The "Golden Thread": Coercive Control and Risk Assessment for Domestic Violence

Different Scripts, Different Casts: A Crime Script Analysis Indicating Intimate Partner Violence Is Not All the Same

Crime script analysis was used to analyze intimate partner violence diversity by identifying variables significantly associated with different script tracks. Qualitative thematic analysis using official police administrative data from Queensland, Australia, was used to develop an intimate partner violence protoscript (n = 40), followed by quantitative hierarchical cluster analysis and cross-tabulations to examine diversity within scripts. Four diverse script tracks were identified: "escalating jealousy," "persistently possessive," "controlling victim agency," and "enduring argument." Intimate partner diversity exists with divisions based on statistically significant variables. Implications for situational crime prevention and the use of mixed methods for strengthening crime script analysis are discussed.

Threats, Violence, and Weapon Use Against Children in Domestic Violence Protection Orders

BACKGROUND AND OBJECTIVES

Childhood exposure to domestic violence is common, but the overlap between threats and violence against children and weapon/firearm use has not been well studied. The objectives of this study were to: assess differences in respondent firearm access and the use of weapons in granted domestic violence protection orders (DVPOs) with and without minors (individuals <18 years of age); and characterize the frequency and characteristics of threats and acts of violence against minors.

METHODS

We conducted a cross-sectional study of a random sample of granted DVPOs from 2014-2020 in King County, Washington. We examined the use of threats, violence, and weapons by restrained individuals (ie, respondents) by reviewing and abstracting information from DVPO case files.

RESULTS

Respondent weapon use and firearm possession were more common among DVPOs including minors than DVPOs not including minors (weapon use: 38.2% and 33.0%; firearm possession: 23.1% and 19.1%, respectively). Almost 2 in 3 DVPOs including minors (1338 of 2029) involved threats or violence directed at a minor perpetrated by the DVPO respondent. About 1 in 3 (32.5%) DVPOs documented explicit threats, and 1 in 2 (48.9%) documented violence. Over two-thirds (680 of 993, 68.5%) of acts of violence directed at minors included a weapon.

CONCLUSIONS

We found higher lethality risk (weapon use and respondent firearm access/ownership) among DVPOs including minors. Many minors experienced threats and acts of violence involving weapons and firearms by DVPO respondents. Evidence-based safety planning strategies and training of judicial officers are needed.

"Does It Really Get Better After Dad Leaves?" Children's Experiences With Domestic Violence: A Qualitative Systematic Review

Domestic violence (DV) can persist and escalate post-separation. However, little focus has been given to children exposed to DV during this period. This review aims to consolidate the available evidence on children's post-separation experiences with DV caused by their fathers. A qualitative systematic review was carried out. Six electronic databases were searched from the inception of each database until July 2022. Qualitative studies of children aged below 24 years, with biological fathers that committed DV, of which each had experienced parental separation were selected. Twenty studies were included in this review after screening according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Using Sandelowski and Barroso's analysis method, a meta-summary and a meta-synthesis were conducted. Three major themes with eight subthemes were identified: (1) continued abuse post-separation, (2) child's wavering mind of their fathers, and (3) wrangling between past and present. Overall, the findings highlighted that the experience of DV persisted post-separation through various forms of abuse. Children also struggled with mixed feelings and thoughts toward their fathers. They found it hard to trust their fathers and were cautious about their fathers' intentions regarding love and interest. Some children had difficulty interacting with their fathers and were exploited by them. Different stakeholders such as healthcare professionals and court officials can play a significant role in supporting and protecting children exposed to DV and schools can play a significant role in empowering children against DV.

The Health Care Provider's Role in Addressing Adolescent Relationship Abuse

Adolescent relationship abuse (ARA) is highly prevalent across all sociodemographic groups with negative outcomes in multiple domains of health. Using a healing-centered engagement approach, health care providers can support healthy adolescent relationships and connect ARA survivors to resources and supports to ensure health and well-being. Essential components of health care support for adolescents experiencing ARA include validation of disclosure, assessing safety, a warm hand-off to advocacy resources, addressing immediate and long-term health needs, and connection to a trusted adult. Informing adolescents about limits of confidentiality and use of shared decision-making after ARA disclosure recognizes adolescents' lived experiences and emerging autonomy.

Manual and instrument asphyxiation/strangulation: Examining perpetrator and victim characteristics

Asphyxiation and strangulation are predominant murder methods, with ligature and hands being common weapons in such attacks. This study examines a broad sample with the goal of establishing statistical significance between manual and instrument asphyxiation/strangulation and both victim and offender characteristics. Two hundred cases of perpetrators who strangled or asphyxiated at least one victim on or after 1970 were randomly selected from the Radford-FGCU Serial Killer Database. Descriptive analysis and association tests were performed for characteristics of the perpetrators, victims and crimes. In 68% of the cases, perpetrators only targeted women. The primary murder motives were sadism (36%) and intense emotions (22%), which were statistically associated with the perpetrators' relationship with their victims, serial killing and motive of asphyxiation. There was a relationship between the perpetrators' favoring the use of manual or ligature strangulation/asphyxiation and their ethnicity, prior history of abuse and the victims' racial/ethnic group. Findings highlight the variety of contexts in which strangulation takes place, ranging from sexually or sadism motivated homicide and intimate partner violence. Moreover, the predominance of manual or ligature asphyxiation/strangulation among different racial/ethnic groups may have implications in legal processes, as well as in risk and threat assessments.

Development and Validation of a Prediction Tool for Reoffending Risk in Domestic Violence

Importance

Current risk assessment tools for domestic violence against family members were developed with small and selected samples, have low accuracy with few external validations, and do not report key performance measures.

Objective

To develop new tools to assess risk of reoffending among individuals who have perpetrated domestic violence.

Design, Setting, and Participants

This prognostic study investigated a national cohort of all individuals arrested for domestic violence between 1998 and 2013 in Sweden using information from multiple national registers, including National Crime Register, National Patient Register, Longitudinal Integrated Database for Health Insurance and Labour Market Studies Register, and Multi-Generation Register. Data were analyzed from August 2022 to June 2023.

Exposure

Arrest for domestic violence.

Main Outcomes and Measures

Prediction models were developed for 3 reoffending outcomes after arrest for domestic violence: conviction of a new violent crime (including domestic violence), conviction of any new crime, and rearrest for domestic violence at 1 year, 3 years, and 5 years. The prediction models were created using sociodemographic factors, criminological factors, and mental health status-related factors, linking data from multiple population-based longitudinal registers. Cox proportional hazard multivariable regression was used to develop prediction models and validate them in external samples. Key performance measures, including discrimination at prespecified cutoffs and calibration statistics, were investigated.

Results

The cohort included 27 456 individuals (mean [SD] age, 39.4 [11.6] years; 24 804 men [90.3%]) arrested for domestic violence, of whom 4222 (15.4%) reoffended and were convicted for a new violent crime during a mean (SD) follow-up of 26.5 (27.0) months, 9010 (32.8%) reoffended and were convicted for a new crime (mean [SD] follow-up, 22.4 [25.1] months), and 2080 (7.6%) were rearrested for domestic violence (mean [SD] follow-up, 25.7 [30.6] months). Prediction models were developed with sociodemographic, criminological, and mental health factors and showed good measures of discrimination and calibration for violent reoffending and any reoffending. The area under the receiver operating characteristic curve (AUC) for risk of violent reoffending was 0.75 (95% CI, 0.74-0.76) at 1 year, 0.76 (95% CI, 0.75-0.77) at 3 years, and 0.76 (95% CI, 0.75-0.77) 5 years. The AUC for risk of any reoffending was 0.76 (95% CI, 0.75-0.77) at 1 year and at 3 years and 0.76 (95% CI, 0.75-0.76) at 5 years. The model for domestic violence reoffending showed modest discrimination (C index, 0.63; 95% CI, 0.61-0.65) and good calibration. The validation models showed discrimination and calibration performance similar to those of derivation models for all 3 reoffending outcomes. The prediction models have been translated into 3 simple online risk calculators that are freely available to use.

Conclusions and Relevance

This prognostic study developed scalable, evidence-based prediction tools that could support decision-making in criminal justice systems, particularly at the arrest stage when identifying those at higher risk of reoffending and screening out individuals at low risk of reoffending. Furthermore, these tools can enhance treatment allocation by enabling criminal justice services to focus on modifiable risk factors identified in the tools for individuals at high risk of reoffending.

Examining the Effectiveness, Acceptability, and Feasibility of Virtually Delivered Trauma-Focused Domestic Violence and Sexual Violence Interventions: A Rapid Evidence Assessment

The COVID-19 pandemic has forced a rapid shift to virtual delivery of treatment and care to individuals affected by domestic violence and sexual violence. A rapid evidence assessment (REA) was undertaken to examine the effectiveness, feasibility and acceptability of trauma-focused virtual interventions for persons affected by domestic violence and sexual violence. The findings from this review will provide guidance for service providers and organizational leaders with the implementation of virtual domestic violence and sexual violence-focused interventions. The REA included comprehensive search strategies and systematic screening of and relevant articles. Papers were included into this review (1) if they included trauma-focused interventions; (2) if the intervention was delivered virtually; and (3) if the article was published in the English-language. Twenty-one papers met inclusion criteria and were included for analysis. Findings from the rapid review demonstrate that virtual interventions that incorporate trauma-focused treatment are scarce. Online interventions that incorporate trauma-focused treatment for this at-risk group are limited in scope, and effectiveness data are preliminary in nature. Additionally, there is limited evidence of acceptability, feasibility and effectiveness of virtual interventions for ethnically, culturally, and linguistically diverse populations experiencing domestic violence and sexual violence. Accessing virtual interventions was also highlighted as a barrier to among participants in studies included in the review. Despite the potential of virtual interventions to respond to the needs of individuals affected by domestic violence and/or sexual violence, the acceptability and effectiveness of virtual trauma-focused care for a diverse range of populations at risk of violence are significantly understudied.

The 'officer effect' in risk assessment for domestic abuse: Findings from a mixed methods study in England and Wales

Research on risk assessment for domestic abuse has focused primarily on the predictive validity of specific tools; less attention has been paid to implementation of risk tools by practitioners. This paper presents findings from a mixed methods study in England and Wales. Multi-level modelling reveals an 'officer effect' whereby victims' responses to the Domestic Abuse, Stalking and Harassment and Honour-Based Violence (DASH) risk assessment are influenced by the specific officer that completes the assessment. Specifically, this officer effect is strongest in relation to questions intended to capture elements of controlling and coercive behaviour, and least apparent in relation to identifying physical injuries. We further present findings from field observations and interviews with first response officers that corroborate and help explain the officer effect. We discuss implications for the design of primary risk assessments, victim safeguarding, and the use of police data for predictive modelling.

The impact of stay-at-home orders on safety and stability for women: A topical review of intimate partner violence and intimate femicide in the United States during the initial phase of COVID-19

Purpose

We intend to identify the links between COVID-19, intimate partner violence (IPV), and intimate femicide (IF) for women in the United States by answering the following questions: (1) what does the existing literature say about the intersection of COVID-19, IPV, and IF and (2) what are the contributing factors leading to rates of violence against women during COVID-19?

Method

This topical review summarizes studies published on IPV and IF during the initial stages of COVID-19 covering the period of March 1, 2020, to July 31, 2021. This review identified 22 articles addressing rates of IPV and IF during COVID-19, exacerbating risk factors for women, and recommendations for responses and intervention efforts.

Results

Findings revealed an increase in help-seeking calls during the initial phase of the pandemic and COVID-related circumstances such as extended confinement, unemployment, school closures, social isolation, and financial strains intensifying women's experiences of violence. Data also revealed an increase in purchasing firearms, which increases the risk of women being killed by an intimate partner (Lyons et al., 2020). The nexus of COVID-19 and IPV disproportionately impact women, specifically, Latina immigrants. Implications for utilizing an intersectional framework to further examine these issues and promote social and political change are provided.

Conclusion

Since the rates of IPV and femicide have been reported as increasing during COVID-19, understanding the complexities and stressors associated with life in a pandemic is essential for addressing inequalities women face and the health of our communities.

Characterizing Possible Acute Brain Injury in Women Experiencing Intimate Partner Violence: A Retrospective Chart Review

Survivors of intimate partner violence (IPV) often experience violent blows to the head, face, and neck and/or strangulation that result in brain injury (BI). Researchers reviewed the de-identified forensic nursing examination records of 205 women. More than 88% of women were subjected to multiple mechanisms of injury with in excess of 60% experiencing strangulation. About 31% disclosed various symptoms consistent with BI. Women experiencing strangulation were 2.24 times more likely to report BI-related symptoms compared to those who reported no strangulation. In conclusion, women experiencing IPV are prone to BI suggesting early screening and appropriate management are warranted.

The Effect of COVID-19 on Domestic Violence and Assaults

The purpose of this research was to examine the effect of COVID-19 on four outcomes including calls for service for domestic violence, calls for service for assaults, arrests for domestic violence, and arrests for assaults in Burlington, Vermont. The data for each outcome collected over the time periods January 2012 through May 2021 were obtained from the Burlington Police Department website and then a monthly time-series data set were created. The analyses including an independent samples t-test, a Poisson regression test, and a monthly interrupted time-series analyses (ITSA) were employed to test the effects of COVID-19 on the previously mentioned outcomes. The results of the ITSA showed that in the first month following the onset of the COVID-19 pandemic, domestic violence calls statistically significantly increased, but no statistically significant change was observed in domestic violence arrests, while assault calls and assault arrests statistically significantly decreased. In addition, during COVID-19, there was a statistically significant decreasing trend in domestic violence calls and domestic violence arrests, while there was no statistically significant change in the trends of assault calls and assault arrests. The results suggest that COVID-19 had an immediate as well as a persistent effect on the numbers of domestic violence and assaults. The results and limitations of this study were also discussed.

The anti-anxiety drug lorazepam changes implicit behaviors but not explicit evaluations of sense of agency under authoritative pressure: A functional magnetic resonance imaging study

Previous research on coercion has neglected the fact that agents under authoritative pressure may also suffer from coercive power, which can trigger anxiety-like emotional negativity on its victims. Furthermore, high levels of neuroticism and/or anxiety have been found to be associated with the compliance of various forms of social pressure. In this study, we investigate the effects of the anxiolytic GABA A (gamma-Aminobutyric acid) modulator, lorazepam, on behavioral and neural responses to coercive power. Here, we applied a virtual obedience to authority paradigm alongside lorazepam administration (versus placebo), and during functional magnetic resonance imaging scanning. Our results show that lorazepam administration exerted differential effects on the reaction times (RTs) when initiating harming versus helping behaviors, with longer harming RTs compared to helping RTs, despite comparable subjective ratings regarding perceived coercion. Coercive harming significantly increased activity in the amygdala, hippocampus, orbitofrontal cortex, and dorsolateral prefrontal cortex (dlPFC). Lorazepam administration decreased amygdala and hippocampus activity, but increased dlPFC and right temporoparietal junction activations. The lower activity in the hippocampus predicted higher ratings for perceived coercion. Furthermore, lorazepam significantly decreased the functional connectivity of the hippocampus with the dlPFC during coercive harming. In conclusion, we provide evidence -by incorporating multimodal indices, including neuroimaging, neuropharmacological interventions, and behavioral assessments- to posit that the GABA A agonist, lorazepam, might aid as a possible intervention in service of coping strategies against coercion.

Sexual Violence Perpetration Against Intimate Partners: Current Progress and Future Directions

PURPOSE OF REVIEW

The literature on sexual violence perpetration against an intimate partner is reviewed and synthesized. Intimate partner sexual violence (IPSV) is compared to other forms of interpersonal violence, and the heterogeneity of perpetrators is explored through an examination of proposed taxonomies. This review also addresses the applicability of existing risk assessment tools to IPSV perpetrators and identifies criminogenic needs of particular relevance to IPSV.

RECENT FINDINGS

Recent research suggests the perpetration of IPSV is heterogeneous in nature, and individuals who perpetrate IPSV present with criminogenic needs consistent with exclusively sexual and violent offenders. There is support for existing risk tools to predict recidivism, but they may not encompass all relevant risk factors specific to IPSV offending. Commonality exists with other forms of interpersonal violence; however, the literature indicates that IPSV is complex and does not wholly resemble other sexual or violent offenses. Although further study is needed to fully understand IPSV perpetration, best practices in risk assessment and rehabilitation should employ tools that capture criminogenic needs.

Domestic Coercive Control and Common Mental Disorders Among Women in Informal Settlements in Mumbai, India: A Cross-Sectional Survey

Coercive control behaviors central to the abuse of power appear more frequent than other types of domestic violence, but little is known about its frequency, features, and consequences for women in India. We aimed to examine the prevalence of domestic coercive control and its association with physical, sexual, and emotional domestic violence in the preceding year and symptoms of depression, anxiety, and suicidal thinking. In a cross-sectional survey, we interviewed 4,906 ever-married women aged 18-49 years living in urban informal settlements in Mumbai, India. We developed a 24-item scale of coercive control, assessed physical, sexual, and emotional violence using existing questions, and screened for symptoms of depression with the Patient Health Questionnaire (PHQ9), anxiety with the Generalized Anxiety Disorder (GAD7) questionnaire, and suicidal thinking with questions developed by the World Health Organization. Estimates involved univariable and multivariable logistic regression models and the prediction of marginal effects. The prevalence of domestic coercive control was 71%. In total, 23% of women reported domestic violence in the past 12 months (emotional 19%, physical 13%, sexual 4%). Adjusted models suggested that women exposed to controlling behavior had greater odds of surviving emotional (aOR 2.1; 95% CI 1.7, 2.7), physical (1.4; 1.0, 1.9), and sexual (1.8; 1.1, 3.0) domestic violence in the past 12 months; and higher odds of a positive screen for moderate or severe depression (1.7; 1.3, 2.2), anxiety (2.1; 1.3, 3.1), and suicidal thinking (1.7; 1.2, 2.3), and increased with each additional indicator of coercive control behavior. When women reported 24 indicators of coercive control, the adjusted predicted proportion with moderate or severe depressive symptoms was 60%, anxiety 42%, and suicidal thinking 17%. Inclusion of coercive control in programs to support domestic violence, would broaden our understanding of domestic abuse to resemble most victims experience and improve interventions.

"I'm Just Like, You Know What, It's Now or Never": Exploring How Women of Color Experiencing Severe Abuse and Homicide Risk Journey Toward Formal Help-Seeking

Women in the United States are more likely to be killed by an intimate partner than anyone else, and prior, severe domestic violence (DV) is typically involved in such intimate partner homicides (IPH). Black women experience disproportionately high rates of DV and IPHs, severe injury, and abuse with weapons. Distinct patterns of escalating DV are associated with impending risk of re-victimization and lethal violence. One of the most common predictors associated with formal DV help-seeking is severity of physical violence. The current study uses semi-structured interviews with 11 severe abuse survivors to answer the following research questions: (1) How do women experiencing severe abuse make sense of DV resources across the course of their abusive relationships? (2) How do women experiencing severe abuse make sense of services when fear of death/homicide risk is present? Approximately 91% of the sample is comprised of women of color (WOC) survivors. Results demonstrate that WOC survivors navigated complex journeys toward formal DV help-seeking that involved resisting help-seeking when the abuse still felt manageable; delaying help-seeking to protect themselves from escalating violence; and hastening help-seeking when breaking points were reached and the risk of death felt tangible. DV resources took on a different meaning in participants' lives as abuse became more severe across the abuse lifecourse, and in relation to life circumstances and patterns of abuse, and personal perceptions of homicide risk. WOC participants also often experienced multiple structural barriers to formal help-seeking and waited until the violence was severe and/or life-threatening to make first contact, which highlights the necessity of immediate risk assessment with responsive service offerings that address the link between DV and poverty, as well as regular follow-up and ongoing support.

Intimate Partner Violence (IPV) in Military and Veteran Populations: A Systematic Review of Population-Based Surveys and Population Screening Studies

Intimate partner violence (IPV) may be a major concern in military and veteran populations, and the aims of this systematic review were to (1) provide best available estimates of overall prevalence based on studies that are most representative of relevant populations, and (2) contextualise these via examination of IPV types, impacts, and context. An electronic search of PsycINFO, CINHAL, PubMed, and the Cochrane Library databases identified studies utilising population-based designs or population screening strategies to estimate prevalence of IPV perpetration or victimisation reported by active duty (AD) military personnel or veterans. Random effects meta-analyses were used for quantitative analyses and were supplemented by narrative syntheses of heterogeneous data. Thirty-one studies involving 172,790 participants were included in meta-analyses. These indicated around 13% of all AD personnel and veterans reported any recent IPV perpetration, and around 21% reported any recent victimisation. There were higher rates of IPV perpetration in studies of veterans and health service settings, but no discernible differences were found according to gender, era of service, or country of origin. Psychological IPV was the most common form identified, while there were few studies of IPV impacts, or coercive and controlling behaviours. The findings demonstrate that IPV perpetration and victimisation occur commonly among AD personnel and veterans and highlight a strong need for responses across military and veteran-specific settings. However, there are gaps in understanding of impacts and context for IPV, including coercive and controlling behaviours, which are priority considerations for future research and policy.

Intimate Partner Violence and the Pediatric Electronic Health Record: A Qualitative Study

OBJECTIVES

To explore expert perspectives on risks associated with the pediatric electronic health record (EHR) for intimate partner violence (IPV) survivors and their children and to identify strategies that may mitigate these risks.

METHODS

We conducted semistructured interviews with multidisciplinary pediatric IPV experts (nursing, physicians, social workers, hospital security, IPV advocates) recruited via snowball sampling. We coded interview transcripts using thematic analysis, then consolidated codes into themes.

RESULTS

Twenty-eight participants completed interviews. Participants identified the primary source of risk as an abuser's potential access to a child's EHR by legal and illegal means. They noted that abuser's access to multiple pediatric EHR components (eg, online health portals, clinical notes, contact information) may result in escalated violence, stalking, and manipulation of IPV survivors. Suggested risk mitigation strategies included limited and coded documentation, limiting EHR access, and discussing documentation with the IPV survivor. Challenges to using these strategies included healthcare providers' usual practice of detailed documentation and that information documented may confer both risk and benefit concurrently. Reported potential benefits of the pediatric EHR for IPV survivors included ensuring continuity of care, decreasing need to repeatedly talk about trauma histories, and communication of safety plans.

CONCLUSIONS

Our findings suggest the pediatric EHR may confer both risks and benefits for IPV survivors and their children. Further work is needed to develop best practices to address IPV risks related to the pediatric EHR, to ensure consistent use of these practices, and to include these practices as standard functionalities of the pediatric EHR.

Predicting Domestic Abuse (Fairly) and Police Risk Assessment

Domestic abuse victim risk assessment is crucial for providing victims with the correct level of support. However, it has been shown that the approach currently taken by most UK police forces, the Domestic Abuse, Stalking, and Honour Based Violence (DASH) risk assessment, is not identifying the most vulnerable victims. Instead, we tested several machine learning algorithms and propose a predictive model, using logistic regression with elastic net as the best performing, that incorporates information readily available in police databases, and census-area-level statistics. We used data from a large UK police force including 350,000 domestic abuse incidents. Our models made significant improvement upon the predictive capacity of DASH, both for intimate partner violence (IPV; AUC = .748) and other forms of domestic abuse (non-IPV; AUC = .763). The most influential variables in the model were of the categories criminal history and domestic abuse history, particularly time since the last incident. We show that the DASH questions contributed almost nothing to the predictive performance. We also provide an overview of model fairness performance for ethnic and socioeconomic subgroups of the data sample. Although there were disparities between ethnic and demographic subgroups, everyone benefited from the increased accuracy of model-based predictions when compared with officer risk predictions.

Accounting for Multiple Nonfatal Strangulation in Intimate Partner Violence Risk Assessment

Nonfatal strangulation is a prevalent, underreported, and dangerous form of intimate partner violence (IPV). It is particularly important to assess for strangulation among abused women as this form of violence may not leave visible injury. The most severe negative physical and mental health consequences of strangulation appear to be dose-related, with those strangled multiple times or to the point of altered consciousness at higher risk of negative sequelae. This research examines the relationship between multiple strangulation, loss of consciousness due to strangulation, and risk of future near-fatal violence to modify the Danger Assessment (DA) and the Danger Assessment for Immigrant women (DA-I), IPV risk assessments intended to predict near-fatal and fatal violence in intimate relationships. Data from one study (n = 619) were used to modify the DA to include an item on multiple strangulation or loss of consciousness due to strangulation. Data from an independent validation sample (n = 389) were then used to examine the predictive validity of the updated DA and DA-I. The updated version of the DA predicts near-fatal violence at 7-8 months follow-up significantly better than the original DA. Adding multiple strangulation or loss of consciousness to the DA-I increased the predictive validity slightly, but not significantly. The DA and DA-I are intended to be used as a collaboration between IPV survivors and advocates as tools for education and intervention. Whether or not an IPV survivor has been strangled, she should be educated about the dangerous nature of strangulation and the need for medical intervention should her partner use strangulation against her. This evidence-based adaptation of the DA and DA-I may assist practitioners to assess for and intervene in dangerous IPV cases.

Prevalence and Social Inequality in Experiences of Domestic Abuse Among Mothers of Young Children: A Study Using National Survey Data from Scotland

Domestic abuse is a pernicious societal issue that has both short- and long-term consequences for those who are victimized. Research points to motherhood being linked to women's victimization, with pregnancy being a particular point of risk. Across UK jurisdictions, new legislation aims to extend the criminalization of domestic abuse to include coercive control. Less clear is the relationship between mothers' victimization of different "types" of abuse and other factors such as age, socioeconomic status, and level of education. The article makes an original contribution to knowledge by addressing these limitations of the existing literature. Using nationally representative data from a Scottish longitudinal survey (N = 3,633) into children's development this article investigates the social stratification of mothers' exposure to different types of abuse, including coercive control, physical abuse, and threats. Overall, 14% of mothers report experiencing any type of domestic abuse since the birth of the study child (age 6), of which 7% experienced physical abuse. Compared to mothers in the highest income households, mothers in the lowest income quintile were far more likely to experience any form of abuse (Logistic Regression, OR = 3.55), more likely to have experienced more types of abuse and to have experienced these more often (OR = 5.54). Age had a protective effect, with mothers aged 20 or younger at most risk of abuse (OR = 2.60 compared to mothers aged 40+). Interaction effects between age and income suggested that an intersectional lens may help explain the cumulative layers of difficulty which young mothers on low incomes may find themselves in when it comes to abusive partners. The pattern of social stratification remained the same when comparing different types of abuse. Mothers of boys were more likely to experience abuse, and to experience more types of abuse, more often. We reflect on how these findings could inform existing policy interventions.

Types of Partner Violence in Couples Affected by Incarceration: Applying Johnson's Typology to Understand the Couple-level Context for Violence

In prior research, samples of incarcerated and reentering men and their partners report partner violence at roughly 10 times the frequency found in the general population. The relationship dynamics underlying these experiences remain poorly understood. Addressing this gap and expanding prior applications of Johnson's typology in other populations-which typically rely on survey data alone and include reports from just one member of a couple-we applied latent class analysis with dyadic survey data from 1,112 couples to identify types of partner violence in couples affected by incarceration. We assessed congruence between quantitative types and couples' qualitative accounts and compared the two major types using two-sample t-tests.In some couples, one partner used various tactics to systematically dominate and control the other, as in Johnson's coercive controlling violence. In others, physical violence arose in the context of jealousy but no other controlling behavior. This type resembled Johnson's situational couple violence. Qualitative data suggested that jealousy represented a common, situational response to periods of prolonged separation, relationship instability, status insecurity, and partnership concurrence and not a tactic of control per se. Victims of coercive controlling violence experienced more PTSD symptoms and felt less safe in their relationships than victims of jealous-only violence. Perpetrators of coercive controlling violence were more likely to use severe physical violence against their partners than perpetrators of jealous-only violence. Findings indicate that broader context is critical for interpreting the presence of jealousy (and whether it constitutes a control tactic). They indicate that prevention and response strategies tailored to these types could help couples cope safely with the extreme relationship stressors of incarceration and reentry. Finally, they suggest a need to move from an exclusive focus on individual accountability and services toward a model that also incorporates institutional accountability and change.

Public Understanding of Coercive Control in Northern Ireland

Coercive control is characterised by negative behaviours which intimidate, threaten, and humiliate a person or restrict a person's liberty. In addition to being a known risk factor for experiencing other forms of violence, research has linked coercive control to symptoms of psychological distress and suicidality. In the UK, coercive and controlling behaviours within intimate and familial relationships have been legislated as offending behaviours. However, there still exists a lack of international evidence on wider public knowledge and understanding of coercive control. The Northern Ireland Life and Times Survey (NILT) is an annual cross-sectional representative survey of social policy topics. Participants are adults aged 18 years or over. Concerning coercive control, respondents were presented with two relationship scenarios: obvious and less obvious coercive control. Following each scenario, respondents indicated their level of agreement to ten statements covering attitudes towards coercive control, victims of coercive control, talking about coercive control, and whether coercive control is a crime. Respondents indicated whether they had heard of the term 'coercive control'. Predictors of coercive control awareness were assessed using multinomial logistic regression. Mixed analysis of variance assessed if agreement levels to the ten statements varied by type of coercive control and victim gender. Most respondents said that they had heard of the term coercive control and knew what it meant. Those who had not heard of coercive control at all were more likely to be on a lower income, less qualified and younger, when compared to those who said they knew what the term meant. Significant interactions between coercive control type and victim gender were evident for all ten statements. While most respondents are aware of the term coercive control, a significant number have not and are therefore unlikely to recognise the signs of this type of abuse.

Experiences of Intimate Partner Violence during Lockdown and the COVID-19 Pandemic

Previous studies have demonstrated that there is an increase in Intimate Partner Violence (IPV) during times of crisis (e.g., financial, environmental, or socio-political situations). The COVID-19 pandemic has triggered an unprecedented global health and financial tragedy, but research is yet to establish exactly how the situation may impact on IPV. The present study investigates victims' experience of IPV during lockdown and the COVID-19 pandemic. We report a qualitative thematic analysis of 50 discussion forum posts written by victims of IPV. Of these, 48 forum posts were written by female victims of male perpetrated violence. All forum posts were obtained from the popular online platform, Reddit. We identified four themes associated with IPV victims' experiences during lockdown and the global pandemic: (i) Use of COVID-19 by the Abuser, (ii) Service Disruption, (iii) Preparation to Leave, and (iv) Factors Increasing Abuse or Distress. The COVID-19 pandemic has had a substantial impact on those living with IPV, often increasing the severity of IPV experienced. The experiences of those affected by IPV during this period inform interventions and the guidance and support provided to IPV victims during times of crisis.

Predictors of spousal coercive control and its association with intimate partner violence evidence from National Family Health Survey-4 (2015-2016) India

Background

The feminist theory posits that spousal coercive control is not random but a purposeful and systematic men’s strategy to control and dominate their female partners. The frequency of coercive control is more than emotional, physical, and sexual intimate partner violence (IPV). Coercive control is usually mistaken with psychological abuse when it is not and has recently gained independent attention within the spectrum of IPV. The role of socioeconomic factors in determining coercive control and associations between coercive control and form of IPV is less researched.

Objective

We aimed to examine sociodemographic and socioeconomic predictors of spousal coercive control and its association with IPV (past 12-months).

Methods

We analysed data of 66,013 ever-married women aged 15-49 from the National Family Health Survey (NFHS)-4 (2015-2016). Estimates involved bivariate and multivariate logistic regression models, and marginal effects prediction.

Results

The prevalence of spousal coercive control is more commonly reported by 48% of women than the prevalence of IPV 25% (emotional 11%, physical 22%, and sexual 5%) in the past 12 months. Adjusted odds ratio indicate that women having three and more children (aOR 1.1, 95% CI: 1.0-1.2), women work status (1.1; 1.1-1.2), husband’s secondary (1.1; 1.1-1.2) or higher education (1.1; 1.1-1.2), and husband alcohol consumption (1.7; 1.6-1.7) increase the odds of coercive control. In the fully adjusted model coercive control independently increased the likelihood of experiencing emotional (aOR 2.8.; 95% CI: 2.6, 3.1), physical (2.2; 2.1, 2.3), and sexual (2.5; 2.3, 2.8) IPV in the past 12 months; and with an increase in each additional indicator of coercive control acts, the likelihood of physical, sexual, and emotional IPV further increases. When women reported six indicators of coercive control, the predicted proportion of women experiencing emotional 53%, physical 45%, and sexual IPV was 25% in the fully adjusted model.

Conclusion

Coercive control limits women’s social support and contacts contributing to low self-esteem, self-efficacy, and poor mental health. The purpose of this study is to highlight that understudied coercive control is more common than other forms of IPV and is a potential risk factor for physical, sexual, and emotional IPV independently. The inclusion of coercive control in interventions is crucial to prevent form of IPV. Survivals long-term safety and independence can be secured if the current protection law against domestic violence is extended to encompass coercive control.

COVID-19 lockdowns, intimate partner violence and coercive control

2020 was a year like no other, with the COVID-19 virus upending life as we know it. When governments around the world imposed lockdown measures to curb the spread of COVID-19, advocates in the domestic and family violence (DFV) sector recognised that these measures were likely to result in increases in violence against women, particularly intimate partner violence (IPV). IPV can take many forms, including physical, emotional, psychological, financial, coercive controlling behaviours, surveillance and isolation tactics. Lockdown conditions provide fertile ground for the exercise of coercive control by encouraging people to stay at home, limiting social interactions to household members, reducing mobility and enabling perpetrators to closely monitor their partner's movements. However, media reports and awareness of IPV are generally dominated by a focus on physical violence and lethality, which are easily defined and measured. By contrast, coercive control as a concept is difficult to operationalise, measure and action in law, policy and frontline interventions. This paper discusses the challenges inherent in measuring coercive control and engages with current debates around the criminalisation of coercive control in NSW. Such reflection is timely as the conditions of COVID-19 lockdowns are likely to lead to an increase in coercive controlling behaviours.

Coercive Control, Stalking, and Guns: Modeling Service Professionals' Perceived Risk of Potentially Fatal Intimate Partner Gun Violence

Intimate partner homicides often involve coercive control prior to the murder while stalking following separation has been associated with control within the relationship as well as with lethal violence. The goal of the present study was to investigate how rural and urban community professionals who encounter intimate partner violence (IPV) victims perceive potential risk factors for intimate partner homicide related to firearms and coercive control. Criminal justice and victim service professionals (N = 133) from one urban and four rural communities participated in structured key informant interviews. A purposeful sampling procedure was employed to target professionals with expertise in domestic violence and/or firearms, followed by snowball sampling to maximize the response rate. The only risk factor that was directly associated with perceived risk of potentially fatal intimate partner gun violence was the perceived risk of an abuser threatening a victim with a gun. However, coercive control, separation, and stalking all mediated the relationship between the perceived risk of an abuser's access to a gun and the perceived risk of an abuser threatening the victim with a gun. These results highlight the importance of controlling behavior following separation for risk assessment and that participants in the present study were aware of the potentially dangerous ramifications of such nonphysically violent risk factors for the risk of injury or death by a firearm at the hands of an intimate partner.

How Victims of Strangulation Survived: Enhancing the Admissibility of Victim Statements to the Police When Survivors are Reluctant to Cooperate

Holding perpetrators accountable for family violence is challenged when survivors are reluctant to testify. In light of recent Supreme Court precedents limiting the admissibility of statements to law enforcement in victimless prosecutions, the current study examined 130 cases of nonfatal strangulation (NFS) to determine whether case characteristics and themes across survivors' on-scene statements can help prosecutors combat common legal defenses raised when victims are unavailable for trial. The history of prior violence and how only 6% of perpetrators stopped strangling victims on their own suggests that NFS complaints should be investigated as an attempted homicide until evidence suggests otherwise.

Examining Relationship and Abuse Tactics Associated with Nonfatal Strangulation Experiences Before and After a Protective Order

Nonfatal strangulation is associated with significant physical harm and lethal violence. The overall objective of this study was to examine relationship and abuse tactics for women with (n = 369) and without (n = 276) nonfatal strangulation experiences the year before, and the year after, a civil protective order (PO) against an abusive (ex)partner was obtained. Furthermore, this study sought to examine which abuse tactics, including nonfatal strangulation, were associated with mental health status at follow-up. In the year before the PO, 57% of women experienced nonfatal strangulation and 12.4% experienced nonfatal strangulation in the year after the PO by their abusive (ex)partner. Those with nonfatal strangulation experiences in the year before the PO were 3.5 times more likely to experience nonfatal strangulation after the PO. Additionally, death threats in the year before the PO as well as having spent any time in the relationship with the abuser after the PO were uniquely associated with post-PO nonfatal strangulation. Furthermore, abuser control tactics and severe violence after the PO were significantly associated with mental health status at follow-up after controlling for baseline mental health status. Study results also suggest that those with nonfatal strangulation experiences may have an especially difficult time initiating and maintaining separation from abusive partners. Results suggest that there are specific risk factors to consider in tailoring PO protections, safety supports, and resources for those with prior nonfatal strangulation experiences.

Expert Perspectives on Intimate Partner Violence Power and Control in Pediatric Healthcare Settings

OBJECTIVE

Childhood exposure to intimate partner violence (IPV) is a pervasive public health epidemic with profound impact on child health. While past work has demonstrated how abusive partners exert control over IPV survivors in a variety of settings (eg workplace, courts, home), scant research has examined how IPV power and control behaviors manifest themselves in pediatric healthcare settings. In this study, we explore the perspectives of pediatric IPV experts about: (1) behaviors used by abusive partners to control IPV survivors in pediatric healthcare settings; (2) how controlling behaviors impact healthcare access and quality; and (3) recommendations for the pediatric healthcare team.

METHODS

Individual semi-structured interviews were conducted with pediatric IPV experts recruited through snowball sampling. Interviews were individually coded by two research team members and analyzed using thematic analysis.

RESULTS

Twenty-eight pediatric IPV experts participated. Participants described several types of controlling behaviors including limiting healthcare access, dominating conversations during medical visits, controlling medical decision making, and manipulating perceptions of the healthcare team. Participants acknowledged the challenges of recognizing controlling behaviors and provided several recommendations to addressing behaviors such as leveraging the expertise of multidisciplinary teams.

CONCLUSIONS

Participants described how abusive partners may attempt to control or discredit their partners in pediatric healthcare settings, using subtle behaviors that may be easily missed by the healthcare team. These results set the stage for further research and clinical practice innovation including triangulating the findings with IPV survivors, examining how frequently these behaviors occur, and developing multidisciplinary IPV training for the pediatric healthcare team.

A Comparison of Intimate Partner Violence Strangulation Between Same-Sex and Different-Sex Couples

Strangulation is a common and dangerous form of intimate partner violence (IPV). Nonfatal strangulation is a risk factor for homicide; can lead to severe, long-term physical and mental health sequelae; and can be an effective strategy of coercion and control. To date, research has not examined strangulation within same-sex couples. The objective of this cross-sectional, observational research is to identify whether and to what extent the detection of strangulation and coercive control differs between same-sex and different-sex couples in police reports of IPV. Data (n = 2,207) were obtained from a single police department in the southwest United States (2011-2013). Bivariate analyses examined differences in victim and offender demographics, victim injury, violence, and coercive controlling behaviors between same-sex (male-male and female-female) and different-sex couples (female victim-male offender). Logistic regression was used to examine associations between strangulation, victim and offender demographics, coercive controlling behaviors, and couple configuration. Strangulation was reported significantly more often in different-sex (9.8%) than in female and male same-sex couple cases (5.2% and 5.3%, respectively; p < .05). Injury, however, was reported more frequently in same-sex than in different-sex couples (p < .05). Couple configuration (p < .05), coercive control (p < .05), and injury (p < .05) significantly predict strangulation. Findings suggest that nonfatal strangulation occurs within at least a minority of same-sex couples; it is possible that underdetection by law enforcement makes it appear less common than it actually is. Regardless of couple configuration, timely identification of strangulation and subsequent referral to medical and social service providers is essential for preventing repeated strangulation, life-threatening injury, and the long-term health effects of strangulation.

Investigating the prevalence of intimate partner violence victimisation in women presenting to the emergency department in suicidal crisis

OBJECTIVE

To investigate the prevalence of intimate partner violence (IPV) and frequency of victimisation questioning by hospital staff in women presenting to EDs for suicide-related complaints and injuries.

METHODS

A cross-sectional survey design was used to assess IPV and ED experiences among women with a recent (<18 months) suicide-related presentation to EDs within six Local Health Districts across New South Wales. Women aged 16 years and over, residing in participating health districts were recruited in-person by hospital staff, or via Facebook advertisements. Variables assessed included demographic characteristics, psychosocial assessment coverage and exposure to IPV (Composite Abuse Scale [Revised]-Short-Form). Binary logistic regression was used to test for independent associations between variables on victimisation questioning by hospital staff.

RESULTS

A total of 563 women completed questionnaires following presentation to the ED for a suicide attempt (n = 329; 58%) or suicide crisis (n = 234; 42%). Of these, 200 women (36%) reported IPV exposure in the 18 months prior and 141 women (25%) reported earlier lifetime victimisation. Of the 341 women with a history of IPV, 155 women (45%) were asked about victimisation by hospital staff. Younger age and lower socio-economic status were significantly associated with questioning (P = 0.03).

CONCLUSION

Findings suggest a large proportion of women seeking support for suicide in the ED are affected by IPV, although few are asked about abuse experiences. Victimisation is associated with complex health issues and heightened mortality risk, which carry important implications for patient-care. Findings support routine ED screening and can be applied to stratify risk within IPV responses.

The Validity and Reliability of Available Intimate Partner Homicide and Reassault Risk Assessment Tools: A Systematic Review

At least one in seven homicides around the world is perpetrated by intimate partners. The danger of intimate partner homicide (IPH) associated with intimate partner violence (IPV) has led to the development of numerous IPV reassault and IPH risk assessment tools. Using 18 electronic databases and research repositories, we conducted a systematic review of IPH or IPV reassault risk assessment instruments. After review, 43 studies reported in 42 articles met inclusion criteria. We systematically extracted, analyzed, and synthesized data on tools studied, sample details, data collection location, study design, analysis methods, validity, reliability, and feasibility of use. Findings indicate that researchers in eight countries have tested 18 distinct IPH or IPV reassault risk assessment tools. The tools are designed for various professionals including law enforcement, first responders, and social workers. Twenty-six studies focused on assessing the risk of male perpetrators, although eight included female perpetrators. Eighteen studies tested tools with people in mixed-sex relationships, though many studies did not explicitly report the gender of both the perpetrators and victims/survivors. The majority of studies were administered or coded by researchers rather than administered in real-world settings. Reliable and valid instruments that accurately and feasibly assess the risk of IPH and IPV reassault in community settings are necessary for improving public safety and reducing violent deaths. Although researchers have developed several instruments assessing different risk factors, systematic research on the feasibility of using these instruments in practice settings is lacking.

Risk Factors in Domestic Homicides: Identifying Common Clusters in the Canadian Context

Little research has attempted to examine risk factor combinations when examining intimate partner violence. A variety of risk factors have been identified in domestic homicides, and it is recognized that risk of lethality may increase with the presence of more rather than less risk factors. This relationship is not necessarily linear, however. The objective of this study was to identify whether particular risk factor combinations are common in cases of domestic homicide. The study comprised 183 deaths that occurred between 2002 and 2012 and were reviewed by the Domestic Violence Death Review Committee, Office of the Chief Coroner of Ontario, Canada, with particular focus on the presence/absence of 40 empirically based risk factors. The analyses identified three distinct risk factor clusters that differed primarily by victim-perpetrator relationship and the likelihood of perpetrator suicide or attempts to commit suicide. Cases involving perpetrators currently in legal marriages or cohabitating with their victims were most common among the Non-Depressed/Non-Violent Cluster followed by the Depressed/Violent Cluster. In contrast, the majority of those in the Non-Depressed/Violent Cluster were estranged from their victims and the least likely to attempt/commit suicide. The study demonstrates that particular risk factor combinations are common in cases of domestic homicide. Future research should expand the number of risk factors examined, increase the sample size to further test cluster validity, and compare lethal and non-lethal intimate partner violence and homicide to allow for an examination of the clusters more unique to lethality. Prevention initiatives should emphasize the heterogeneity of domestic homicides and target specific interventions.

Considerations of the impacts of COVID-19 on domestic violence in the United States

"Stay home, save lives" has been shown to reduce the impacts of COVID-19; however, it is crucial to recognize that efforts not to stress healthcare systems may have unintended social consequences for domestic violence. This commentary addresses domestic violence as an important social and public health implication of COVID-19. As a pandemic with a high contagion level, necessary social distancing measures have been put in place across the world to slow transmission and protect medical services. We first present literature that shows that among the effects of social distancing are social and functional isolation and economic stress, which are known to increase domestic violence. We then present preliminary observations from a content analysis conducted on over 300 news articles from the first six weeks of COVID-19 "lockdown" in the United States: articles predict an increase in domestic violence, report an increase in domestic violence, and inform victims on how to access services. Assessing the intersection of the early news media messaging on the effect of COVID-19 on DV and the literature on social isolation and crisis situations, we conclude the commentary with implications for current policy related to (1) increased media attention, (2) increased attention in healthcare systems, (3) promoting social and economic security, and (4) long-term efforts to fund prevention and response, as well as research implications to consider. The research is presented as ongoing, but the policy and procedure recommendations are presented with urgency.

Service Provider Difficulties in Operationalizing Coercive Control

We examined perspectives of social workers, police officers, and specialist domestic abuse practitioners about their perceived ability and organizational readiness to respond effectively to incidents of coercive and controlling behavior. Interviews revealed intervention and risk assessment strategies structured around an outdated, maladaptive concept of domestic abuse as an unambiguous and violent event and frontline services that lacked appreciation of the power dynamics inherent in controlling relationships. The analysis demonstrates how lack of definitional clarity around nonphysical domestic abuse can increase the use of discretion by frontline services and, by extension, increase the discounting of coercive control by pressured frontline officers.