Factors that mediate and moderate the link between partner abuse and suicidal behavior in African American women

Men's attitude towards wife-beating: understanding the pattern and trend in India

BACKGROUND

Intimate partner violence (IPV) is a severe human rights violation and a global burden on public health. Wife-beating is a form of IPV and an extension of the patriarchal philosophy that legitimizes men's control over their spouses. This study investigates (a) the trends and patterns of men's attitudes towards justification of wife-beating and (b) the socio-demographic factors associated with changes in men's attitudes towards wife-beating between 2005-06 and 2019-21 in India.

METHODS

The present study utilized data from the last three rounds of the National Family Health Survey (NFHS): NFHS-3 (2005-06), NFHS-4 (2015-16), and NFHS-5 (2019-21) with a total sample of 2,76,672 men aged 15-54. The primary outcome variable was men's attitudes toward wife-beating. Attitude towards the household and the sexual autonomy of the wife were the two key predictors, in addition to other structural factors. Descriptive, bivariate, and multivariate logistic regression analyses were performed on weighted data using Stata. Hosmer-Lemeshow test, Classification table, and ROC curve were carried out to enhance the robustness of the analysis and validity of the model.

RESULTS

In 2005-06, 50% of men justified wife-beating in at least one of the seven contexts, which reduced to 42% in 2015-16 and then marginally increased to 44% in 2019-21. Men with an authoritarian attitude toward household autonomy (AOR: 2.34; CI: 2.30,2.38) and sexual autonomy of the wife (AOR: 1.68; CI: 1.65,1.71) were more likely to justify wife-beating than their egalitarian counterparts. Inadequate education, younger age, family history of IPV, alcohol consumption, poverty, and rural settings are associated with an elevated risk of abusive attitudes towards wife-beating.

CONCLUSION

A sizable percentage of men, more so those socio-economically marginalized, continue to justify wife-beating, albeit with considerable decline over the years. The findings suggest customized policies and programs enhancing gender egalitarian norms among young men, more opportunities to pursue higher education, alleviating poverty through employment opportunities, and raising awareness about domestic violence in rural settings would help develop more egalitarian gender norms and attitudes towards wife-beating.

Unraveling the Links among Witnessing Interparental Conflict, Hopelessness, Psychological Dating Violence Victimization, and Adult Depressive Symptoms

Witnessing interparental conflict in childhood predicts psychological dating violence victimization (PDVV) in adulthood. As found in previous studies, PDVV and hopelessness are associated with depression. However, the associations among these four variables have not been explored in detail. The present study, therefore, examined the association between perceived interparental conflict and depression in adulthood and whether PDVV and hopelessness might operate as sequential mechanisms accounting for the association. Participants (N = 283; Mage = 23.37 years, SD = 4.04 years) in romantic relationships completed measures of perceived interparental conflict, PDVV, hopelessness, and depression. The perceived interparental conflict was related to PDVV and depression but not to hopelessness in adulthood. Moreover, the association between witnessing interparental conflict and depression was serially mediated via PDVV and hopelessness. The results are discussed in regard to previous research, and their implications for future research are presented.

Precipitating Circumstances Associated With Intimate Partner Problem-Related Suicides

INTRODUCTION

In 2020, suicide was the 12th leading cause of death among adults in the U.S. Previous research has shown that one common precipitating circumstance among adult suicide decedents is experiencing intimate partner problems (IPPs), such as divorce, separation, romantic break-ups, arguments, conflicts, and intimate partner violence. This study examines how precipitating factors differ between IPP- and non-IPP-related suicides.

METHODS

In 2022, this study analyzed National Violent Death Reporting System data from adult suicide decedents in 48 states and 2 territories between 2003 and 2020. Multivariable logistic regression models were used to compare precipitating circumstances between IPP- and non-IPP-related suicides, controlling for sociodemographic characteristics.

RESULTS

Of the 402,391 suicides, 20% (n=80,717) were known to be IPP-related. Circumstances that significantly increased the odds of IPP-related suicides included a history of suicidal thoughts and attempts and mental health problems (depressed mood, alcohol problem, mental health diagnosis), life stressors (interpersonal violence perpetration and victimization, arguments, financial problems, job problems, family problems), and recent legal problems. Non-IPP-related suicides were more likely to occur among older individuals and to be precipitated by a physical health problem or crime.

CONCLUSIONS

The findings can inform prevention strategies that build resiliency and problem-solving skills, strengthen economic support, and identify and assist people at risk for IPP-related suicides. The Centers for Disease Control and Prevention's Suicide Resource for Action and Intimate Partner Violence Prevention resource packages highlight the best available evidence for policies, programs, and practices related to preventing suicides and IPP.

Self-reported anxiety and depression problems and suicide ideation among black and latinx adults and the moderating role of social support

Suicide is a critical public health problem. Over the past decade, suicide rates have increased among Black and Latinx adults in the U.S. Though depression is the most prevalent psychiatric contributor to suicide risk, Black and Latinx Americans uniquely experience distress and stress (e.g., structural adversity) that can independently operate to worsen suicide risk. This makes it important to investigate non-clinical, subjective assessment of mental health as a predictor of suicide ideation. We also investigate whether social support can buffer the deleterious impact of poor mental health on suicide ideation.We analyzed data from 1,503 Black and Latinx participants of the Washington Heights Community Survey, a 2015 survey of residents of a NYC neighborhood. Multivariable logistic regression was conducted to examine the effect of subjectively experienced problems with anxiety and depression on suicide ideation independent of depression diagnosis, and the role of social support as a moderator.Estimated prevalence of past two-week suicide ideation was 5.8%. Regression estimates showed significantly increased odds of suicide ideation among participants reporting moderate (OR = 8.54,95% CI = 2.44-29.93) and severe (OR = 16.84,95% CI = 2.88-98.46) versus no problems with anxiety and depression, after adjustment for depression diagnosis. Informational support, i.e., having someone to provide good advice in a crisis, reduced the negative impact of moderate levels of anxiety and depression problems on suicide ideation.Findings suggest that among Black and Latinx Americans, subjective feelings of anxiety and depression account for a significant portion of the suicide ideation risk related to poor mental health. Further, social support, particularly informational support, may provide protection against suicide ideation.

Coping and Protective Factors of Mental Health: An Examination of African American and US Caribbean Black Women Exposed to IPV from a Nationally Representative Sample

Existing research continues to highlight the harm that intimate partner violence (IPV) can pose to health and well-being. However, little is done to understand the effectiveness of coping and protective mechanisms in helping women manage under adverse circumstances. The current study addresses the mental health of US Black women and the role of coping and protective moderators. An analysis of data from the National Survey of American Life (2001-2003), the most comprehensive survey on the health of US Blacks, was conducted. The association between severe physical intimate partner violence and mental health outcomes were confirmed. Resilience moderated the relationship between severe intimate partner violence and mood disorder among US Black women, but this differed between African American and Caribbean Blacks. Resilience, emotional family support, and spirituality reduced the likelihood of having a mental health condition for some African American and Caribbean Black women, while the opposite was found for religiosity. Demographic factors were also associated with mental health conditions and behaviors. The study draws our attention to potential coping and protective mechanisms that could be incorporated into counseling and intervention practices while recognizing factors that may be harmful to the mental health of individuals.

Role of Social Support in Women facing Domestic Violence during Lockdown of Covid-19 while Cohabiting with the Abusers: Analysis of Cases Registered with the Family Counseling Centre, Alwar, India

The present study aims to analyze the role of social support in the lives of women survivors of domestic violence who filed a complaint with the Mahila Salah and Suraksha Kendra (MSSK) Alwar, India, while residing with the abusive husband and his family during the lockdown period of COVID-19. The study explores the role of MSSK with extended vulnerability of women during the lockdown period at large. This study adopts an exploratory qualitative method. A total of 36 married women who had filed a complaint with MSSK before and during the lockdown were included. Interviews with the women were held through telephonic conversations on vulnerability, coping mechanism and extent and forms of social support. Thematic content analysis was done in a stepwise manner. Results show that degeneration of social support model is time -bound and the accuracy of applying this model wane under extended condition of vulnerability caused due to COVID-19. MSSK can expand support by creating and integrating virtual community networks to detect and deter violence during the lockdown. The study suggests that the government can ensure and empower bystanders with skills of modern communication. The existing physical institutional delivery mechanism need to evolve strategies that are resilient to emerging threats from the vulnerable ecosystem.

Neighborhood Disorder, Social Support, and Outcomes Among Violence-Exposed African American Women

Intimate partner violence (IPV) against women, particularly those living in poverty who have multiple marginalized identities, is a significant public health issue. IPV is associated with numerous mental health concerns including depression, hopelessness, and suicidal behavior. The present study examined the ecological determinants of these mental health outcomes in a high-risk sample of 67 low-income, African American women survivors of IPV. Based on an ecological framework that conceptualizes individuals as nested in multiple, interactive systems, we examined, longitudinally, the main and interactive effects of self-reported neighborhood disorder and social support from family members and friends on participants' mental health (i.e., self-reported depressive symptoms, hopelessness, and suicide intent). In multiple regression analyses, neighborhood disorder interacted with social support from family members to predict depressive symptoms and hopelessness over time. Neighborhood disorder also interacted with social support from friends to predict hopelessness and suicide intent over time. High levels of social support buffered against the dangerous effects of neighborhood disorder on depressive symptoms, hopelessness, and suicide intent; at low levels of social support, there was no significant association between neighborhood disorder and those mental health outcomes. Neighborhood disorder and social support did not yield significant main effects. These findings underscore the importance of interventions that target individuals, families, and communities (e.g., community empowerment programs). Group interventions may also be important for low-income, African American women survivors of IPV, as they can help survivors establish and strengthen relationships and social support.

Associations of Power Relations, Wife-Beating Attitudes, and Controlling Behavior of Husband With Domestic Violence Against Women in India: Insights From the National Family Health Survey-4

This study assesses the relationship of power relations, attitudes toward wife-beating, and controlling behavior of husband with violence against women in India using the recent National Family Health Survey (NFHS-4). In India, about 31% of ever-married women experienced domestic violence committed by their partner during 2015-16. Women's decision-making power was associated with a decreased likelihood of spousal violence. However, the justification of wife-beating and controlling behavior of husband increased the risk of intimate partner violence. This study emphasizes the need for prioritizing girls' education, enhancing women's autonomy, prevention of child marriage, and promoting gender equality in society to address the problem of spousal violence.

Protective factors against suicidal ideation among community-dwelling older adults with experience of spousal physical abuse: focusing on direct and indirect protections

Purpose of the Study: The current research investigated the impact of protective factors - problem-focused coping, emotion-focused coping, having as a confidant either family or friends, and social support from friends - on suicidal ideation among older adults using Wisconsin Longitudinal Study (WLS) data. This study also investigated the indirect effects of protective factors on suicidal ideation (hereafter SI) as mediated by depressive symptoms among older adults who have experienced physical abuse from a spouse or romantic partner.Method: Data from The Wisconsin Longitudinal Study (WLS) were used. The sampled respondents were 475 men and women ages 64 to 65 who reported a history of being physically abused by a spouse or romantic partner. A path analysis using Mplus was employed to identify protective factors against SI.Results: Problem-focused coping and social support had negative indirect effects on SI as mediated by depressive symptoms. Emotion-focused coping had positive direct and indirect effects on SI.Conclusion: Tailored services to boost protective factors and regular screening tests are imperative to reduce depressive symptoms and SI among older adults who have experienced spousal or romantic partner physical abuse.

For Whom Does Cognitively Based Compassion Training (CBCT) Work? An Analysis of Predictors and Moderators among African American Suicide Attempters

OBJECTIVES

Both Cognitively-Based Compassion Training (CBCT) and support-based group intervention have been found to be effective for African American suicide attempters in reducing suicidal ideation and depression, as well as enhancing self-compassion. This study aims to further our understanding of effective interventions by exploring participants' responses to both interventions.

METHODS

Exploratory analyses were conducted in a sample of low-income African Americans who had attempted suicide (n=82) to determine how baseline demographic and psychological characteristics would (1) predict outcomes (i.e., suicidal ideation, depression, and self-compassion) regardless of intervention conditions, and (2) moderate outcomes in interaction with intervention condition.

RESULTS

Non-reactivity, a mindfulness facet, was identified as an intervention moderator for suicidal ideation and depressive symptoms, suggesting that CBCT outperformed the support group for African American suicide attempters who had low baseline non-reactivity (or high reactivity). Individuals who had high non-reactivity at baseline appeared to benefit more from both conditions in self-compassion as an outcome. There was a pattern that homeless individuals benefited less in terms of their levels of depressive symptoms and self-compassion as outcomes regardless of the assigned condition. When applying Bonferroni corrections, only non-reactivity as an intervention moderator for depressive symptoms was significant.

CONCLUSIONS

Findings reveal the relevance of mindfulness and to a lesser extent socioeconomic status in informing compassion-based intervention outcomes with this underserved population and the importance of intervention matching and tailoring to maximize treatment effects. Future large trials are needed to replicate findings and directions indicated from the current pilot study.

Interpersonal trauma and suicide attempts in low-income depressed mothers in home visiting

BACKGROUND

Risk of suicide is a major concern for depressed mothers in the perinatal period. The strongest predictor of completing suicide is having made a previous attempt. Little is known about the clinical features of low-income, depressed mothers who have attempted suicide in contrast to those who have not.

OBJECTIVE

This study examined clinical and psychosocial features of 170 low-income, young, depressed mothers with and without previous suicide attempts who were enrolled in an early childhood home visiting program.

METHOD

Mothers were identified via screening at three months postpartum and diagnosed with major depressive disorder (MDD) using a semi-structured interview. Psychiatric history and presentation, child maltreatment history, intimate partner violence, and social functioning were measured.

RESULTS

31.8% of mothers had previous suicide attempts. Mean age of first attempt was 14.38 years (SD = 2.55) and the median number of lifetime attempts was 2. In contrast to no attempts, those who had attempted suicide had more MDD symptoms, earlier age of first MDD episode, and more episodes. A previous attempt was associated with greater childhood trauma, more current MDD symptoms and PTSD diagnosis. No differences were found on intimate partner violence. Mothers who made an attempt reported lower levels of tangible social support and smaller social networks.

CONCLUSIONS

History of suicide attempts is associated with childhood trauma history and later psychosocial impairments in low income, depressed mothers in home visiting. Implications for addressing the needs of depressed mothers with suicide attempt histories in the context of early childhood programs are discussed.

Associations of adverse childhood experiences and social support with self-injurious behaviour and suicidality in adolescents

BACKGROUND

There is little investigation on the interaction effects of adverse childhood experiences (ACEs) and social support on non-suicidal self-injury (NSSI), suicidal ideation and suicide attempt in community adolescent populations, or gender differences in these effects.AimsTo examine the individual and interaction effects of ACEs and social support on NSSI, suicidal ideation and suicide attempt in adolescents, and explore gender differences.

METHOD

A school-based health survey was conducted in three provinces in China between 2013-2014. A total of 14 820 students aged 10-20 years completed standard questionnaires, to record details of ACEs, social support, NSSI, suicidal ideation and suicide attempt.

RESULTS

Of included participants, 89.4% reported one or more category of ACEs. The 12-month prevalence of NSSI, suicidal ideation and suicide attempt was 26.1%, 17.5% and 4.4%, respectively; all were significantly associated with increased ACEs and lower social support. The multiple adjusted odds ratio of NSSI in low versus high social support was 2.27 (95% CI 1.85-2.67) for girls and 1.81 (95% CI 1.53-2.14) for boys, and their ratio (Ratio of two odds ratios, ROR) was 1.25 (P = 0.037). Girls with high ACEs scores (5-6) and moderate or low social support also had a higher risk of suicide attempt than boys (RORs: 2.34, 1.84 and 2.02, respectively; all P < 0.05).

CONCLUSIONS

ACEs and low social support are associated with increased risk of NSSI and suicidality in Chinese adolescents. Strategies to improve social support, particularly among female adolescents with a high number of ACEs, should be an integral component of targeted mental health interventions.Declaration of interestNone.

Fatigue in systemic lupus: the role of disease activity and its correlates

OBJECTIVES

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that leads to a variety of negative health outcomes resulting from inflammation in various organ systems. Although treatment continues to advance, fatigue remains one of the most salient, poorly understood and addressed patient complaints. Understanding the mechanisms of fatigue can help guide the development of interventions to improve health outcomes. The aim of this research was to evaluate the contribution of six variables (disease activity, insomnia, depression, stress, pain and physical health) to fatigue in SLE without concomitant fibromyalgia (FM).

METHODS

A total of 116 ethnically diverse, primarily female participants (91%) with SLE, receiving care at university medical centers, completed assessments of disease activity and quality of life outcomes (FACIT-FT, Insomnia Severity Index, Perceived Stress Scale (PSS-4), Pain Inventory, Depression-PHQ-9, and LupusPRO-physical function). All patients met the American College of Rheumatology classification criteria for SLE and did not have a known diagnosis of FM. Multivariate linear and stepwise regression analyses were conducted with fatigue (FACIT-FT) as the dependent variable, and the above six variables as independent variables.

RESULTS

Mean (SD) age was 39.80 (13.87) years; 50% were African American, 21% Caucasian, 13% Hispanic, 9% Asian and 8% other. Mean (SD) FACIT-FT was 20.09 (12.76). Collectively, these six variables explained 57% of the variance in fatigue. In the multivariate model, depression, stress and pain were significantly and independently associated with fatigue, but not disease activity, sleep or physical health. Stress had the largest effect on fatigue (β 0.77, 95% CI 0.17-1.38, p = 0.01), followed by depression (β 0.66, 95% CI 0.21-1.10, p = 0.005). On stepwise regression analysis, only stress, depression and pain were retained in the model, and collectively explained 56% of the variance in fatigue. All three remained independent correlates of fatigue, with the largest contribution being stress (β 0.84, 95% CI 0.27-1.42, p = 0.005), followed by depression (β 0.79, 95% CI 0.44-1.14, p < 0.001) with fatigue.

CONCLUSION

Stress, depression and pain are the largest independent contributors to fatigue among patients with SLE, without concurrent FM. Disease activity, sleep and physical health were not associated with fatigue. The evaluation of stress, depression and pain needs to be incorporated during assessments and clinical trials of individuals with SLE, especially within fatigue. This stress-depression-fatigue model requires further validation in longitudinal studies and clinical trials. Significance and innovation: • Disease activity, sleep, pain, stress, depression, and physical health have been reported individually to be associated with fatigue in lupus. This analysis evaluated the role of each and all of these six variables collectively in fatigue among patients with SLE without a known diagnosis of FM. • Disease activity, sleep and physical health were not significantly related to fatigue, but depression, stress and pain were. • The results emphasize the need to evaluate and treat fatigue in individuals with SLE utilizing a biopsychosocial approach, particularly in the realm of clinical trials. Behavioral medicine interventions are shown to be most effective for the treatment of depression, stress and pain.

Willingness to Seek Treatment Among Black Students With Anxiety or Depression: The Synergistic Effect of Sociocultural Factors With Symptom Severity and Intolerance of Uncertainty

Anxiety and depressive disorders are among the most commonly diagnosed psychiatric disorders, yet they remain largely undertreated in the U.S. and Black adults are especially unlikely to seek or receive mental health services. Symptom severity has been found to impact treatment-seeking behaviors as have sociocultural factors. Yet no known research has tested whether these factors work synergistically to effect willingness to seek treatment. Further, emerging data point to the importance of transdiagnostic risk factors such as intolerance of uncertainty (IU). IU may be negatively related to seeking treatment given that Black adults may be uncertain whether treatment might benefit them. Thus, the current study examined the relations between symptom severity/IU and willingness to seek treatment for anxiety/depression problems and the impact of key sociocultural variables (i.e., cultural mistrust-interpersonal relations [CMI-IR], perceived discrimination [PED]) on these relations among 161 (85% female) Black undergraduates. Consistent with prediction, symptom severity was positively related to willingness, but unexpectedly, IU was positively related. There was a significant Symptom Severity × CMI-IR interaction such that severity was positively related to willingness among students with lower cultural mistrust, but not higher mistrust. There were also significant IU × PED interaction such that IU was positively related to willingness among students with lower PED, but not higher PED. Results highlight the importance of considering the interplay between symptom severity, transdiagnostic vulnerability factors, and sociocultural variables when striving to identify factors related to treatment seeking behaviors among anxious and/or depressed Black students.

The relation of protective factors to deliberate self-harm among African-American adults: moderating roles of gender and sexual orientation identity

BACKGROUND

Few studies have examined correlates of deliberate self-harm (DSH) among African-Americans. Moreover, most research on the correlates of DSH in general has focused on risk factors rather than protective factors.

AIMS

This study examined differences in perceived social support, religiosity (both spirituality and church attendance) and overall life satisfaction between African-Americans with and without a history of DSH, as well as the moderating roles of gender and sexual orientation in these relations.

METHOD

Participants were 244 African-American university students who completed questionnaires.

RESULTS

Participants with (vs. without) DSH reported significantly lower levels of social support. Additionally, rates of DSH were significantly higher among participants who attended church irregularly versus regularly or rarely/never. However, the association between DSH and church attendance was significant only for women (vs. men) and LGBQ (vs. heterosexual) women. Further, gender moderated the relation between DSH and social support from both significant others and friends, with self-harming women (but not men) reporting less support than their non-DSH counterparts.

CONCLUSIONS

Findings add to the literature on DSH among African-Americans, highlighting both social support and church attendance (depending on regularity) as potential protective factors within this population.

The Conditional Indirect Effects of Suicide Attempt History and Psychiatric Symptoms on the Association Between Intimate Partner Violence and Suicide Ideation

BACKGROUND

Women seeking shelter from intimate partner violence (IPV) experience heightened risk for suicide ideation and attempts compared to abused and non-abused women in the general population. However, few theory-guided studies have examined what cognitive-emotional symptoms might underlie this increased risk.

METHODS

Guided by fluid vulnerability theory, this cross-sectional, survey study tested whether depressive symptoms, PTSD symptoms, and hopelessness mediate the association between IPV (coercive control and physical violence) and suicide ideation and whether suicide attempt history facilitated these mediated relations in 134 women seeking shelter from IPV.

RESULTS

Depressive symptoms, but not PTSD symptoms or hopelessness, mediated the relation between coercive control and suicide ideation, and suicide attempt history facilitated this association. No variables mediated the association between physical violence and suicide ideation.

LIMITATIONS

The small sample size may have limited statistical power. The cross-sectional design precludes temporal conclusions from being drawn.

CONCLUSIONS

Shelter-seeking women subjected to coercive control who experience associated depressive symptoms may be at risk of suicide ideation, with history of a suicide attempt increasing this risk. Fluid vulnerability theory may help guide suicide risk assessment and intervention efforts among women seeking shelter from IPV.

Military/Civilian Risk Markers for Physical Intimate Partner Violence: A Meta-Analysis

This meta-analysis compared risk markers for perpetration of physical intimate partner violence (IPV) among military and civilian males. We also examined strength of risk markers among male and female service members. In total, 36 military studies and 334 civilian studies, which reported 883 effect sizes, were included in the analyses. Results revealed more similarities than differences in risk markers for IPV among military and civilian males and among military males and females. Of the risk markers examined, relationship satisfaction and alcohol problems were significantly stronger risk markers for IPV among civilian males compared to military males. Perpetrating emotional abuse was a significantly stronger risk marker for IPV perpetration among military females compared to military males. Recommendations for IPV prevention and intervention are discussed.

Suicidal Behavior Among Low-Income African American Women: A Comparison of First-Time and Repeat Suicide Attempters

This investigation ascertained dimensions of a suicide attempt and psychological and historical risk factors that differentiate low-income, female, African American suicide attempters as a function of having made a single, first-time attempt versus multiple attempts. Two groups were compared: first time attempters ( n= 135) and repeat attempters ( n= 139). Participants were recruited from a large, urban hospital following a suicide attempt (i.e., index suicide attempt). Sociodemographic characteristics, details of the index attempt (i.e., the attempt that prompted entry into the study), psychological functioning, hopelessness, substance abuse, and trauma history were assessed. The two groups were largely similar across sociodemographic characteristics. Multivariate analyses of variance were used to test hypotheses. Relative to first-time attempters, the attempts of repeat attempters involved higher levels of intent, planning, and perceived lethality and were associated with more psychological distress, hopelessness, substance abuse, and childhood trauma. Research and clinical implications of the findings are discussed.

Domestic Violence in the African American Community

This article discusses intimate partner violence (IPV) as a major public health issue for women, in particular, African American women. The intersection of IPV and institutional racism doubly victimizes African American women as they try to break out of the cycle of violence. The research shows that IPV in the African American community is more common and violent than in the Caucasian community due to structural, cultural community, and situational contexts, overshadowed by institutional racism, that effect the romantic relationships of African American men and women. Research shows that the anger, hatred, and frustrations of African American men, caused by institutional racism, are being displaced onto their wives and lovers. Suggestions for intervention are presented.

Abusive Partners and Ex-Partners

This study examined how being abused by a current partner versus an ex-partner might affect psychological well-being and social support in a community sample of 398 women, half of whom had experienced abuse in the past 6 months. The impact of emotional and physical abuse was influenced by partner status, with emotional abuse being more detrimental to women abused by current partners and physical abuse being more detrimental to women abused by ex-partners. Emotional support was negatively related to depression in women abused by current partners, whereas practical support was negatively related to depression in women abused by ex-partners. The implications for interventions with abused women are discussed.

The Association of Partner Abuse Types and Suicidal Ideation Among Men and Women College Students

Despite the well-documented relations between intimate partner violence and suicidal ideation, gender differences regarding the relationships between intimate partner violence types and suicidal ideation are less understood. In addition, few studies have examined the risk that harassment may confer for suicidal ideation in the context of intimate partner violence. This study examined gender differences in the associations of harassment, emotional, and physical intimate partner violence with suicidal ideation in 502 college students, while controlling for the influence of depressive symptoms. Results indicated that physical abuse, but not harassment or emotional abuse, was associated with increased suicidal ideation in men. In contrast, emotional abuse, but not physical abuse or harassment, was associated with increased suicidal ideation in women. Clinicians should consider potential gender differences in the impact of intimate partner violence on suicidal ideation when assessing suicide risk.

The underlying role of posttraumatic stress disorder symptoms in the association between intimate partner violence and deliberate self-harm among African American women

African American women are at heightened risk for intimate partner violence (IPV) and its negative consequences, including health-compromising behaviors. Deliberate self-harm (DSH) is one clinically-relevant behavior that has been understudied among African American women generally and those with exposure to IPV in particular. To date, no studies have examined factors that may account for the relationship between IPV and DSH. Therefore, the goal of the present study was to examine the intercorrelations among IPV (physical, psychological, and sexual), PTSD, and DSH history and versatility, and the potentially mediating role of PTSD symptoms in the IPV-DSH relation. Participants were 197 African American community women currently experiencing IPV. Sixty participants (31%) reported a history of DSH. Among participants who reported DSH, there was an average endorsement of 2.3 unique forms of deliberate self-harm (i.e., DSH versatility). Significant positive associations were detected among physical IPV severity, psychological IPV severity, PTSD symptom severity, and DSH history and versatility. PTSD symptom severity mediated the relationships between physical and psychological IPV severity and DSH history and versatility. Results highlight the relevance of PTSD symptoms to DSH and suggest that treatments targeting PTSD symptoms may be useful in reducing DSH among IPV-exposed African American women.

A theory-based approach to understanding suicide risk in shelter-seeking women

Women seeking shelter from intimate partner violence are at an increased risk for suicide ideation and attempts compared to women in the general population. Control-based violence, which is common among shelter-seeking women, may play a pivotal role in the development of suicide ideation and attempts. Current risk assessment and management practices for shelter-seeking women are limited by the lack of an empirically grounded understanding of increased risk in this population. We argue that in order to more effectively promote risk assessment and management, an empirically supported theory that is sensitive to the experiences of shelter-seeking women is needed. Such a theory-driven approach has the benefits of identifying and prioritizing targetable areas for intervention. Here, we review the evidence for the link between coercive control and suicide ideation and attempts from the perspective of Baumeister's escape theory of suicide. This theory has the potential to explain the role of coercive control in the development of suicide ideation and eventual attempts in shelter-seeking women. Implications for suicide risk assessment and prevention in domestic violence shelters are discussed.

Informal support for women and intimate partner violence: the crucial yet ambivalent role of neighbours in urban India

Women who experience intimate partner violence often rely on informal support to mitigate intimate partner violence's health effects. Yet there is little known about who gives the support and how it is provided. This paper explores from whom and how low-income women experiencing domestic violence in urban India seek informal support. In South Asia, women's reliance on kin for support is culturally valued, yet the urban social context makes it more likely that they will access such support from non-kin when they experience intimate partner violence. The paper draws on observations and interviews with 10 families collected over 14 months of in-depth ethnographic research in one Delhi slum community. Using a case study approach to explore women's responses to violence longitudinally, it was possible to track how women drew on support. Results show that even as women sought emotional support and direct intervention from their neighbours to deal with their domestic violence, they restricted these relationships, faced stigma, and emphasised the need to protect their families. Understanding the informal, but deeply ambivalent, systems of social support that women engage to deal with intimate partner violence is a first step toward strengthening such networks, a key recommendation to stem the health impacts of domestic violence.

Mediators of the childhood emotional abuse-hopelessness association in African American women

Although there is an association between experiencing childhood emotional abuse and feeling hopeless as an adult, it is critical to understand the factors that may be protective in this relationship. The goal of this study was to determine if two protective factors, namely spiritual well-being, including both religious and existential well-being, and positive self-esteem, served to mediate the association between childhood emotional abuse and adult hopelessness. The sample for this investigation was low-income African American women suicide attempters who were abused by a partner in the prior year (N=121). A path analysis revealed that in this sample, the childhood emotional abuse-hopelessness link was mediated by existential well-being and positive self-esteem, as well as by the two-mediator path of emotional abuse on existential well-being on self-esteem on hopelessness. Results suggested that existential well-being may be a more salient protective factor for hopelessness than religious well-being among abused, suicidal African American women who experienced childhood emotional abuse. Findings highlight the value of culturally relevant strategies for enhancing existential well-being and self-esteem in this at-risk population to reduce their vulnerability to feelings of hopelessness.

Validation of the multi-dimensional scale of perceived social support (MSPSS) and the relationship between social support, intimate partner violence and antenatal depression in Malawi

BACKGROUND

Lack of social support is an important risk factor for antenatal depression and anxiety in low- and middle-income countries. We translated, adapted and validated the Multi-dimensional Scale of Perceived Social Support (MSPSS) in order to study the relationship between perceived social support, intimate partner violence and antenatal depression in Malawi.

METHODS

The MSPSS was translated and adapted into Chichewa and Chiyao. Five hundred and eighty-three women attending an antenatal clinic were administered the MSPSS, depression screening measures, and a risk factor questionnaire including questions about intimate partner violence. A sub-sample of participants (n = 196) were interviewed using the Structured Clinical Interview for DSM-IV to diagnose major depressive episode. Validity of the MSPSS was evaluated by assessment of internal consistency, factor structure, and correlation with Self Reporting Questionnaire (SRQ) score and major depressive episode. We investigated associations between perception of support from different sources (significant other, family, and friends) and major depressive episode, and whether intimate partner violence was a moderator of these associations.

RESULTS

In both Chichewa and Chiyao, the MSPSS had high internal consistency for the full scale and significant other, family, and friends subscales. MSPSS full scale and subscale scores were inversely associated with SRQ score and major depression diagnosis. Using principal components analysis, the MSPSS had the expected 3-factor structure in analysis of the whole sample. On confirmatory factor analysis, goodness-of-fit indices were better for a 3-factor model than for a 2-factor model, and met standard criteria when correlation between items was allowed. Lack of support from a significant other was the only MSPSS subscale that showed a significant association with depression on multivariate analysis, and this association was moderated by experience of intimate partner violence.

CONCLUSIONS

The MSPSS is a valid measure of perceived social support in Malawi. Lack of support by a significant other is associated with depression in pregnant women who have experienced intimate partner violence in this setting.

Overlapping genetic and environmental influences on nonsuicidal self-injury and suicidal ideation: different outcomes, same etiology?

IMPORTANCE

Nonsuicidal self-injury (NSSI) and suicidal self-injury are very harmful behaviors and are associated with several psychiatric disorders. In the recently developed fifth edition of the DSM, NSSI and suicidal behavior disorder are for the first time introduced as conditions in their own right instead of symptoms of other psychiatric disorders. It is unclear to what extent NSSI and suicidal self-injury share the same underlying biological mechanisms and are influenced by the same environmental factors.

OBJECTIVE

To determine the relative importance of genetic and environmental influences on the variation in NSSI and suicidal ideation and their covariation.

DESIGN, SETTING, AND PARTICIPANTS

Classical twin design using a sample of 10,678 male and female adult twins (mean [SD] age, 32.76 [6.99] years) from the Australian Twin Registry, a population-based twin registry. Between 1996 and 2009, the twins participated in semistructured telephone interviews that primarily focused on psychiatric disorders.

MAIN OUTCOMES AND MEASURES

Lifetime presence of self-reported NSSI and suicidal ideation. RESULTS The prevalences of NSSI and suicidal ideation were 4.7% and 26.5%, respectively, and individuals who engaged in self-harm were much more likely to report suicidal ideation (odds ratio = 8.39; 95% CI, 6.84-10.29). Results from a bivariate genetic model indicated that genetic factors explain a substantial part of the variance in both NSSI (37% for men and 59% for women) and suicidal ideation (41% for men and 55% for women), while residual influences (including nonshared environmental influences and measurement error) explain the remainder of the variance. Shared (family) environment did not seem to play a role. Moreover, both behaviors were strongly correlated (r = 0.49 for men and 0.61 for women), and this correlation was largely explained by overlapping genetic influences (76% for men and 62% for women), whereas residual influences accounted for the remainder of the phenotypic correlation.

CONCLUSIONS AND RELEVANCE

Results indicated that the substantial correlation between NSSI and suicidal ideation is largely driven by overlapping genetic factors, suggesting that the 2 behaviors share similar biological underpinnings. Overlapping residual influences also explain part of the covariance between the 2 traits. Future research should further investigate which genetic and environmental influences underlie the vulnerability to NSSI and suicidal ideation.

Mediators of the daily hassles-suicidal ideation link in African American women

Depressive symptoms and hopelessness as mediators of the daily hassles-suicidal ideation link in low-income African American women exposed to intimate partner violence (n = 100) were investigated. As hypothesized, daily hassles, depressive symptoms, and hopelessness were each significantly and positively associated with suicidal ideation. Moreover, the relation between daily hassles and suicidal ideation was, in part, accounted for by depressive symptoms and hopelessness. This study demonstrates the importance of assessing for the presence of these risk factors when determining the likelihood that an abused African American woman will consider suicide. The findings further highlight the value of designing and implementing interventions that target the reduction in depressive symptoms and hopelessness in abused African American women exposed to daily hassles to reduce their suicide risk.

The role of Violence Against Women Act in addressing intimate partner violence: a public health issue

Intimate partner violence (IPV) is defined as violence committed by a current or former boyfriend or girlfriend, spouse or ex-spouse. Each year, 1.3 to 5.3 million women in the United States experience IPV. The large number of individuals affected, the enormous healthcare costs, and the need for a multidisciplinary approach make IPV an important healthcare issue. The Violence Against Women Act (VAWA) addresses domestic violence, dating violence, sexual assault, and stalking. It emphasizes development of coordinated community care among law enforcement, prosecutors, victim services, and attorneys. VAWA was not reauthorized in 2012 because it lacked bipartisan support. VAWA 2013 contains much needed new provisions for Native Americans; lesbian, gay, bisexual, transgender, gay, and queer (LGBTQ) individuals; and victims of human trafficking but does not address the large amount of intimate partner violence in America's immigrant population. There are important remaining issues regarding intimate partner violence that need to be addressed by future legislation. This review examines the role of legislation and addresses proposals for helping victims of IPV.

Examining the Intersection Between Suicidal Behaviors and Intimate Partner Violence Among a Sample of Males Receiving Services From the Veterans Health Administration

Veterans comprise 10% of the population, and suicide among Veterans has garnered national media and policy attention. Existing research suggests that intimate partner violence (IPV) is a risk factor for suicidal behaviors among some high-risk populations. This report offers a new perspective: the intersection between Veterans’ suicidal thoughts and IPV, both victimization and perpetration. The data were obtained from a northeast telephone survey of Veterans ( n = 296) using Veterans Health Administration services and yielded a 27% participation rate. Findings suggest male Veterans who are IPV involved have increased odds of suicidal thoughts and behaviors.

Gender and racial differences for suicide attempters and ideators in a high-risk community corrections population

BACKGROUND

Community corrections populations are a high-risk group who carry multiple suicide risk factors.

AIMS

To identify factors correlated with historical suicide attempts and ideation among African-American men, African-American women, White men, and White women in a community corrections population.

METHOD

Self-report data from 18,753 enrollees in community corrections were analyzed. Multinomial logistic regression analyses were conducted to determine associations between historical suicidal ideation and attempts among the four demographic groups.

RESULTS

Participants with historical suicide attempts tended to be younger, White, female, be taking psychotropic medication, have a history of physical or sexual abuse, and meet criteria for dependence on alcohol, amphetamines, cocaine, opioids, or sedatives. Five variables were commonly associated with suicide attempts for all four race/gender groups: younger age, being on disability or retirement, taking psychotropic medication, history of sexual or physical abuse, and cocaine dependence. Other demographic variables had race or gender specificities as risk factors for suicide attempts.

CONCLUSIONS

Participants had high rates of historical suicide attempts with unique correlates differentiating attempters from ideators among different racial and gender groups. Cocaine dependence was universal predictor of suicide attempts, while other substance dependencies show specific racial and gender profiles associated with suicide attempts.

Mediators of a culturally-sensitive intervention for suicidal African American women

This study explored intervention outcomes and mechanisms that could help explain why low-income, African American women with a history of intimate partner abuse and suicide attempt improve in response to a culturally-informed intervention, the Grady Nia Project. Specifically, the investigation examined whether or not the intervention had effects on the women and whether or not spiritual well-being and coping mediated the effects of the intervention on suicidal ideation and depressive symptoms. In this randomized controlled clinical trial, data from 89 women who completed both pre- and post-intervention assessments were analyzed. During the post-intervention follow-up, women in the active intervention group reported lower levels of suicidal ideation and depressive symptoms and higher levels of existential well-being and adaptive coping skills than those women randomized to the treatment as usual group. However, only existential well-being was found to mediate treatment effects on suicidal ideation and depressive symptoms. Religious well-being, as well as adaptive and maladaptive coping, did not serve a mediational function. These findings highlight the importance of designing and implementing culturally-sensitive and evidence-based strategies that enhance existential well-being in this population.

The association between social relationships and self-harm: a case-control study in Taiwan

BACKGROUND

Although suicide has been postulated as a result of social breakdown, relatively little attention has been paid to the association between social relationships and non-fatal self-harm. We sought to investigate the extent to which social factors correlate with self-harm in this case-control study.

METHODS

The primary outcome was self-harm with hospital presentation. Cases of self-harm from the Emergency Department in a general hospital in Northern Taiwan were recruited, and individually age-and-gender-matched control participants were recruited from non-psychiatric outpatient clinics at the same hospital. The Close Persons Questionnaire was administered and its social support and social network subscales were used to measure social relationships in the 12 months prior to the interview. Other covariates, comprising sociodemographic factors, major life events, physical and mental health, were adjusted in conditional logistic regression models.

RESULTS

A total of 124 case-control pairs were recruited. The mean (standard deviation) age of the case group was 34.7 (12.8) years and 80.6% were female. Higher social isolation score remained significantly associated with self-harm after adjustment (adjusted odds ratio per standard deviation increase 2.92, 95% confidence interval 1.44-5.95) and household size was negatively associated with the outcome (adjusted odds ratio per unit increase 0.54, 95% CI 0.32-0.94).

CONCLUSIONS

More limited social networks were associated with self-harm after adjustment for potential confounders. Enhancing social structure and effective networking of people with self-harm to community resources may be important for self-harm management in Asian societies and elsewhere.

Reasons for living, social support, and Afrocentric worldview: assessing buffering factors related to Black Americans' suicidal behavior

This study utilized an ecological framework to explore the role of 4 culturally relevant protective factors-reasons for living, Afrocentric worldview, family support, and friend support-in protecting Black American college students from suicidal behavior. Participants were 289 Black American college students. We hypothesized that these 4 culturally relevant factors would exert indirect protective effects on suicidal behavior through their association with reduced depressive symptoms. Results indicated that reasons for living, perceived supportive behaviors from family, and Afrocentric worldview exerted indirect protective effects on suicidal behaviors through their negative associations with depressive symptoms. The mediation effect from friend support to depression and suicidal behavior was not significant.

Race of Interviewer Effect on Disclosures of Suicidal Low-Income African American Women

Few studies have investigated the impact of interviewer race on the results gleaned through psychological assessment. African American and European American clinical evaluators conducted face-to-face interviews with 161 low-income African American women seeking services at an inner-city hospital following a suicide attempt. Participants were administered measures related to various current life stressors, including the Survey for Recent Life Events, which assesses various forms of daily hassles, and the Index of Spouse Abuse, which taps both physical and nonphysical intimate partner violence (IPV). Multivariate analyses of variance revealed a significant difference on the participants’ reports of daily hassles and IPV to African Americanand European American evaluators. With regard to overall life stress, African American women reported higher levels of total life stress, time pressure stress, social acceptability stress, and social victimization to African American than in European American–led interviews. They also endorsed higher levels of both physical and nonphysical IPV to interviewers of the same race as themselves as compared with interviewers from a different racial background. There were no group differences in terms of work stress, sociocultural differences, and finances. The findings underscore the saliency of interviewer race as a source of nonrandom measurement error capable of influencing statistical results. Implications of ignoring race of interviewer effects in analysis are explored and suggestions are offered in terms of culturally responsive assessment processes.

Intimate partner abuse and suicidality: a systematic review

Research has demonstrated an association between intimate partner abuse and suicidality, presenting a serious mental health issue. However, studies have differed widely in the samples and methods employed, and in the depth of the investigation. Given the level of heterogeneity in the literature, this systematic review examines, for the first time, the nature of the relationship between intimate partner abuse and suicidality. The three main psychological and medical databases (PsychInfo 1887-March 2011; Medline, 1966-March 2011; Web of Knowledge 1981-March 2011) were searched. Thirty-seven papers on the topic of intimate partner abuse and suicidality were found. With only one exception, all of the studies found a strong and consistent association between intimate partner abuse and suicidality. Significantly, this relationship held irrespective of study design, sample and measurement of abuse and suicidality, thus demonstrating a consistently strong relationship between intimate partner abuse and suicidality. This review highlights that intimate partner abuse is a significant risk factor for suicidal thoughts and behaviours, which has important clinical implications.

Rethinking social support and conflict: lessons from a study of women who have separated from abusive partners

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

Violence and other stressful life events as triggers of depression and anxiety: what psychosocial resources protect African American mothers?

Understanding the risk and protective factors related to maternal mental health problems is important for improving the well-being of mothers and children, particularly in African American populations which may be at greater risk for maternal depression and resulting child behavior problems. This study explored whether three psychosocial resources--emotional resilience, social support, and ethnic identity--serve as protective factors in the face of specific stressful events that may trigger African American mothers' depression and anxiety symptoms. Standard self-report measures of depression, anxiety, negative life events, community violence, abuse, emotional resilience, social support, and ethnic identity were administered to African American mothers (N=209) of 2-18 month-old children. Linear regression models revealed main effects of negative life events and abuse on increased depression and anxiety symptoms, while emotional resilience and social support predicted decreased symptoms. There was also a significant interaction revealing a protective-reactive effect of ethnic identity on the associations of witnessed community violence with depression and anxiety symptoms. It is important for primary care providers to screen African American mothers for negative life events and abuse to identify those at increased risk for maternal depression and anxiety symptoms. Treatment programs should target emotional resilience, enhanced social support, and stronger ethnic group affiliation, which may be most effective at preventing mental health problems among mothers exposed to relative lower levels of community violence.

The Impact and Consequences of Partner Abuse on Partners

This study represents a comprehensive review and critique of 122 empirical articles and 10 review articles on the psychological and physical consequences of psychological and physical abuse on partners and yielded several strong and consistent conclusions. Victims of psychological and physical abuse experience more physical injuries, poorer physical functioning and health outcomes, higher rates of psychological symptoms and disorders, and poorer cognitive functioning compared to nonvictims. These findings were consistent regardless of the nature of the sample and, with some exceptions, generally greater for female victims compared to male victims. Moreover, psychological victimization appears to be at least as strongly related to victims’ psychological consequences as is physical victimization. There was a relative dearth of research examining the consequences of psychological abuse for male victims, and the results of those studies have been mixed. Research examining sex differences yields strong and consistent evidence that physical violence has more deleterious consequences for women overall. However, the severity of the physical abuse seems to moderate differences in injury rates. In addition to these known findings from past reviews, this study generated several novel findings. First, there is a small but critical group of studies demonstrating the effects of abuse on health behaviors. Second, physical victimization has serious economic and social consequences for victims and society at large. Third, the consequences of abuse were significantly worse for female victims who were of low income, ethnic minorities, and/or unemployed. In the second section of this article, we critique the existing literature in terms of the content of the research, as well as on conceptual and methodological grounds. In the third section we offer specific recommendations for future research and intervention efforts.

Suffering and smiling: West African immigrant women's experience of intimate partner violence

AIMS AND OBJECTIVES

This study reports the intimate partner violence experiences of West African women living in Australia.

BACKGROUND

Increasing diversity in Australia's population presents new and complex challenges to nurses and other health care providers, particularly in relation to the health needs of immigrant women.

DESIGN

A qualitative naturalistic inquiry design was used.

METHOD

A convenience sample of 21 West African immigrant women in Australia who were 18 years and over were engaged in face-to-face, in-depth interviews and asked to talk about their health experiences. The interviews were transcribed verbatim and analysed thematically. Intimate partner violence was revealed as a major theme in this analysis.

RESULTS

Data revealed that eighteen of the women had experienced intimate partner violence. The women's accounts of intimate partner violence were dominated by two subthemes 'suffering in silence' and 'reluctance to seek help.'

CONCLUSION

Findings revealed intimate partner violence as a significant issue for the newly migrated African women who participated in this study.

RELEVANCE TO CLINICAL PRACTICE

Intimate partner violence is associated with significant adverse physical and psychological health outcomes. It is important that nurses understand the cultural barriers that can impede immigrant women's ability to seek out and receive appropriate support and intervention and provide opportunities for women to disclose experiences of intimate partner violence.

"Let me count the ways:" fostering reasons for living among low-income, suicidal, African American women

Protective factors for fostering reasons for living were examined among low-income, suicidal, African American women. Bivariate logistic regressions revealed that higher levels of optimism, spiritual well-being, and family social support predicted reasons for living. Multivariate logistic regressions indicated that spiritual well-being showed unique predictive value for reasons for living. Further, the multivariate model accurately predicted reasons for living 72% of the time. Partial support was found for a cumulative protective model hypothesizing a linear relationship between the number of protective factors endorsed and increased reasons for living. Implications for community-based preventive and recovery-oriented intervention efforts and future research are discussed.

Suicidal behavior among low-income, African American female victims of intimate terrorism and situational couple violence

This study examined risk of suicidal behavior among low-income, African American women (N = 369) in three types of male intimate relationships- intimate terrorism (IT) (i.e., physical violence used within a general pattern of coercive control), situational couple violence (SCV; i.e., episodic physical violence that is not part of a general pattern of coercive control), and nonviolent (NV; i.e., no physical violence). IT victims had more than double the odds of suicidal behavior compared to SCV victims and this association remained significant after controlling for physical violence severity, depression symptoms, and alcohol and drug abuse. Risk of suicidal behavior was not significantly different for SCV victims compared to women in NV relationships. Findings emphasize the need for researchers and practitioners to distinguish between types of male partner violence when examining its context and consequences for female victims.

Prevalence and correlates of suicidal behavior among adult female victims of intimate partner violence

The prevalence and correlates of suicidal threats and attempts among 662 racially and ethnically diverse adult female victims of intimate partner violence (IPV) were studied. One in five women had threatened or attempted suicide during her lifetime. They observed that multiple logistic regression results indicated that women at greater risk of severe or potentially lethal assaults as measured by the Danger Assessment and those who reported having a chronic or disabling illness were more likely to have threatened or attempted suicide. A linear association was found between age and suicide threats/attempts, with younger women having increased odds. Finally, African American IPV victims were less likely to have threatened or attempted suicide as compared to Latina victims. Study implications are discussed.

Mental and physical health symptoms of family court intimate partner violence petitioners

This paper explores the impact of intimate partner violence on victim health and proposes interdisciplinary coordination between legal and mental health services as a means to assist victims. Data was collected from 95 female petitioners at an upstate New York Domestic Violence Intensive Intervention Court (DVIIC). Study participants completed surveys on physical health, mental health, and social functioning. Survey results demonstrated decreased mental health and social functioning as well as a strong willingness to utilize court-based mental health services if offered. Findings from this study support court-based settings as appropriate sites for addressing mental health needs through collaborative efforts between legal and mental health professionals.

Resilience to suicidality: the buffering hypothesis

Recent years have seen a growing interest into resilience to suicidality, which has been described as a perception or set of beliefs which buffer individuals from suicidality in the face of stressors. The current review extends this research by introducing the buffering hypothesis, a framework for the investigation of resilience to suicidality. The key proposal of this is that psychological resilience factors should be viewed as existing on a separate dimension to risk which acts to moderate the impact of risk on suicidality. Furthermore, like risk factors, resilience factors are bipolar, with their positive pole conferring resilience and their negative pole acting to amplify suicidality. Seventy-seven studies were identified which investigated (a) whether psychological moderators of risk exist and (b) the particular psychological constructs which may act as moderators. The review found strong support for the existence of psychological moderators and indicated a moderating impact of attributional style, perfectionism, agency and hopelessness. These findings support the buffering hypothesis and suggest that a range of psychological factors may confer resilience to suicidality. These results suggest that the identification of moderators may improve estimates of suicide risk and that the development of buffering factors could be a key focus of suicide interventions.

Partner violence and psychological well-being: buffer or indirect effect of social support

OBJECTIVES

To determine the effect of two kinds of intimate partner violence (IPV) (physical and psychological) in the previous 12 months (current) and before the previous 12 months (past) on psychological well-being among women aged 18 to 70 years who attend primary healthcare centers in Spain; and to analyze the effect of the duration of lifetime IPV and social support on psychological well-being.

METHODS

A cross-sectional survey was carried out among 10,322 women randomly recruited in primary healthcare centers in Spain. Outcome variables were three indicators of psychological well-being (psychological distress, psychotropic drug use, and self-perceived health). Predictor variables were the different types of IPV, IPV timing (current and past), duration of lifetime IPV, and social support. Logistic regression models were fitted.

RESULTS

Both types of IPV increased the probability of worse psychological well-being in both IPV timings (current and past). Longer duration of lifetime IPV, friends network size, and tangible support were independently associated with worse psychological well-being. However, an interaction between current IPV and family network size was found. The probability of poor self-perceived health status was reduced by 29% among women exposed to current IPV who had a large family network (odds ratio, 0.71; 95% confidence interval, 0.54-0.94).

CONCLUSIONS

Psychological well-being was independently affected by IPV (types and duration) and social support (friends network size, tangible support). Only family network size mitigates the negative consequences of IPV on self-perceived health status.

The impact of childhood abuse history and domestic violence on the mental health of women in Japan

OBJECTIVE

To understand the independent and interactive effects of childhood abuse history (CAH) and domestic violence (DV) on the mental health status of women in Japan.

METHODS

A self-administered questionnaire survey was conducted among a sample of 340 women staying in 83 Mother-Child Homes in Japan to assess the women's CAH and DV experiences, along with their current mental health problems, including dissociated, depressed, and traumatic symptoms.

RESULTS

Independent from DV, CAH, especially psychological abuse, had a significant impact on all of the women's mental health symptoms. DV was found to have an independent effect on traumatic symptoms. Weak interactive effects of CAH and DV were found on dissociated and traumatic symptoms. Among those women without CAH, DV was significantly associated with dissociated and traumatic symptoms; however, DV had no impact on dissociated and traumatic symptoms if CAH was present.

CONCLUSIONS

The findings suggest the significant impact of CAH on women's mental health problems, independent from DV. CAH and DV weakly interact on women's mental health.

PRACTICE IMPLICATIONS

In psychological therapy for battered women with mental health problems, if the cases were abused during childhood, it is recommended that therapy be focused on childhood abuse, especially if the client was psychologically abused. In addition, mental health care and welfare providers should be aware that the mental health problems of mothers without CAH might be exacerbated by DV; thus, appropriate resource allocation should be considered.

Does the health status of intimate partner violence victims warrant pharmacies as portals for public health promotion?

OBJECTIVES

To explore whether the health status of intimate partner violence (IPV) victims warrants pharmacies to be portals for public health promotion. Specific objectives included (1) identifying prevalence of IPV including domestic violence (DV) and sexual assault (SA) in a community sample, (2) describing characteristics and correlates of DV/SA between participants who reported and did not report DV/SA, and (3) exploring whether DV/SA status is related to mental health medication use.

DESIGN

Cross sectional.

SETTING

Upstate New York during 2006.

PARTICIPANTS

English- and Spanish-speaking respondents younger than 65 years of age answering four questions to assess DV/SA.

INTERVENTION

Secondary analysis of a countywide random telephone survey, the 2006 Monroe County Adult Health Survey, which collects prevalence data on health behaviors and health status indicators.

MAIN OUTCOME MEASURE

To determine whether those reporting DV/SA are at increased odds for mental health medication use, controlling for other sociodemographic- and health-related variables.

RESULTS

The survey response rate was 30.3%, with 1,881 respondents meeting inclusion criteria. Those reporting DV/SA were almost twice as likely to use mental health medications. However, when controlling for other variables, only poor mental and physical health were significant in increasing the odds of mental health medication use.

CONCLUSION

The analyses reported here suggest that DV/SA victims in a community sample use mental health medications. When controlling for other variables, survey respondents reported worse physical and mental health. If pharmacies are suitable portals for DV/SA outreach, curricula would need to provide the knowledge and skills needed to take an active role in this public health promotion.