Adolescent dating violence and date rape

PURPOSE OF REVIEW: In this review we intend to examine recent literature on dating violence among female adolescents, including prevalence, risk factors, sequelae, screening practices, and potential interventions. RECENT FINDINGS: Dating violence is perpetrated by both males and females and occurs frequently within heterosexual dating relationships. Attitudes toward physical aggression, including those of peers, and abuse by siblings predict later violence as victim and perpetrator. Victims of childhood or dating violence may be at greater risk of developing eating disorders. New strategies and measures to promote screening are available. SUMMARY: Dating violence occurs among all groups of adolescents with common and unique risk factors for dating violence found across adolescents grouped by race/ethnicity, sex, and prior victimization. Efforts to decrease dating violence should (1) increase the use of screening tools that measure victimization as well as attitudes and contextual parameters that promote dating violence; (2) increase self-efficacy to negotiate safer sex; (3) reduce the use/abuse of alcohol and other drugs that facilitate dating violence; and (4) eliminate the influence of negative peer behavior. Interventions to prevent dating violence will likely also reduce rates of unintended pregnancies, HIV, and sexually transmitted diseases among adolescents.     

Intimate partner violence and HIV risk behaviors among socially disadvantaged Chilean women

The objective of this study was to determine if a relationship exists between intimate partner violence (IPV) and HIV risk among socioeconomically disadvantaged Chilean women. A correlational analysis with data from the NIH-funded project, "Testing an HIV/AIDS Prevention Intervention for Chilean Women," was conducted. Two hundred and sixty-one women were included in this analysis (n = 261). Those women who had experienced any type of IPV in the past 3 months had significantly higher risk for HIV than those who had not (t = -2.016, p < .05). Also a linear trend was found among those women who had experienced more than one type of IPV in the past 3 months and HIV risk.     

Should I stay or should I go? Some thoughts on the variants of intimate violence

Approaches to understanding and potentially intervening in the variations of the risk of lethal and sublethal violence against women are suggested. Batterers vary in their ability to desist techniques of control, patterns of dangerousness, and lethality. Such variations are important to explore because of the extent it offers in maximizing the options for women seeking respite, escape and refuge from such violence. The indisputable evidence that some men abuse and batter when they court women warns of the links between heterosexual intimacy and men's abuse. Alvi and Selvee proved that the seriousness of such abuse and violence rises as the relationship advances from casual to serious dating to cohabitation. Termination of the relationship does not guarantee women's safety; separation, rather than divorce per se, is the critical risk factor in lethal violence. Although some women who leave violent men may acutely feel the threat of lethal violence, its actuality is not predictable, an area being explored by Ellis and DeKeseredy. Knowledge about men's lethality to intimate partners is crucial for improving the services and advocacy for women battered by men. When analyzing mechanisms to support women challenging domestic violence and aid in the reduction of separation femicide Ellis and DeKeseredy propose the enhancement of interventions that increase the confidence of the woman and symbolize our opposition to her abuse. Finally, provision of legal advocacy, facilitative divorce legislation, and assistance for battered women lying on the understanding of all public service personnel who work with intimate violence.     

Domestic abuse in a central Mediterranean pregnant population

The Mediterranean region is generally characterized by a patriarchal society that generally predisposes towards a higher prevalence of spouse abuse. The prevalence of domestic spouse abuse in a central Mediterranean closed island community was assessed to approximate 11.7% of the pregnant population. The abuse varied from psychological to physical abuse. There was a strong history of experience of domestic violence/abuse during childhood in both the victim and perpetrator suggesting that a "circle of abuse" may play a role in some cases. The socio-biological characteristics of the victim did not appear to statistically predispose towards a higher risk for domestic abuse, though single mothers were statistically more likely to report a history of domestic abuse. Abused women were more likely to smoke cigarettes during pregnancy than their counterparts. The perpetrator was statistically more likely to be unemployed, and smoke cigarettes and drink alcohol. There were no statistical correlation between a history of spouse abuse and educational level attained by both the victim and perpetrator. A history of domestic abuse appears to have an adverse effect on the pregnancy with a higher risk of premature birth and its attendant complications; although it is difficult to ascertain how much the reported poor obstetric outcome is a direct effect of violence itself or to other associated adverse social or biological co-factors. About a third of the women interviewed were unaware of the domestic violence services being offered in their community emphasizing the need of an information drive. The antenatal period, with the distribution of leaflets and antenatal classes, is an opportune time to promote the support services available in the community.     

Schwangere in Not – häusliche Gewalt

Domestic violence has been defined as physical, sexual, or emotional abuse by an adult perpetrator directed towards an adult victim in the context of a close relationship. Most often, violence is perpetrated by a man towards his current or former partner; 23.5% of women experienced domestic violence in their lifetime, 3% of which occurred during pregnancy. Domestic violence is regarded as an important risk marker for the development of obstetric complications and depressive symptomatology. Physical and sexual abuse is significantly associated with irregular menstrual cycle, urinary tract infections, and pelvic pain independent of menses. Especially gynecologists and general practitioners have to be aware that their patients might be victims of violence. This is important for adequate diagnosis and therapy and to avoid retraumatization in affected women. Domestic violence training is necessary to equip health professionals with the knowledge and skills they need to respond to domestic violence more effectively.     

Electroshock as a form of violence against women

This article reframes electroconvulsive therapy as a form of violence against women. Drawing on women's testimony and on scientific research, it establishes that this "treatment," which is overwhelmingly given to women, results in extensive cognitive and physical impairment. Correspondingly, it functions and is experienced as a form of assault and social control, not unlike wife battery. Emergent themes include electroshock as life destroying, a sign of contempt for women, punishment, a means of enforcing sex roles, a way to silence women about other abuse, an assault, traumatizing for those who undergo it and those forced to witness it.     

Violent maternal deaths in North Carolina

OBJECTIVE: To describe the frequency of domestic violence and substance abuse among a series of injury-related maternal deaths, determine awareness of the obstetric provider of domestic violence in those deaths by intimate partner homicide or depression in those deaths by suicide, and examine the relative risk of violent maternal death for unmarried status and non-white race. METHODS: A follow-up investigation was carried out for a case series of 41 injury-related maternal deaths identified from 1992 to 1994 in North Carolina. Death certificates, police records, newspapers, and records from medical examiners were used to ascertain mechanism and intent, history of alcohol or drug abuse, and, in cases of homicide, the relationship of the perpetrator to the victim. The obstetric provider was asked about his or her knowledge of domestic violence, depression, and drug or alcohol abuse relevant to the deceased victim. RESULTS: A total of 21 women (51.2%) were known to have or suspected of having been abused by either an intimate partner or an acquaintance. Of the 41 women, 11 (26.8%) were known to have abused drugs and/or alcohol. The obstetric provider was aware or suspicious of abuse in one third of homicides committed by an intimate partner. In three of the five suicide deaths, the obstetric provider was aware of depression. CONCLUSION: Domestic violence and drug and alcohol abuse were common in this series of injury-related maternal deaths. Domestic violence and depression were often unrecognized by the obstetric provider in these severe cases.     

Domestic violence among women living with HIV/AIDS in Kano, Northern Nigeria

Despite the increased risk of domestic violence among women living with HIV/AIDS, its burden has not been adequately explored in many developing countries including Nigeria. Using interviewer administered questionnaires we assessed the prevalence and risk factors for domestic violence among 300 HIV seropositive women attending a teaching hospital in northern Nigeria. Participants have been diagnosed HIV positive for an average of 6.7 years; 66.3% were seroconcordant with their intimate partners while 16.3% were serodiscordant, the rest 17.4% did not know the partner's status; 67.1% had disclosed their status to their partners; and 64(22.1%) [95% CI (17.5% to 27.4%)] had experienced domestic violence following HIV diagnosis. Specifically, 30.0% (n = 19) experienced physical violence (slapping, kicking and punching), 59.3% (n = 38) reported verbal violence (insults, threats) and 10.7% (n = 7) endured emotional violence. None was sexually assaulted. Predictors of domestic violence were the woman's age, marital status, disclosure and partner's educational status. This calls for urgent steps and strategies for prevention, protection and post-test counseling on disclosure to avert this human right infringement.     

Women's experience of violence during stalking by former romantic partners: factors predictive of stalking violence

This study investigated female experiences of physical violence during stalking by a former romantic partner. It aimed to identify factors that were predictive of such stalking violence. Two hundred and twenty female undergraduates who defined themselves as victims of stalking following the dissolution of a romantic relationship completed a short questionnaire. From their responses, 11 predictor variables were considered. These were self-reported relationship experiences of physical and sexual violence, intentional damage to participant's property, partner jealousy, isolation, monitoring, criticism and insults by the former partner, former partner's drug and alcohol abuse, and specific threats of violence while being stalked. The dependent variable in the study was whether stalking violence occurred; 35.9% (79/220) of participants experienced stalking violence. Logistic regression analysis revealed that there were statistically significant independent associations between threats, partner jealousy, and former partner drug abuse and stalking violence.     

Trends and determinants of pregnancy-related domestic violence in a referral center in southern Nigeria

Objective

To describe the trend and identify associated risk factors for pregnancy-related domestic violence.

Methods

In a cross-sectional study of 502 women attending the sixth week postnatal clinic in a tertiary hospital in urban Nigeria, participants completed semi-structured questionnaires on experience of domestic violence before and during pregnancy, and in the puerperium. Multivariate logistic regression was used to assess risk factors associated with experiencing violence.

Results

The prevalence of domestic violence was 43.5% during the 12 months before the pregnancy, 28.3% during the pregnancy, and 4% in the puerperium. Psychological violence was the commonest form of violence experienced. All forms of violence were least common in the puerperium. Experience of violence in the 12 months before pregnancy (P < 0.0001, odds ratio 274.34 [95% CI, 66.4-1133.8]), HIV seropositivity (P = 0.02, odds ratio 2.81 [95% CI, 1.2-6.5]), and regular alcohol intake (P < 0.0001, odds ratio 11.60 [95% CI, 3.8-35.1]) significantly increased the likelihood of experiencing domestic violence.

Conclusion

Pregnancy-related domestic violence is an important health problem in this community in southern Nigeria. Experience of violence before the pregnancy, HIV infection, and regular alcohol consumption are risk factors.     

Recent and past intimate partner abuse and HIV risk among young women

OBJECTIVE: To examine the associations between past intimate partner abuse experienced during adolescence (verbal and physical), recent intimate partner abuse (verbal, physical, and sexual), and HIV risk (as indicated by lack of condom use) for sexually active young adult women in relationships with male partners. DESIGN: Secondary data analysis of waves II and III of the National Longitudinal Study of Adolescent Health (Add Health). SETTING: The Add Health Study is a longitudinal, in-home survey of a nationally representative sample of adolescents. SAMPLE: Analyses involved 2,058 sexually active young adult women. MAIN OUTCOME MEASURES: HIV risk was measured by consistent condom use over the past 12 months. RESULTS: Physical and verbal abuse experienced in adolescence were associated with physical/verbal abuse experienced in young adulthood. Young, sexually active women experiencing no abuse in their relationships were more likely to consistently use condoms in the past 12 months than were their abused counterparts. CONCLUSION: A causal pathway may exist between prior abuse, current abuse, and HIV risk.     

Preterm labor,placental abruption,and premature rupture of membranes in relation to maternal violence or verbal abuse

Objective: The prevalence of preterm labor (PTL) in prenatal populations has been estimated to be from 6.9 to 10.0%. It has been suggested that violence during pregnancy may be associated with an increase in antenatal complications. The hypothesis is that physical violence and verbal abuse in pregnancy lead to increased risk of PTL.

Methods: A cohort of 636 women attending the Adult Obstetrical Clinic for their first prenatal visit, between December 1989 and September 1990, were approached; 567 women enlisted as study participants. Study participants were interviewed 3 times during the course of their prenatal care, and 401 participants successfully completed their third prenatal interviews. Violence data were obtained during the third interview. Obstetrical and neonatal outcome data were obtained by abstracting the maternal and neonatal medical records.

Results: When stratified by levels of violence, women who experienced moderate or severe violence had incidences of PTL of 15.4 and 17.2%, respectively. Chi-square test for homogeneity revealed a significant difference among these groups.

Conclusions: In our cohort of women, serious acts of verbal abuse and physical violence occurred with significant frequency. PTL was strongly correlated with increasing acts of violence with 4.1 times greater risk of PTL in women who experienced severe violence as compared to those who experienced no maternal abuse.     

The prevalence of violence investigated in a pregnant population in Sweden

All women registered for antenatal care within a Swedish municipality during a 6-month period were assessed regarding acts of violence. The Abuse Assessment Screen was used on two occasions during pregnancy, and once between 4 and 20 weeks after delivery. The efficacy of repeated interviews was investigated, and characteristics of abused and non-abused women were compared. The participation rate was 93% (1038 women). Physical abuse by a close acquaintance or relative during or shortly after pregnancy was reported by 1.3%, and by 2.8% when the year preceding pregnancy was included. The lifetime prevalence of emotional, physical or sexual abuse was 19.4%. Repeated questioning increased the detection of abuse. Women abused during pregnancy reported more preceding ill-health and more elective abortions than non-abused women. Intervention against sexual violence has been on the political agenda in Sweden for several decades. Even so, physical abuse is a risk factor comparable in frequency to obstetric complications such as gestational diabetes and pre-eclampsia. Routines need to be established to make questioning about violence an integral part of the standardized screening for risk factors during pregnancy.     

Domestic violence, lifetime trauma and psychological health of childbearing women

OBJECTIVE: Although histories of abuse are associated with psychiatric illness in women, health professionals rarely enquire directly about such experiences. This study examined the association between physical and sexual violence and lifetime trauma and depressive and posttraumatic stress symptoms in women receiving maternity care. DESIGN: Cross sectional study. SETTING: South London Hospital maternity services. POPULATION: Two hundred women receiving postnatal or antenatal care. METHODS: Two hundred women receiving postnatal or antenatal care at a South London maternity service were screened for lifetime experiences of trauma and domestic violence. Information was obtained about self-harming behaviour, suicidal thoughts and attempts and psychiatric history. Women completed the Edinburgh Postnatal Depression Scale (EPDS) and the Posttraumatic Diagnostic Scale (PTDS). MAIN OUTCOME MEASURES: RESULTS: One hundred and twenty-one (60.5%) women reported at least one traumatic event and two-thirds of these had experienced multiple traumatic events. The most frequent (34%) was witnessing or experiencing physical assault by a family member. Forty-seven (23.5%) women had experienced domestic violence. Physical and sexual abuse commonly co-occurred. Thirteen (10.7%) women with a trauma history had current posttraumatic stress disorder. Severe posttraumatic symptoms were associated with physical and sexual abuse histories and repeat victimisation. Adult and childhood physical and sexual abuse histories were also associated with more severe depressive symptomatology. Significant social factors associated with depression were being single, separated or in a non-cohabiting relationship. CONCLUSION: Traumatic events are under-recognised risk factors in the development of depressive and posttraumatic stress symptoms in childbearing women. Childhood abuse creates a vulnerability to re-traumatisation in adulthood. Awareness of the impact of trauma and abuse on psychological health may enable more appropriate targeting of clinical services and support for women receiving maternity care.     

Prediction of domestic violence against married women in southwestern Turkey

Objective

To determine the prevalence of, and independent risk factors for various domestic violence categories among married women of reproductive age in southwestern Turkey.

Methods

The present cross-sectional study included 260 randomly selected women registered to a family physician in the district of Gönen, Isparta. During home visits between October 1 and December 31, 2012, the women completed a questionnaire that included between four and eight questions for each violence category (physical, verbal, economic, emotional, and sexual) to assess the lifetime presence of domestic violence. Logistic regression models with backward elimination were constructed to define independent risk factors for domestic violence.

Results

In total, 176 (67.7%) women reported any type of domestic violence at least once in their lifetime. Verbal/psychological abuse was the most frequent type (reported by 121 [46.5%] women). Living in a village, young age (19–29 years) of the husband, adolescent age (< 19 years) of the husband at marriage, and problem alcohol use or problem gambling in the partner were independent predictors of domestic violence.

Conclusion

Attention should be given to area of residence, age of both partners at marriage, adolescent marriage, and husband characteristics during screening for domestic violence.     

Gewalt gegen Frauen in der Schwangerschaft

In Germany approximately one in every four women becomes a victim of violence and/or sexual abuse within a relationship at least once during life beyond childhood. The systematic report for Germany by Schröttle and Müller (2004) indicates that violence is not entirely a problem in poor social classes. Even in the vulnerable condition of pregnancy women become victims of violence. Various risk factors have been identified one of which is primary rejection of pregnancy, others such as race or level of education seem to be less important. The German College of Obstetrics and Gynecology (DGGG) has formulated guidelines on how to proceed in cases where domestic violence is suspected. Physicians and gynecologists in particular play a key role in detecting victims of violence as well as guiding and counseling them properly within already existing social and legal networking institutions.     

The invisible wounds: The occurrence of psychological abuse and anxiety compared with previous experience of physical abuse during the childbearing year

The aim of this study was to measure the prevalence, effects and character of psychological abuse in women visiting antenatal clinics. A standardized questionnaire based on four different established scales (PMWI, SVAW, TSC-33, and STAI) was used to estimate the frequency of psychological, physical and sexual abuse, anxiety and depression. in the study 207 pregnant Swedish born women married to or cohabiting with Swedish born men were consecutively chosen from three different antenatal dimes from the city of Göteborg, Sweden. Personal interviews were conducted in connection to their regular visit to the antenatal dink, ranging from the first to the third trimester. Fifty-one (24.5%) women out of 207 reported threats and/or acts of violence during the last year according to the Severity of Violence Against Women Scale (SVAW). There was 89.4% who had experienced dominance/isolation according to the Psychological Maltreatment of Women Inventory (PMWI) and 44.4% of the women reported emotional/verbal abuse. Occupational status, but not age income or education, was found to be significantly correlated to physical violence, dominance/isolation and to emotional/verbal factor according to Psychological Maltreatment of Women Inventory (PMWI). Threats of moderate violence and ‘serious violence’ were strongly correlated to physical violence (correlation coefficient 0.9433 and 0.9405, respectively). Sexual abuse demonstrated a high correlation to physical violence and emotional/verbal factor. The results indicate that sexual violence is highly represented in the abusive relationship and also that depression and anxiety in the childbearing year may be caused by domestic violence. This study emphasises the importance of incorporating screening for threats and actual acts of psychological, physical and sexual abuse into routine care for women, enabling health care providers to identify high-risk patients and improve quality of care.