may be associated with partner violence and risk for unintended pregnancy among young adult females utilizing family planning clinic services.

Study Design

A cross-sectional survey was administered to females ages 16-29 years seeking care in five family planning clinics in Northern California (N=1278).

Results

Fifty-three percent of respondents reported physical or sexual partner violence, 19% reported experiencing pregnancy coercion and 15% reported birth control sabotage. One third of respondents reporting partner violence (35%) also reported reproductive control. Both pregnancy coercion and birth control sabotage were associated with unintended pregnancy (AOR 1.83, 95% CI 1.36-2.46, and AOR 1.58, 95% CI 1.14-2.20, respectively). In analyses stratified by partner violence exposure, associations of reproductive control with unintended pregnancy persisted only among women with a history of partner violence.

Conclusions

Pregnancy coercion and birth control sabotage are common among young women utilizing family planning clinics, and in the context of partner violence, are associated with increased risk for unintended pregnancy.     

Unperceived intimate partner violence and women's health

Objective

Women who experience intimate partner violence (IPV) often do not perceive themselves as abused. This study sought to estimate the health effects of unperceived IPV (uIPV), taking violence-free women as the reference, and to compare the effects of uIPV with those of perceived IPV (pIPV).

Method

We performed a cross-sectional population study through telephone interviews of 2835 women aged 18 to 70 years living in the region of Madrid and having an ongoing intimate partner relationship or contact with a former partner in the preceding year. Based on 26 questions from the Conflict Tactics Scale-1 and the Enquête Nacional sur les Violences envers les Femmes en France and the question “Do you feel abused by your partner?” a variable was constructed in three categories, namely, the absence of IPV, uIPV and pIPV. Using logistic regression, we analyzed the association between health problems, medication use, health-service utilization and IPV (perceived and unperceived) vis-à-vis the absence of IPV.

Results

There were 247 cases of uIPV and 96 of pIPV (prevalences of 8.8% and 3.4%, respectively). The multivariate analysis showed that a substantial number of the outcomes explored were associated with uIPV, pIPV, or both. The highest odds ratios (ORs) were obtained for depression (Patient Health Questionnaire-9 ≥ 10) (uIPV: OR 3.4, 95% CI 2.4-3.8; and pIPV: 4.1, 95%CI 2.5-6.8). In most problems, the ORs did not significantly differ between the two types of IPV.

Conclusions

uIPV is 2.6 times more frequent than pIPV and is associated with at least as many health problems as pIPV.     

Household and neighborhood contexts of intimate partner violence

OBJECTIVES: Two sources of contextual risk on the prevalence and severity of intimate partner violence (IPV) are investigated: household economic condition and neighborhood disadvantage. There is debate about whether each context is an independent source of IPV risk and whether risks cumulate over contexts. METHODS: Data from the second wave of the National Survey of Families and Households are combined with tract level data from the 1990 U.S. Census. A sub-sample of co-resident couples with a child aged 5-17 in the household was selected for analysis (n=2,273). IPV is measured in three ways: as any physical violence reported by either partner in the year prior to the survey, as gendered violence in which both partners are identified as aggressors, and as severe violence in terms of injury and frequency. RESULTS: Regardless of how IPV is assessed, couples with IPV are more likely to present a vulnerable economic risk profile and to live in neighborhoods of high disadvantage. When economically vulnerable couples living in advantaged versus disadvantaged neighborhoods are compared, there are no significant differences in rates of IPV, regardless of the measure of IPV that is used. Neighborhood context matters, however, in comparisons among economically advantaged couples: rates of IPV are significantly higher among those in disadvantaged neighborhoods. CONCLUSIONS: The consistency of effect for economic vulnerability and its invariance across neighborhood settings suggests that reducing economic vulnerability is likely to have beneficial effects in both disadvantaged and non-disadvantaged neighborhoods.     

Female victims of intimate partner physical domestic violence (IPP-DV), California 1998

BACKGROUND: This study was conducted to identify factors associated with adult female victims of intimate partner physical domestic violence (IPP-DV) in California and to estimate statewide IPP-DV prevalence. METHODS: We analyzed data from the 1998 California Women's Health Survey, a random, computer-assisted telephone interview (CATI) survey of 4006 California women aged > or = 18, conducted by the California Department of Health Services. RESULTS: Data from the survey indicated that 6% of the women reported that in the previous 12 months, their intimate partners threw objects at them, or hit them with an object, or kicked, pushed, slapped, choked, beat up, or threatened them with a gun or a knife. Odds ratio (OR) analyses controlling for age and race/ethnicity suggest that a large number of factors are associated statistically with IPP-DV victims. These factors include feelings of ill physical and mental health; pregnancies at early age; smoking status; nutritional needs; low income; participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program; having children aged < 18 in the household; and limited access to health care. Among the non-U.S.-born respondents, IPP-DV victims were significantly younger when they entered the United States than their nonvictim counterparts. A multiple logistic regression model identified the following factors as main correlates with IPP-DV: feelings of being overwhelmed in the past 30 days (OR = 3.4, 95% confidence interval [CI] = 2.5-4.6); aged 18 to 44 (OR = 2.8, 95% CI = 1.9-4.1); current smoking status (OR = 2.1, 95% CI = 1.5-2.9); participation in WIC in the previous 2 years (OR = 1.8, 95% CI = 1.2-2.6); and being out of work (OR = 1.4, 95% CI = 1.1-1.9). CONCLUSIONS: The above findings suggest that a variety of venues (e.g., schools, mental and physical health care providers, WIC, immigration programs, and social services) will be needed in order to identify/gain access to IPP-DV victims, provide referral resources, and implement any future prevention efforts.     

儿童期虐待与亲密伴侣暴力关系

目的通过研究儿童期不同形式虐待与其成人后亲密伴侣暴力的关系，为家庭暴力的心理干预提供科学的理论依据。方法采用自编《新婚夫妇婚前暴力调查表》和《儿童期虐待问卷》对湖南省长沙市2个社区领取结婚证愿意接受婚前暴力调查研究的291对新婚夫妇进行调查。结果受虐组的情感虐待因子分、躯体虐待因子分及量表总分高于非受虐组；女性受虐组的躯体虐待因子分和性虐待因子分高于非受虐组；男性受虐组的情感虐待因子分、躯体虐待因子分和情感忽视因子分均高于非受虐组。但差异无统计学意义（P〉0．05）。2组间在受教育程度、职业、婚前有无同居史上差异有统计学意义（x^2=10．433，P=0．034；x^2=15．525。P=0．008；x^2=8．843。P=0．003）。结论儿童期情感虐待和躯体虐待对其成人后受虐有影响；女性儿童期躯体虐待和性虐待对其成人后受虐有影响；男性儿童期虐待对其成人后受虐无影响。亲密伴侣暴力（IPV）与受教育程度、职业、婚前同居史相关。