Mental health consequences of intimate partner violence in Vhembe district,South Africa

Objective

The aim of this study was to assess the contributions of different forms of intimate partner violence (physical violence, sexual violence, psychological abuse, and stalking) on symptoms of posttraumatic stress disorder (PTSD) and depression.

Methods

In all 268 women (18 years and older) consecutively receiving a protection order in the Vhembe district in South Africa were assessed by an external interviewer. Hierarchical regressions tested the unique effects of different types of intimate partner violence on PTSD and depression.

Results

In terms of PTSD symptom severity, more than half (51.9%) of the sample reported severe PTSD and 66.4% reported severe depression symptoms. Two types of intimate partner violence (physical and sexual) were significantly associated with PTSD symptoms, while only psychological violence was moderately correlated with depression symptoms. Physical abuse contributed to the prediction of PTSD and psychological abuse to depression.

Conclusions

A significant number of women with protection orders suffer from PTSD and depression. The results confirm a relationship between severity of intimate partner violence and mental health problems (PTSD and depression). Assessment of intimate partner violence should incorporate the multiple dimensions that have been identified as contributing to poor mental health.     

Le changement psychologique d’hommes auteurs de violences conjugales après leur thérapie en groupe de responsabilisation

ObjectivesThe aim of our research was to examine the association between impulsivity, alexithymia and depression and the perpetration of physical and psychological intimate partner violence. We focused on these particular psychological characteristics in order to understand this phenomenon and its prevention and/or treatment. Our initial study of fifty-six male perpetrators showed domestic violence was associated with a high level of alexithymia and depression. Analyses showed they reported more depressive feelings, and more difficulties to express their emotions than did general population. To determine if reductions were noted about these psychological characteristics at the end of intervention program, the present study examined longitudinal data.Patients and methodsTwenty-four male offenders (voluntary or judicialized) were surveyed using self-report questionnaires and structured clinical interview to collect sociodemographic data and to assess specific psychological variables, namely emotional distress (Beck Depression Inventory), impulsive behavior (Barratt Impulsivity Scale 11) and alexithymia (Toronto Alexithymia Scale 20), the inability to experience and express subjective emotions. These men were examined before the start of therapeutic program (T1) and at the end of it (T2), after 42 hours of psychological support.ResultsFindings showed both alexithymia and depression were reduced after therapeutic management. Analyses showed male intimate partner violence offenders reported less difficulty to express their emotions and less depressive feelings at the end of their intervention program. However, we only observe a significant result for alexithymia and its dimension “difficulties identifying feelings”. Impulsivity, on the other side, remains unchanged between the two evaluation times for all participants after the therapeutic program.ConclusionOur findings suggested a strong link between alexithymia and domestic violence and showed the positive effect of specific therapeutic interventions on alexithymia and depression. We pointed out the fact that with the decrease of alexithymia, participants may have a better awareness of themselves and of their behavior. In conclusion, it is encouraging to note that specific treatment programs increase awareness about the problem of intimate partner violence.     

Responsive versus Treatment-Resistant Perpetrators in Batterer Intervention Programs: Personal Characteristics and Stages of Change

This article aims to identify different personal characteristics in treatment-responsive and treatment-resistant perpetrators of intimate partner violence who completed a batterer intervention program (BIP). The sample consists of 105 perpetrators of intimate partner violence who were court-mandated to a community-based cognitive behavioral program. Perpetrators were classified by professionals as resistant or responsive to treatment based on the stage of change they reached upon completion of the program. The results show that before starting the intervention program, treatment-resistant perpetrators scored higher than treatment-responsive perpetrators in external responsibility attributions and attitudes toward violence in intimate relationships. No differences were found in personality disorders or psychological symptoms between the groups. However, longer program participation correlates with increasing differences between the two groups. The results suggest that targeting the personal characteristics which differentiate treatment-responsive perpetrators from treatment-resistant ones may help to increase the efficacy of BIPs.     

Étude sur les caractéristiques psychologiques des hommes auteurs de violences conjugales : quel type de fragilité psychique le passage à l’acte violent dissimule-t-il ?

Introduction

Historically, intimate partner violence has been ignored and minimized, despite its seriousness and widespread prevalence in our culture. In the past three decades, many studies have addressed the question of the impact of intimate partner violence on physical or mental health for victims (spouses, ex-partners and children). But, what about authors? Currently, due to the multifactorial character of the phenomenon of domestic violence, it is still difficult to estimate the impact of the existing therapeutic programs which offer a support for the authors of this violence. The current study sought to examine the association between trait impulsivity, alexithymia and depression and the perpetration of physical and psychological intimate partner violence. We focused on particular psychological characteristics that would seem to have much potential as an aid to understand this phenomenon and its prevention and/or treatment.

La croissance post-traumatique chez les victimes de violences conjugales : une étude pilote dans la Vienne

ObjectiveThis study aimed to: (1) evaluate posttraumatic growth in survivors of intimate partner violence, (2) compare and characterize this posttraumatic growth with the one measured in survivors of other types of violence, and (3) evaluate post-traumatic stress disorder and its relationship with posttraumatic growth in our clinical population.MethodsWe realized a monocentric pilot study in Poitiers (Vienne, France) recruiting 17 survivors of intimate partner violence and 42 survivors of other types of violence from two medical departments: the Unit of Forensic Medicine, where victims are oriented following complaints, and the Psychotrauma Center. Participants were administrated questionnaires comprising socio-demographics data and specific scales, namely the PTGI and PCL-5.ResultsWe found a higher prevalence of posttraumatic growth in survivors of intimate partner violence (82 %), when compared with survivors of sexual assault and other interpersonal types of violence (52 % and 53 %, respectively). Posttraumatic growth was low to moderate, and faster as it was detected in victims recruited in the Unit of Forensic Medicine. All domains of posttraumatic growth were positively affected, i.e. higher scores from the PTGI were recorded in survivors of intimate partner violence. No difference was found when results were compared between groups from the Psychotrauma Center. We were unable to identify socio-demographic predictors of posttraumatic growth. À posttraumatic stress disorder was found in survivors of intimate partner violence, and negatively related to posttraumatic growth.DiscussionTo our knowledge, this is the first study comparing post-traumatic growth across such conditions and using specific and recognized scales. Our pilot study demonstrated that survivors of intimate partner violence were able to develop low to moderate posttraumatic growth faster than survivors of other types of violence. All domains of posttraumatic growth were affected, demonstrating the ability of survivors to withstand adversity. Scientific data regarding the link between posttraumatic growth and posttraumatic stress disorder is unclear, probably depending on the trauma, the circumstances, the timing of the measurement. In our study, we found a clear negative correlation between the two parameters. Our results underline the necessity to provide overall and rapid intervention in survivors of intimate partner violence, comprising legal, psychological, social and medical approaches, to facilitate the development of posttraumatic growth.     

Maltraitances sexuelles infantiles et répétition victimaire dans les relations conjugales à l’âge adulte

AimsIn this article, we show the consequences of childhood sexual abuse on psychic development and its implication in victimary repetition in adulthood.MethodThe case study presented in this article is from a doctoral research project in psychology about the impact of early relationships on the experience of intimate partner violence in adulthood. This case appears emblematic of the rest of our population. The elements mentioned are anonymized and analyzed from a psychoanalytic perspective.ResultsThe results show the conscious and unconscious consequences of childhood sexual abuse on the victims’ psychological development. Indeed, the psychic intrusion following early sexual abuse hinders the construction of the self and prevents the psychic instances from functioning properly. This intrusion also leads to repetition in violent intimate relationships. Oscillating between primary and secondary processes, the person can cut her/himself off from a part of her/his emotional life to avoid psychic and/or somatic disorganization.DiscussionAfter experiencing early sexual trauma, even if the psychic apparatus is temporarily able to keep the traumatic elements far from the conscious mind, these elements still act in the unconscious. The work of shame and guilt, which are constitutive elements of moral masochism, lock the subject into a deadly repetition compulsion that can promote the experience of repetitive intimate partner violence (physical, psychological, sexual) in adulthood.ConclusionTo prevent, detect, and care for women victims of childhood sexual abuse, it is necessary to consider their modalities of psychic functioning, the formation of their Self, and their ability to psychically transform the trauma they suffered.     

Homophobia,Heteronormativism and Hegemonic Masculinity: Male Same-Sex Intimate Violence from the Perspective of Brisbane Service Providers

Few studies have explored the problem of male same-sex intimate partner violence, especially in the context of Australia. Utilizing in-depth interviews with gay-friendly service providers in Brisbane, the research presented in this article sought to ascertain whether (a) intimate partner violence occurs in male same-sex intimate relationships, (b) if so, what form this violence takes, (c) what contextual triggers underpin this violence, (d) what barriers victims face in exiting abusive relationships and seeking support, and (e) what services are available and appropriate to the needs of men in violent intimate relationships with other men. Results suggest that the prevalence, types and contextual triggers of violence in male same-sex relationships parallel abuse in opposite-sex relationships. Heteronormativism, homophobia, and its close association with hegemonic masculinity, however, emerge as features unique to the male same-sex intimate partner violence experience.     

Childhood Sexual Abuse and Sociodemographic Factors Prospectively Associated with Intimate Partner Violence Perpetration Among South African Heterosexual Men

Background

Intimate partner violence directed at women by men continues to be a global concern. However, little is known about the factors associated with perpetrating intimate partner violence among heterosexual men.

Purpose

History of childhood sexual abuse and other sociodemographic variables were examined as potential factors associated with severe intimate partner violence perpetration toward women in a sample of heterosexual men in South Africa.

Methods

Longitudinal logistic generalized estimating equations examined associations of childhood sexual abuse and sociodemographic variables at baseline with intimate partner violence perpetration at subsequent time points.

Results

Among participants with a steady female partner, 21.81 % (190/ 871) reported perpetrating intimate partner violence in the past year at baseline. Having a history of childhood sexual abuse (p < .001), binge drinking (p = .002), being employed (p = .050), and more difficulty controlling sexual impulses in order to use a condom (p = .006) at baseline were associated with self-reported intimate partner violence perpetration in the past year at subsequent time points.

Conclusions

With high levels of recent severe physical and/or sexual intimate partner violence perpetration in South Africa, comprehensive interventions are urgently needed. To more fully address gender-based violence, it is important to address associated factors, including exposure to childhood sexual abuse that could impact behavior later in life and that have long-lasting and deleterious effects on men and their female partners.

     

Intimate partner violence: A loop of abuse,depression and victimization

Intimate partner violence has been recognized as a serious public health issue. Exposure to violence contributes to the genesis of, and exacerbates, mental health conditions, and existing mental health problems increase vulnerability to partner violence, a loop that imprisons victims and perpetuates the abuse. A recently described phenomenon is when male violence against females occurs within intimate relationships during youth, and it is termed adolescent or teen dating violence. In this narrative review, factors associated with intimate partner violence and consequences of exposure of children to parental domestic violence are discussed, along with possible intensification of violence against women with the spread of coronavirus disease 2019 pandemic and subsequent lockdown. Intervention programs with a multicomponent approach involving many health care settings and research have a pivotal role in developing additional strategies for addressing violence and to provide tailored interventions to victims. Prevention policy with a particular attention on healthy child and adolescent development is mandatory in the struggle against all forms of violence.     

Borderline personality disorder and couple dysfunctions

The central characteristics of borderline personality disorder (BPD) are bound to be associated with the development and maintenance of couple dysfunction. Although seven of the nine diagnostic criteria of BPD in the DSM-IV-TR refer directly to interpersonal functioning, very few empiric studies have addressed the exact nature of the relationship between BPD and couple functioning. This article examines recent studies describing couple outcomes—union formation and durability, partner choice, relationship satisfaction, intimate violence, attachment security, and sexual functioning—associated with BPD. The relationship between couple dynamics (including partner personality characteristics) and BPD symptomatology is probably bidirectional or reciprocal. The review concludes with an exploration of diagnostic and treatment implications.     

Pacific Islands families study: intimate partner stressors and psychological distress among pacific adults

Although there has been increased research about the nature and predictors of sexual problems, relatively little is known about sexual health and well-being among minority ethnic groups across the world. This study explored stressful intimate relationship events that made a significant impact on psychological distress among Pacific adults living in New Zealand. The Pacific Islands Families (PIF) study is a longitudinal investigation of Pacific children born in New Zealand, and their parents. The 12-item General Health Questionnaire (GHQ12) and intimate partner stress items were used to assess the relationship between these stressful events and psychological distress among Pacific mothers and fathers (n = 3963 interviews with 2114 individuals). For both men and women, the most significant partner stress associated with psychological distress was problems with sex. These findings show how stressful events around sexuality and intimate relationships affect Pacific psychological well-being. These intimate issues need to be considered when designing intervention and treatment programmes that are adaptive for long-term family stability and sexual well-being. The relationship between culture, sexuality, and psychological distress needs further investigation. Using a qualitative methodology would provide a more intensive exploration of the role that cultural context plays in intimate relationships and sexuality in Pacific adults.     

Comparing cognitive behavioral therapy and integrated cognitive behavioral therapy/psychodynamic therapy in group treatment for partner violent men

This was a pilot study comparing the effectiveness of cognitive-behavioral therapy (CBT; n = 18) with integrated CBT and psychodynamic therapy (CBT/PT; n = 27) in reducing partner violence. The study examined differences between the two treatment groups at posttreatment with regard to attachment dimensions, interpersonal problems, psychological/behavioral functioning, and general symptom and relationship distress. Results indicated that the CBT/PT groups showed significantly more improvement than the CBT groups on measures of partner violence, attachment, and interpersonal problems at posttreatment. Conversely, the CBT groups showed significantly more improvement than the CBT/PT groups on measures of psychological/behavioral functioning and general symptom and relationship distress. Finally, there was a significant difference between the treatment groups on recidivism rate, with the CBT/PT groups having the lowest rate. (PsycINFO Database Record (c) 2010 APA, all rights reserved).     

Longitudinal study of depression and health status in pregnant women: incidence, course and predictive factors

The aim of this study was to determine the effect of isolated psychological intimate partner violence and psychosocial factors (social support and alcohol or drug use by a partner/family member) on psychological well-being (depression or poor self-perceived health status) at 5 and 12 months post-partum. A longitudinal cohort study was carried out with a consecutive sample of 1,400 women in their first trimester of pregnancy, who attended the prenatal programme in the Valencia Region (Spain) in 2008 and were followed up at 5 months and 12 months post-partum. A logistic regression model was fitted using generalized estimating equations, to assess the effect of isolated psychological intimate partner violence, social support, alcohol consumption and illicit drug use problems by a partner or family member on subsequent psychological well-being at follow-up. We observed a decrease in the incidence of poorer psychological well-being (post-partum depression and poor self-perceived health status) at 12 months post-partum. The strongest predictor of poor psychological well-being was depression (AOR = 6.83, 95 % CI: 3.44–13.58) or poor self-perceived health status (AOR = 5.34, 95 % CI: 2.37–12.02) during pregnancy. Isolated psychological IPV increased the risk of a deterioration in psychological well-being. Having a tangible social network was also a predictor of both post-partum depression and poor self-perceived health status. The effect of functional social support varied according to the type of psychological well-being indicator being used. Problems of alcohol consumption or illicit drug use by a partner or family member were a predictor of post-partum depression only. Psychological well-being during the first year after birth is highly affected by isolated psychological IPV and psychosocial factors.     

The Impact of Substance Use, Sexual Trauma, and Intimate Partner Violence on Sexual Risk Intervention Outcomes in Couples: A Randomized Trial

Background

Few HIV prevention interventions focus on sexual risk reduction as mutual process determined by couple members, though risk behaviors are inter-dependent.

Purpose

This trial examined the impact of substance use, history of sexual trauma, and intimate partner violence on sexual risk associated with participation in a risk reduction intervention.

Methods

HIV seroconcordant and serodiscordant multicultural couples in Miami, Florida (n?=?216) were randomized to group (n?=?112) or individual (n?=?104) couple-based interventions.

Results

Group intervention participants increased condom use in couples in which women had a history of sexual trauma [F(2,221)?=?3.39, p?=?0.036] and by partners of alcohol users. History of sexual trauma was a determinant of conflict resolution, predicting negative communication and intimate partner violence.

Conclusions

Results emphasize the need for group sexual risk reduction interventions targeting sexual trauma, partner violence, and substance use among HIV seroconcordant and serodiscordant couples.     

Women’s Experiences with Intimate Partner Violence and Their Mental Health Status in India: A Qualitative Study of Sambalpur City

The intimate partner violence (IPV) against women has been identified as a violation of human rights and a serious public health concern. There is not only the immediate consequence of partner violence, such as injury or death but also the other long-term health consequences. IPV can be associated with psychological effects such as depressive disorder, posttraumatic stress disorder, and substance abuse. The study aims to explore the nature and causes of IPV on women’s life and their personal experiences to deal with. This is an NGO-based study. For better understanding of the issues, Purposive sampling was used in selecting women with clinically diagnosed mental illness who experienced IPV. The qualitative research methodology was employed to explore the experiences and impact of IPV on the mental health status of women. For analysis, we used a phenomenological approach and conducted in-depth interviews. Findings show the participating women were suffering from IPV in physical, psychological, and sexual forms. Majority of respondents felt that wife-beating and abusing was fairly common. Most of the women had to face violence on a frequent and occasional basis. IPV experienced women were facing a mental illness like anxiety, depression and sleeping-disorder. The women, who were facing mental illness due to IPV, have been and continue to be exposed to such violence. Despite being employed and suffering from IPV deeply, women choose to stay with their abusive partner because of their children future, lack of support, and social security. The mental health of victims’ was clinically diagnosed, including self-assessed symptoms. It means participants were aware that they are mentally ill because of IPV. The healthy and quick recovery treatment should be given according to the need of women, rather than providing comprehensive standardised treatment for all.     

A longitudinal investigation of intimate partner violence among mothers with mental illness

OBJECTIVE: Severe mental illness, substance use, and intimate partner violence have emerged as major intersecting public health problems that adversely and disproportionately impact the lives of women in the United States. This longitudinal study investigated the demographic and clinical correlates of intimate partner violence in a sample of 324 mothers with severe mental illness. METHODS: A secondary analysis of longitudinal data was conducted by using multiple logistic regression. Participants were part of a longitudinal, community-based study of mothers with severe mental illness, which was aimed at understanding how these mothers viewed motherhood. The women were interviewed initially at baseline (interviews were conducted between 1995 and 1996) and then about 20 months later at follow-up (interviews were conducted between 1997 and 1998). RESULTS: At follow-up the prevalence rate of intimate partner violence was 19%. Multiple logistic regression analyses showed a significant positive relationship between alcohol and drug misuse at baseline and intimate partner violence at follow-up, indicating that women with a co-occurring diagnosis of a substance use disorder (dual diagnosis) were more likely than women without such a diagnosis to report intimate partner violence. The number of lifetime psychiatric hospitalizations and the number of symptoms related to psychiatric disability exhibited at baseline were positively associated with intimate partner violence at follow-up, and age was inversely associated with intimate partner violence. CONCLUSIONS: Mental health professionals serving mothers with mental health problems need to be aware of and prepared to assess the significant correlation between these intersecting public health problems in order to influence successful interventions. Particular attention must be given to the special treatment needs related to dual diagnosis and victimization and the impact of these factors on this vulnerable population.     

Drug abuse and intimate partner violence: a comparative study of opioid-dependent fathers

Because very little is known about the coparenting relationships of drug-abusing men, this comparative study was designed to examine the lifetime prevalence and recent frequency of intimate partner violence in the coparenting relationships of 106 fathers enrolled in methadone maintenance treatment. When compared with 118 community controls, the opioid-dependent fathers reported greater prevalence of physical, sexual, and psychological aggression directed at the mother of their youngest biological child over the course of the relationship. They also reported more frequent physical, sexual, and psychological aggression directed at the mother during the previous year. Similarly, the opioid-dependent fathers reported both greater prevalence of physical and sexual aggression directed at them by the mother of their youngest child over the course of the relationship and more frequent sexual aggression directed at them over the previous year. The results highlight the need for clinicians to consider risk for intimate partner violence in coparenting relationships when planning family-oriented intervention designed to meet the needs of fathers, mothers, and children affected by chronic drug abuse.     

Bridging Healthcare,Police, and Court Responses to Intimate Partner Violence Perpetrated by Individuals with Severe and Persistent Mental Illness

A subgroup of individuals with severe and presistent mental illness (SPMI) commit acts of intimate partner violence (IPV). State and federal legislators have enacted statutes altering police response to IPV. Proarrest laws have curbed police discretion to a degree, and resulted in more IPV arrests. Unaware of alternative options, such as family court, mental health professionals may refer families with IPV to the police. However, perpetrators with SPMI may be inappropriate for adjudication in the criminal justice system. A singular legal response to IPV may miss the opportunity for detection and assertive treatment of SPMI, that could promote safety and reduce the likelihood of violence. Offenders with SPMI may also have difficulty comprehending court procedures. This article discusses the potential for a more flexible approach to IPV through interdisciplinary coordination and training of police, judges, attorneys, legal advocates, mental health professionals and substance abuse providers.     

Relationship conflict and partner violence by UK military personnel following return from deployment in Iraq and Afghanistan

Purpose

Risk of violence by UK military personnel, both towards non-family and family, has been found to be higher post-deployment. However, no UK research to date has attempted to examine relationship conflict and intimate partner violence (IPV) in this period. This study estimated the prevalence of and risk factors for post-deployment relationship conflict and partner violence in UK military personnel.

Methods

We utilised data on military personnel who had deployed to Iraq and/or Afghanistan (n = 5437), drawn from a large cohort study into the health and well-being of UK military personnel.

Results

34.7% reported relationship conflict (arguing with partner) and 3.4% reported perpetrating physical IPV post-deployment. Males were more likely than females to report relationship conflict. There were similar rates of self-reported physical IPV perpetration among males and females. Among our male sample, factors associated with both relationship conflict and physical IPV perpetration post-deployment included being in the Army compared with the Royal Air Force, higher levels of childhood adversity, higher levels of military trauma exposure and recent mental health and alcohol misuse problems. Being over 40 at time of deployment (vs being under 25) and having deployed in a combat role were also associated with relationship conflict, but not physical IPV perpetration.

Conclusions

Deployment-related variables and mental health and alcohol misuse problems were found to be key factors associated with post-deployment relationship conflict and IPV. Services providing health or welfare support to military personnel must collaborate with mental health services and consider history of deployment, and particularly deployment-related trauma, in their assessments to improve identification and management of intimate partner violence and abuse in military communities.