The psychological subtype of intimate partner violence and its effect on mental health: a systematic review with meta-analyses

Comparative Analysis of Intimate Partner Violence Perpetrators According to their Referral Type: Self-Referred, Legally Mandated, and Formally Pressured

Intimate partner violence (IPV) is a major public health issue with long-lasting consequences, necessitating effective treatments to disrupt its intergenerational transmission. However, the common one-size-fits-all approach in IPV programs may fail to acknowledge the diversity among perpetrators. This study compared three types of IPV perpetrators entering treatment: self-referred, legally mandated, and formally pressured. Among 1,302 men surveyed, self-referred men were generally older, more educated, and reported more clinical symptoms than those in the other groups. They appeared more ready to change and less influenced by social desirability biases. Legally mandated men reported fewer minor IPV behaviors, but more severe behaviors compared with self-referred men. They seemed to minimize or deny their behavior, failing to acknowledge their problem with violence. Formally pressured men exhibited mixed characteristics. They appeared to be motivated by the fear of losing custody of their children. These findings underscore the need for tailored therapeutic approaches.

Are we gatekeeping trauma? A conceptual model to expand criterion A for invisible, identity-based, and systemic traumas

Since the inception of the criterion A framework into the posttraumatic stress disorder (PTSD) diagnosis in DSM-III, what qualifies as traumatic has been a fieldwide debate. Historically, social movements coinciding with advances in research have spurred improvements in the definition of criterion A, often by expanding the breadth of experiences that are considered trauma exposure. Contemporary issues of ongoing racial discrimination, ethno-violence, public health pandemics, warfare, oppression, and climate change warrant a re-examination of the criterion A definition. This critical review builds on prior critiques of criterion A and addresses (1) the limitations to the current criterion A definition in DSM-5 in capturing the experience of minoritized individuals; (2) three categories of trauma that are under-recognized in the current criterion A definition; and (3) the implications of expanding criterion A on clinical and research practice. We critically review three trauma categories that disproportionately affect minoritized individuals-invisible traumas, identity-based traumas, and systemic traumas. Evidence to date suggests that several traumatic experiences in these categories rise to the level of being traumatic, are associated with PTSD symptoms, and are prevalent among minoritized individuals. We discuss the implications of these traumas being omitted from criterion A and call for future work to critically examine the definition of criterion A in the PTSD diagnostic framework. Overall, this critical review captures traumas which remain undertreated, underdiagnosed, and under-represented by our current psychiatric nosology.

Relationship Between Different Types of Violence and Mental Health in Adults from Northern Mexico

The aim of this study is to analyze the relationships between different types of violence (social, cyberbullying, partner violence, and child abuse and neglect) and mental health (depression, anxiety, stress, self-esteem, and paranoid thoughts). There were 421 adult participants, 18 years or older, from the cities of Juarez (n = 202), Chihuahua (n = 99), Parral (n = 57), Nuevo Casas Grandes (n = 50), and other (n = 13), located in the Mexican state of Chihuahua. The mean age was 37.7 (SD = 12.3) years and 64.8% of the sample reported being females. Mental health variables were measured with the Patient Health Questionnaire, the Beck Anxiety Inventory, the Perceived Stress Scale, the Rosenberg Self-Esteem Scale, and the Paranoid Thoughts due to Social Violence Scale. Types of violence were measured with the Victimization Scale, the Partner Violence Scale, the Child Abuse and Neglect Scale, and the Cyberbullying-Victimization Scale. Pearson correlations and multiple linear regressions were used to analyze the relationship among mental health and violence variables. The main findings show that participants from the different cities have experience social violence such as kidnapping, sexual assault, carjacking, among others. Most correlations were statistically significant; guilt (child abuse) and cyberbullying had the highest correlations with mental health. In the regression analyses, the same variables, guilt and cyberbullying, had the strongest and statistically significant standardized betas with mental health. Our findings indicate that interventions should not be limited to preventing and addressing social violence alone; other forms of violence among adults must also be taken into consideration.

The Intimate Partner Violence Impact on Maternal Parenting: The Mediational Role of Depressive Symptoms

Currently, intimate partner violence (IPV) constitutes a major public health issue and those women experiencing IPV in the context of motherhood have to face additional challenges related to parenting. Literature on how IPV impact on maternal parenting characteristics is controversial and the role of maternal depression on parenting in the context of IPV is still understudied. The current preliminary study included 61 Italian women victims of IPV who completed an online questionnaire. We tested a path-analysis model in which IPV was expected to explain parental practices and stress through the mediation of maternal depression. Our results showed that depressive symptoms in mothers mediated the relationships between IPV and higher engagement in maternal inconsistent discipline and higher parental stress. Findings supported the spillover hypothesis and, at the same time, suggest the need to consider another important factor in the link between IPV and parenting that is mothers' mental health. It emerged the need to take care of women victims of IPV and also fostering parenting skills and strategies.

Development and Validation of the Psychological Abuse in Relationships Scale

Psychological abuse within intimate relationships is a highly prevalent subtype of intimate partner violence (IPV) that is frequently associated with other types of IPV such as sexual or physical violence. Psychological abuse can cause enduring harm, including the loss of agency and self-belief, and entrapment in a relationship. Previous measures of psychological abuse have been characterized by inconsistencies in conceptualization and measurement contributing to problems in identifying its prevalence, impact, and patterns. To address many of the existing challenges and gaps, we developed a new measure of psychological abuse, building upon scale development work to date, and in consultation with lived experience and academic experts. A sample of 765 adult women in Australia completed our survey of 31 psychologically abusive behaviors to establish reliability and validity evidence for a new measure of psychological abuse victimization and impact. Exploratory factor analysis generated a scale comprising 20 items and four factors-Severe Psychological Abuse, Coercive Emotional Abuse, Restrictive Isolating Abuse, and Financial Abuse-with Cronbach's alphas ranging from 0.73 to 0.85 and overall explained variance of 57.2%. Exhibiting evidence of validity and reliability, the Psychological Abuse in Relationships Scale is a contemporary, concise, and comprehensive measure of psychological IPV that will improve the ability of researchers to identify this common and harmful type of abuse.

Disability and intimate partner violence experience among women in rural Samoa: A cross-sectional analysis

BACKGROUND

Women with disabilities experience higher rates of intimate partner violence (IPV). Evidence suggests this violence often manifests in more subtle and severe forms over longer periods of time. There is limited evidence on this association in the Pacific Islands region, despite facing one of the highest global prevalences of IPV.

OBJECTIVE

Examine the prevalence of disability and the association between disability and types of IPV experience among women in rural Samoa as part of the EVE Project.

METHODS

This study analysed cross-sectional data collected with nine communities in rural Samoa between December 2022 and February 2023. Enumerators collected data with 707 women on tablets using REDCap. IPV was measured using the standardised Demographic and Health Survey (DHS) domestic violence methodology. Disability was assessed using the Washington Group questions. Logistic regression was conducted to examine the association between disability and experiences of IPV (physical, sexual, emotional and economic violence) among women.

RESULTS

Having a disability was significantly associated with increased IPV experience among women in this study. When controlling for age and education, women with severe disability were significantly more likely to experience sexual (OR 4.31; p = 0.01) and emotional (OR 2.87; p = 0.02) IPV, when compared to women with no disability.

CONCLUSIONS

Our findings point towards a greater vulnerability of women with disabilities to IPV, and particularly sexual and emotional IPV, in rural Samoa. Qualitative research in partnership with women with disabilities is essential to inform the design of measurement tools and prevention programmes that are grounded in the context-specific experiences and needs of all women with disabilities.

Perinatal Intimate Partner Violence and Maternal-Infant Bonding in Women With Anxiety Symptoms in Pakistan: The Moderating Role of Breastfeeding

Intimate partner violence (IPV) during the perinatal period can negatively affect both a woman's health and the bonding with her infant. Research on IPV among pregnant women experiencing psychological distress in South Asia is limited. We examined associations between perinatal exposure to IPV and postnatal maternal-infant bonding in Pakistani women with symptoms of anxiety and assessed if breastfeeding practices moderated these associations. Postnatal data were collected from 720 Pakistani women who reported at least mild levels of anxiety symptoms in pregnancy. We performed Poisson regression with robust variance analyses to examine the associations between IPV during pregnancy or within 6 weeks after delivery (i.e., the perinatal period) and maternal-infant bonding. Interaction terms between IPV and breastfeeding practices were included in the analytic models to examine the moderating effects. About 27% of women were exposed to at least one type of perinatal IPV. Women who were exposed to IPV were more likely to have moderate to severe postpartum anxiety (n = 57, 28.9% of IPV-exposed women), compared to those without IPV (n = 65, 12.4% of unexposed women; p value < .001). Compared to women not reporting IPV, women exposed to any IPV showed a 38% increase in Postpartum Bonding Questionnaire scores, suggesting higher likelihood of impaired bonding (risk ratio [RR] = 1.38, 95% confidence interval [CI] [1.21, 1.56]). Among women who initiated breastfeeding later than 1 hr post-delivery, IPV was associated with impaired bonding (RR = 1.09, 95% CI [1.06, 1.20]), whereas no association was present for women who initiated breastfeeding within 1 hr (RR = 1.03, 95% CI [0.98, 1.08]). In addition to the efforts to reduce IPV, encouraging IPV-exposed women to adhere to the breastfeeding guidelines (e.g., early breastfeeding) may enhance maternal-infant bonding.

Responses to the mental health care needs of survivors of intimate partner violence in Portugal: Perspectives of survivors and mental health professionals

BACKGROUND

Survivors of intimate partner violence (IPV) are at an increased risk of developing mental health conditions.

AIMS

To examine the perspectives and perceptions of mental health professionals on their provision of mental healthcare to IPV survivors and to hear the lived experiences of IPV survivors regarding their use of mental health services in Portugal.

METHODS

An online survey was conducted to gather data on the experiences of IPV survivors who had or had not accessed mental health services in Portugal. Additionally, two focus groups involving 17 mental health professionals were held. Audio recordings were transcribed verbatim, and the data were thematically analysed using MAXQDA software.

RESULTS

Both IPV survivors and mental health professionals frequently acknowledged the critical role of mental health support in the recovery process for individuals who experienced IPV. However, professionals often lack sufficient specialised knowledge to address the complexities of IPV, potentially leaving survivors' mental healthcare needs inadequately met.

CONCLUSIONS

Comprehensive approaches are required, including trauma- and violence-informed care, multi-disciplinary collaboration, and inter-sectoral efforts. Further research is essential to investigate the nuances of mental health service utilisation by IPV survivors and to identify the most effective interventions for this population across diverse geographical and cultural settings.

Adaptation of an Emotional Stroop Test for Screening of PTSD Related to Intimate Partner Violence in Spanish-Speaking Women

Cognitive assessment instruments with emotional components may be useful to address the limitations of the self-report scales commonly used to assess post-traumatic stress disorder (PTSD) in women victims of domestic violence (IPV). The aim of this study was to develop an Emotional Stroop task designed to identify post-traumatic stress disorder (PTSD) linked to intimate partner violence (IPV) in Spanish-speaking women. The validation of this test involved a comparative analysis between two groups: a clinical group (n = 50) and a non-clinical group (n = 50) of women with an average age of 38.38 (SD = 12.31; 100% female participants). The study indicates that the clinical group scored significantly higher on the PTSD Symptom Severity Scale (EGS) and lower on the three Stroop tasks compared to the non-clinical group. Notably, there was a significant negative correlation between the results of the modified Stroop tasks and the EGS test. The results show that our adapted Stroop task serves as an efficacious tool for detecting PTSD related to intimate partner violence (IPV) in Spanish-speaking women. Moreover, it has the potential to alleviate the constraints of presently available tools designed for this specific purpose.

"Many Endure Because of What People Will Say." Psychological Gender-Based Violence in Spanish Rural Women

Gender-based violence, understood as the most extreme expression of asymmetric power relations based on gender, aims primarily to perpetuate inequalities, acting as a significant obstacle to progress toward equality. The psychological gender-based violence manifests as a prelude to a complex scenario of abuse within and outside heterosexual partner relationships and emerges as the main strategy of abusers to exert their system of dominance. In rural areas, this type of violence takes on specific nuances, conditioned by demographic, familial, and socioeconomic factors. The aim of this study is to analyze how the rural context influences in this case, shedding light on the needs, proposals, and opportunities for intervention and prevention in these territories. To achieve this, a qualitative study is presented, based on in-depth interviews and discussion groups with women who have experienced psychological gender-based violence and specialists in gender-based violence of Spain (N = 27). The results show the sociocultural difficulties that arise in rural environments related to psychological gender-based violence, affecting the experience and impact on women, further intensifying their concealment. The social pressure and stigma associated with disclosing situations of gender-based violence are more prominent due to close relationships and the small size of the population. These factors represent significant barriers that discourage women from taking the step to seek help or report. The support network formed by the community, feminist associations, and specialized professionals can be of vital importance and can make a significant difference in the recovery of victims and in the cessation of gender-based violence in these contexts. There is an urgent need to incorporate the assessment of psychological risk into evaluation tools, inter-institutional coordination, and support programs adapted to rural reality.

Intergenerational transmission of childhood interpersonal trauma in adults entering therapy for intimate partner violence: The role of identity diffusion

BACKGROUND

Childhood Interpersonal Trauma (CIT) is a major public health issue that increases the risk of perpetrating and sustaining intimate partner violence (IPV) in adulthood, perpetuating intergenerational cycles of violence. Yet, the explanatory mechanisms behind the intergenerational transmission of trauma warrant further exploration.

OBJECTIVE

This study explored identity diffusion as an explanatory mechanism linking cumulative and individual CIT (sexual, physical and psychological abuse, physical and psychological neglect, witnessing parental physical or psychological IPV, bullying) to IPV (sexual, physical, psychological, coercive control) and to the next generation's exposure to family violence. Gender differences (men, women, gender diversity) in these links were examined.

PARTICIPANTS AND SETTING

A sample of 846 adults (60.4 % men, 36.4 % women, 3.2 % gender diverse) entering therapy across 21 community IPV specialized organizations were recruited.

METHODS

Participants completed brief validated questionnaires assessing CIT, identity diffusion, IPV perpetration and victimization, and new generation's exposure to family violence.

RESULTS

Four path analysis models showed that cumulative CIT, psychological neglect, and bullying were indirectly associated with adult IPV perpetration and victimization, and new generation family violence exposure through higher identity diffusion (βs ranging 0.037-0.091). Cumulative CIT was not related to IPV perpetration for gender diverse individuals, nor was identity diffusion related to IPV victimization for this group.

CONCLUSIONS

This study highlights the relevance of trauma-sensitive and identity-focused interventions that consider familial history and gender identity to effectively address the intergenerational transmission of trauma.

Intimate Partner Violence and Sexual Risk-Taking: Attachment Avoidance as a Linking Mechanism

Why might women who experience intimate partner violence (IPV) become more likely to engage in risky sexual behavior? Women's interest in casual sex may satisfy relational expectations and connection needs, while avoiding the types of close attachments that previously were violent. Specifically, attachment avoidance was tested as a mechanism linking IPV victimization and risky sexual behavior. Women who experienced (vs. did not experience) partner violence reported higher rates of risky sexual behavior, and this association was mediated by attachment avoidance (Study 1, N = 312; age range 18-58 years, M = 28). Making IPV salient via an experimental manipulation caused more avoidant perceptions (Study 2, N = 140; age range 19-57 years, M = 31), and inducing an avoidant mindset via an experimental manipulation caused greater sexual interest (Study 3, N = 128; age range 19-66 years, M = 33). These findings suggest that IPV disrupts expectations of security and reinforces a manner of connecting with partners that leads to risky sexual encounters.

Gender Differences in Intimate Partner Violence Victimization and Its Relationships With Anxiety, Depression Symptoms and Suicide Behaviours in China

Objectives

To investigate the gender difference in Intimate partner violence (IPV) victimization and its association with mental health, examine social-demographic and health characteristics-specific relationships.

Methods

This cross-sectional study evaluated lifetime prevalence of total, psychological, physical and sexual IPV victimization. Gender-stratified multiple logistic regressions were performed to examine associations between total and subtypes of IPV victimization and anxiety and depressive symptoms, suicide ideation and suicide attempt. Sensitivity analyses and stratification analyses were additionally conducted.

Results

Among 21,824 participants (female: 44.7%), females reported higher total, psychological and physical but not sexual lifetime prevalence of IPV victimization than males. Specifically, male participants with psychological (OR = 3.62, 95% CI: 2.58-5.08 vs. OR = 1.87, 95% CI: 1.39-2.51) or sexual (OR = 4.02, 95% CI: 2.61-6.20 vs. OR = 1.46, 95% CI: 0.91-2.35) IPV victimization presented greater odds of presenting possible anxiety than females; males with physical IPV victimization showed greater likelihood of with suicide ideation than females (OR = 9.95, 95% CI: 6.68-14.82 vs. OR = 4.61, 95% CI: 3.02-6.15).

Conclusion

Prevention programs should be tailored to respond to IPV in various contexts to reduce the likelihood of and the detrimental effects of IPV.

Psychological intimate partner violence, child witnessing of parental arguments, and emotional-behavioral outcomes in five-years old: The French ELFE cohort

BACKGROUND

Intimate partner violence (IPV) is associated with children's emotional and behavioral difficulties. Psychological-IPV (P-IPV) is most common, and occurs alone or along other forms of IPV. Little is known about the longitudinal course of P-IPV exposure and its consequences on children taking into account whether or not they are present during parental arguments.

OBJECTIVE

To identify longitudinal trajectories of P-IPV from preconception through the child's second year of life and examine associations with children's emotional-behavioral outcomes at age five years, depending on the child's presence during parental arguments in the second year of life.

PARTICIPANTS AND SETTING

Data from the nationally representative French birth cohort ELFE including children born in 2011 were used.

METHODS

P-IPV exposure was assessed before conception, during pregnancy, at two months and at two years postpartum. Parents completed the Strengths and Difficulties Questionnaire (SDQ) at five years. Group-based trajectory modelling was used to identify P-IPV trajectories. Multivariate logistic regression models were used to study the relationship between P-IPV trajectories and SDQ.

RESULTS

9639 children were included. Five trajectories of exposure to P-IPV were identified: minimal (70.6 %), prenatal (10.0 %), increasing (6.4 %), decreasing (7.5 %), persistent (5.5 %). Persistent and decreasing P-IPV trajectories and frequent child presence during parental arguments were associated with children's increased odds of having abnormal total SDQ scores (OR 2.31 95 % CI 1.54-3.47; OR 1.64 95%CI: 1.11-2.43; OR 1.88 95%CI:1.17-3.02, respectively).

CONCLUSIONS

Early identification and consideration of children living in a home where IPV occurs could allow provision of timely and appropriate support.

Emotion dysregulation and posttraumatic stress symptom severity: The influence of cortisol reactivity following idiographic emotion inductions

OBJECTIVE

Emotion dysregulation plays a central role in the etiology and maintenance of posttraumatic stress symptoms (PTSS). Individual differences in physiological responses to emotionally evocative events may influence the strength of this association. The objective of this study was to test whether cortisol reactivity following idiographic emotion induction tasks moderated the relation between emotion dysregulation and PTSS severity.

METHOD

Participants were 94 community women currently experiencing intimate partner violence and using substances (age: M = 40.5 years; 35.2% Black; 61.5% unemployed). PTSS severity was assessed at baseline via a clinician-administered diagnostic interview. Participants provided a self-report of emotion dysregulation at baseline. Samples of salivary cortisol were collected pre-, during, and postidiographic emotion inductions during an experimental session.

RESULTS

A significant emotion dysregulation by cortisol reactivity interaction was found (b = 0.18, p = .02). Emotion dysregulation was related to PTSS severity for those with high (b = 0.13, p < .001), but not low (b = -0.001, p = .99), levels of cortisol reactivity following idiographic emotion inductions.

CONCLUSIONS

Findings provide novel evidence of the interplay of emotion dysregulation and cortisol reactivity, an indicator of hypothalamic-pituitary-adrenal system axis stress reactivity, following emotionally evocative stimuli in relation to PTSS severity. Information from this study may help to identify individuals who are at highest risk of more severe PTSS. Future work is needed to replicate findings among diverse populations impacted by trauma (e.g., veterans, men). (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Improving women's health and well-being by exploring the impact of emotional, physical, and sexual intimate partner violence

BACKGROUND

Over the past two decades, several studies have highlighted the harmful mental and physical effects of intimate partner violence (IPV) on its victims. However, more repeated measures research is needed to observe the long-term health and emotional effects of IPV. This includes how these impacts change when violence is reduced or ceases, such as when the perpetrator receives intervention. Further limitations of existing research include the lack of data on abuse frequency, severity, and impacts linked with specific forms of abuse.

OBJECTIVES

This research explores the impacts on IPV victims whose abusive (ex-)partners participate in perpetrator programs (PPs). It aims to identify distinct patterns of impacts associated with different IPV types and pinpoint the most damaging IPV behaviors through repeated measures data.

DESIGN

Longitudinal.

METHODS

In total, 349 heterosexual women, who were (ex-)partners of men enrolled in multiple European gender-based violence PPs, completed the Impact Outcome Monitoring Toolkit questionnaire.

RESULTS

The results showed that emotionally abusive behavior and-especially coercive control and online violence-were highly prevalent and had profound, alarming impacts, including self-harm and suicidal ideation. Over two-thirds of the sample reported experiencing sadness as a result of the violence endured, which was identified as a significant impact. Moreover, isolation had a common effect on emotional and physical violence. Recognizing threats and their damaging effects on victims has emerged as crucial because of their impact on victims. Finally, sexual violence, refusing to use contraception and forcing sex were the most damaging behaviors. Interestingly, our study found specific impacts of extreme abusive behavior depending on the type of abuse.

CONCLUSION

This study clearly supports the statement that the impact of abusive behavior can persist after it ends, as half of the victims no longer experiencing violence at the end of the PP reported at least one impact.

Intimate partner violence and physical health in England: Gender stratified analyses of a probability sample survey

BACKGROUND

Gender differences in the associated health outcomes of different forms of intimate partner violence (IPV) are understudied. The long-term effects of IPV on specific physical health conditions are also under-researched in comparison to the effects on general health and mental health.

OBJECTIVES

To examine gender differences in the association between IPV and specific physical health conditions, accounting for differences in the types and number of types of IPV experienced.

DESIGN

We used data from the 2014 Adult Psychiatric Morbidity Survey, a cross-sectional survey using a stratified, multistage random sampling design to cover the household population of England aged 16 years and older.

METHODS

Descriptive and multivariable regression analyses of 4120 women and 2764 men who had ever had a partner. Lifetime IPV by types (physical, sexual, psychological, and economic), any lifetime and recent IPV, the number of IPV types experienced, and multiple chronic health conditions experienced over the past 12 months were included in the analyses.

RESULTS

Gender differences were observed in both the prevalence of IPV and associated health conditions. Women were more likely to experience any type and a higher number of IPV types than men. Women's exposure to any lifetime and 12-month IPV were significantly associated with an increased likelihood of reporting 12 and 11 conditions, respectively, while men's exposure to any lifetime and 12-month IPV were significantly associated with 4 and 1 conditions, respectively. Specific IPV types had varied health impacts, particularly among women. A cumulative association was evident for women but not for men.

CONCLUSION

Healthcare systems need to be mobilised to address IPV as a priority health issue for the female population. Our findings highlight the need for gender-informed approaches in IPV intervention strategies and healthcare provision, emphasising the development of IPV-responsive healthcare systems and comprehensive IPV curricula in medical and health training.

Understanding Cognitive Performance, Psychological Factors, and Personality Traits in Women Exposed to Intimate Partner Violence

Intimate partner violence (IPV) might increase the risk of depression, traumatic stress and affect cognitive performance. We analyzed the cognitive performance, psychological factors, and personality traits of 136 Brazilian women (n = 70 exposed to IPV and n = 66 non-exposed) aged 18 years or older. We utilized clinical interviews, the NEO Personality Inventory, and a neuropsychological testing battery. The statistical analyses employed moderation within variables, resulting in determination coefficients (r2) of 0.15 and 0.35. The husband was the primary aggressor, physical violence was the most frequent (90.6%). Women exposed to IPV exhibited more symptoms of post-traumatic stress disorder (PTSD), depression, neuroticism, difficulties in visual memory, and visuospatial abilities. The analysis indicated the influence of IPV, neuroticism, PTSD, and depression on the cognitive performance of the exposed to IPV.

Subtle or Covert Abuse Within Intimate Partner Relationships: A Scoping Review

Intimate partner violence (IPV) is a global health problem enacted with varying degrees of severity, leading to mental and physical damage. Despite the acknowledgment that perpetration can be enacted in a subtle or covert way, there is a paucity of literature defining and describing such subtle abuse. Consequently, understanding about the behaviors and impacts of subtle abuse is limited, and there is a potential inability by therapists to recognize it in their clients. This scoping review sought to identify and synthesize the literature around subtle or covert abuse (SCA) in intimate adult relationships to clarify the concept, with the aim to aid professional recognition. PsychINFO (EBSCO), MEDLINE Complete (EBSCO), CINAHL (EBSCO), PsychArticles (EBSCO), Scopus, ProQuest Dissertations and Theses Global, and EThOS were searched using relevant search terms. In total, 19 studies met the inclusion criteria by containing a description or definition of abuse based on primary research with adults in intimate partner relationships. Findings were synthesized using descriptive content analysis under four headings: (a) Descriptions and groupings of SCA behaviors, (b) The impact of SCA on victims, (c) Underlying theories of SCA, and (d) Recognition by professionals. This review suggests that SCA may be the most damaging of all abuses.

Twelve-Month Sustainment of IPV Screening and Response Programs in Primary Care: Contextual Factors Impacting Implementation Success

PURPOSE

The Veterans Health Administration (VHA) employed implementation facilitation (IF) as a strategy to boost uptake of intimate partner violence (IPV) screening programs in primary care. This study examined the sustainment of screening uptake 1 year after IF and identified factors impacting sustainment success.

METHODS

A mixed-methods evaluation using quantitative and qualitative data was conducted. IPV screening rates from the conclusion of the IF period (i.e., initial adoption) through the 1-year sustainment period served as the primary outcome. We categorized sites into four groups of screening adoption and sustainment success (high adoption and high sustainment, moderate adoption and moderate sustainment, low adoption and low sustainment, and no adoption and/or no sustainment). Qualitative analysis of key informant interviews was used to identify contextual factors affecting screening 12 months post-IF. A mixed sustainment analysis matrix integrated quantitative and qualitative findings and enabled the identification of cross-site patterns.

MAIN FINDINGS

Seven of the nine sites sustained IPV screening at the most basic level (saw static or increased screening rates). High adopting and high sustaining sites (n = 3) were marked by consistently supportive medical center leadership, ongoing training for clinicians, clear protocols for responding to positive screens, and robust referral options for women experiencing IPV. Nonsustaining sites (n = 2) were marked by a host of barriers including staffing shortages, competing priorities, and inconsistent messaging from leadership regarding the importance of IPV screening.

CONCLUSIONS

Knowing barriers and facilitators to successful IPV screening sustainment can inform health care systems to tailor IF and other implementation strategies to sustain IPV screening in primary care. Sustainment of IPV screening requires attention to a combination of facilitators (e.g., consistent leadership support and robust referral options) as well as addressing key barriers (e.g., staff turnover and competing priorities).

Development and Initial Validation of a Scale to Measure Social Abuse in Intimate Partner Relationships

Social abuse represents a distinct form of intimate partner violence characterized by intentional violations of a victim's social rights and inherent need to belong. This is achieved by tactics such as severing, interfering with, and surveilling the victim's social connections as well as limiting their social participation. Such abuse often results in victims experiencing social isolation, potentially causing adverse mental health outcomes and failure to seek help. This study aimed to develop and validate the Social Abuse Scale (SAS) to measure social abuse in intimate partner relationships. After generating the preliminary items, content validity testing was performed. Ten international experts reviewed the items and assessed their relevance. Additionally, 17 interview participants assessed the items for clarity and ease of response. Thereafter, the SAS was administered to 251 individuals, either currently in or who had an intimate relationship in the previous year. The final SAS comprised 30 items unified under a single-factor structure, which accounted for approximately 69.77% of the total variance. Confirmatory factor analysis confirmed the model's satisfactory fit. The instrument showed excellent internal consistency, as evidenced by Cronbach's alpha and a McDonald's omega value of .986. The SAS can be employed to investigate the prevalence of social abuse, its underlying mechanisms, and its impacts, and it can also assist in further development and evaluation of programs aimed at its prevention.

Adrenocortical deviations and adverse clinical outcomes in children and adolescents exposed to interparental intimate partner violence: A systematic review

Childhood exposure to interparental intimate partner violence (i-IPV) is a pervasive form of child maltreatment, posing major public health concerns and elevating risks for enduring adverse clinical and developmental consequences. However, assessing the full spectrum of clinical effects is challenging, potentially leading to inconsistent identification of children in need of early intervention. This systematic review aimed to identify hypothalamic-pituitary-adrenocortical axis dysfunction following i-IPV exposure, elucidating the underlying biopsychobehavioural mechanisms and predicting adverse outcomes. We searched Embase, MEDLINE, and PsycINFO for peer-reviewed studies from infancy through adolescence, screened reference lists and conducted forward searches. Analysis of 23 publications (N = 1848) revealed associations between i-IPV and altered adrenocortical function from early childhood, influenced by FKBP5 haplotype, parental caregiving and offspring emotional insecurity. Results showed that the adrenocortical stress response may predict internalising and externalising problems, childhood asthma, impaired executive function and poor academic performance. Nonetheless, inconsistencies in findings between studies suggest methodological heterogeneity and potential bias. Identifying biomarkers such as cortisol can enhance prediction and mechanism-based intervention efforts but long-term studies with a common theoretical and methodological framework are needed for comprehensive understanding. Integrating biological, emotional, and behavioural assessments could potentiate trauma services and research, ultimately improving outcomes for affected children.

Correlates of Intimate Partner Violence, Including Psychological Partner Violence, in a Multisite U.S. Cohort of People in HIV Care

We examined past-year intimate partner violence (IPV), including psychological violence without physical/sexual violence, and health outcomes among people with HIV (PWH) in care in a multi-site U.S. cohort. Between 2016 and 2022, PWH reported 12-month psychological, physical, and sexual IPV in a routine assessment. We used linear and logistic regression models adjusted for age, race/ethnicity, and site to examine relationships with health outcomes. Among 9748 PWH (median age 50 years, 81% cisgender male/16% cisgender female/1% transgender female; 44% non-Hispanic white/36% non-Hispanic Black/15% Hispanic), 9.3% (n = 905) reported any IPV in the past 12 months; half reported psychological IPV without physical/sexual IPV (n = 453). PWH reporting any type of IPV were on average younger than those who did not experience IPV. In adjusted models, any IPV was associated with increased likelihood of unstable housing, HIV viral load detection (HIV viral load ≥ 75 copies/mL), moderate-to-severe depressive symptoms, anxiety with panic symptoms, substance use (methamphetamines, cocaine/crack, illicit opioids, marijuana, heavy episodic/hazardous drinking), and concern about exposure to sexually transmitted infection. PWH reporting any IPV in the past 12 months had 4.2% lower adherence to antiretroviral therapy, 2.4 more HIV-related symptoms, a 1.9 point higher HIV stigma score, and a 9.5% lower quality of life score than those without IPV. We found similar associations among PWH reporting only psychological IPV, without physical/sexual IPV. IPV was common among PWH. Half reporting IPV reported only psychological IPV and had similarly poor outcomes as those reporting physical/sexual IPV, demonstrating the need to assess psychological as well as physical and sexual IPV.

Responding to the needs of survivors of intimate partner violence in Lithuania: perceptions of mental health and social care professionals

Around eight-out-of-ten survivors of domestic violence in Lithuania are women, and of those, eight-out-of-ten suffer violence specifically from their intimate partners (IPV). Women who experience IPV are at higher risk of having mental health conditions. This study aims to explore the perspectives of mental health and social care professionals regarding the provision of mental health support to IPV survivors in Lithuania. Four focus groups were conducted among 29 service providers from across the country. Audio-recordings were transcribed verbatim and analyzed thematically using MAXQDA software. The five main themes derived from the analysis reveal: 1) low levels of IPV awareness among IPV survivors who seek support with their mental health; 2) a lack of specialized training among professionals as a barrier to effective support; 3) a low prioritization on the national level; 4) little inter-sectoral collaboration which undermines the complexity of needed responses; 5) broader systemic problems. The provision of mental health support to IPV survivors lacks the recognition that IPV is gender-based violence and a major public (mental) health problem. The complexity of needed services is absent. Further research needs to explore the utilization of mental health services by IPV survivors and their perceptions concerning it.

Prevalence and risk factors of intimate partner violence during the COVID-19 pandemic: Results from the population-based study DREAMCORONA

OBJECTIVES

This study examines the 12-month prevalence rates of intimate partner violence (IPV) victimization, including psychological, physical, and sexual forms, in women and men. It also aims to identify changes in IPV victimization during the COVID-19 pandemic and to explore factors associated with the occurrence of any IPV victimization during this period.

METHODS

Data from the DREAMCORONA study in Germany collected from May 2020 to February 2021 included 737 participants, i.e., (expectant) mothers (64%) and fathers (36%). The Revised Conflict Tactics Scale (CTS2S) short form was used to assess the 12-month IPV victimization. Prevalence of IPV victimization as well as changes in IPV victimization during the pandemic were analyzed descriptively, with results stratified by sex. Multiple logistic regression was employed to identify risk factors for IPV.

RESULTS

Psychological IPV was found to be the most prevalent form of violence, with the occurrence of any psychological IPV affecting 48.5% of women and 39.4% of men, while 2.6% of women and 3.3% of men reported the occurrence of any physical IPV victimization, and 2.8% of women and 1.5% of men reported the occurrence of any sexual IPV victimization. Of those who experienced the occurrence of any IPV in the last 12 months, 89.7% of women and 89.8% of men were victimized by one single act of violence. The majority of affected participants reported no change in psychological and physical IPV victimization during the pandemic. Nevertheless, for certain IPV behaviors on the psychological and physical IPV victimization subscales, both affected women and men also reported higher frequencies during the COVID-19 pandemic. Multiple logistic regression revealed that higher levels of relationship satisfaction were negatively associated with the occurrence of any IPV victimization for women and men, whereas greater levels of own anger-hostility symptoms were positively associated with the occurrence of any IPV victimization.

CONCLUSIONS

Psychological IPV was present in almost every second (expectant) couple. The majority of affected women and men reported no change in their psychological and physical IPV victimization, suggesting that they continued to experience IPV during the pandemic. This underlines the importance of promoting healthier relationship dynamics, coping strategies, and emotional well-being to reduce the risk of IPV, even in times of crisis. Our study sheds light on the early stages of the pandemic and highlights the ongoing need for research into the temporal dynamics of IPV.

Investigating the relationship between spousal violence against women and total fertility rate in Afghanistan

BACKGROUND

spousal violence against women (SVAW) is a common form of violence that occurs within the family context, with spouses being the main perpetrators. Afghanistan has one of the highest rates of SVAW in the world, and its impact on reproductive health and fertility is not well understood. This study aims to investigate the extent to which SVAW influences the total fertility rate (TFR) of Afghan women.

METHODS

In this study, a regression model of discrete-time survival models was used to calculate the total fertility rate (TFR), parity progression ratio (PPRs), and average closed birth intervals (CBI) between two children. The method used in this study has its roots in the works of Griffin Finney (1983) and was further developed by Redford et al. (2010). The study population utilized the 2015 Afghanistan Demographic and Health Survey, and sample weights were used to ensure accurate estimates for the population of Afghanistan as a whole.

RESULTS

The study found that women in Afghanistan who have experienced SV are more likely to progress to the next parity, start childbearing faster, and continue to do so. Women who have not experienced SV tend to progress to higher parities at a slower pace during their initial reproductive years. The study also suggests that women with spousal violence (SV) experience may have slightly higher fertility rates and shorter birth intervals for certain birth orders, although the differences between the two groups are generally small. Specifically, the total fertility rate (TFR) for women who experienced SV was 6.9, while the TFR for women who did not experience SV was 6.2.

CONCLUSIONS

These results provide valuable information for policymakers and public health professionals in developing effective policies and programs to address SVAW and improve maternal and child health outcomes in Afghanistan.

Intimate partner violence, depression, hazardous alcohol use, and social support among people with HIV initiating HIV care in Cameroon

Intimate partner violence (IPV) has been associated with poor mental health among people with HIV (PWH) globally. Social support may be a strategy to foster mental health among PWH. Little is known about whether the relationship between IPV and mental health differs by IPV type or level of social support. Interviews were conducted with 426 PWH initiating HIV care in Cameroon. Log binomial regression analyses were used to estimate the association between four types of IPV (controlling behavior and emotional, physical, and sexual IPV) and symptoms of depression or hazardous alcohol use, separately by IPV type and level of social support. Over half (54.8%) of respondents experienced moderate/high levels of controlling behavior, 42.0% experienced emotional IPV, 28.2% experienced physical IPV and 23.7% experienced sexual IPV. Controlling behavior was associated with greater prevalence of depressive symptoms. This relationship did not vary meaningfully by level of social support (low: aPR 2.4 [95% CI 1.2, 4.9]; high: 1.7 [95% CI 1.0, 2.7]). Emotional and physical IPV were associated with greater prevalence of depressive symptoms among those with low social support (emotional IPV: aPR 1.9 [95% CI 1.0, 3.4]; physical IPV: aPR 1.8 [95% CI 1.2, 2.8]), but not among those with high social support (emotional IPV: aPR 1.0 [95% CI 0.7, 1.6]; physical IPV: aPR 1.0 [95% CI 0.6, 1.6]). Controlling behavior, emotional IPV, and physical IPV were associated with a greater prevalence of hazardous alcohol use, with moderately larger effect estimates among those with high compared to low social support. Sexual IPV was not associated with depressive symptoms or hazardous alcohol use. Services to screen and care for people experiencing IPV are urgently needed among PWH in Cameroon. Future research to identify barriers, feasibility, acceptability, and organizational readiness to integrate IPV and mental health services into HIV care settings is needed.

Geographic pattern of the prevalence of intimate partner violence against women in Zanjan (Iran)

Introduction

Intimate partner violence (IPV) against women is a serious public health issue and refers to physically, sexually and psychologically harmful behaviors as well as emotionally controlling behaviors and financial abuse that occur in the form of marriage or cohabitation. Knowing the current situation of the IPV prevalence against women and high-risk areas in the Zanjan city, Iran, can help policymakers to establish better health programs for risk reduction.

Methods

This population-based cross-sectional study consisted of married women aged 18-55 years living in Zanjan city in 2021. 760 married women covered by 19 urban comprehensive health service centers (UCHSCs) were selected by the stratified systematic random sampling method. The prevalence of IPV against women was measured in four types: psychological, physical, sexual, and economic.

Results

Mean (SD) age of the women was 35.49 (8.76) years. 606 women (79.7%) experienced one type of IPV. The highest and lowest IPV prevalence against women were psychological (76.6%) and economic (12%), respectively. The highest and lowest prevalence of psychological violence were observed in CUHSCs 2 and 17, physical violence in CUHSCs 1 and 14, sexual violence in CUHSCs 2 and 17, and economic violence in CUHSCs 2 and 8, respectively. The severity of violence was higher among self-employment or workers husbands, with low monthly household income, and among younger women.

Discussion

The IPV rate in the target population is high, and the highest rate is related to psychological violence. These results highlight the need to intervention in the society and high-risk women for policymakers of the health system.

Examining the Content Validity of the Measure of Psychologically Abusive Behaviors: A Qualitative Approach

The content validity of the Measure of Psychologically Abusive Behaviors (MPAB) was examined via qualitative content analysis of interviews conducted with 262 women who experienced intimate partner violence. Data were coded using MPAB categories and items. Approximately 73.4% of the data were represented by the MPAB at both the category and severity levels; half of the data mapped onto "severe" items. At the category level, 12.3% of the data did not map onto the MPAB; 15.5% of the data mapped onto a category but did not match a severity level. Results support the content validity of the MPAB.

The association between intimate partner violence type and mental health in migrant women living in Spain: findings from a cross-sectional study

Introduction

The association between intimate partner violence (IPV) and mental health has been clearly established in the literature, however the differential associations between IPV type and mental health are less well understood, particularly in migrant groups who are at increased risk of both IPV and poor mental health. Under-studied and emerging forms of violence such as economic abuse and technology-facilitated abuse must be considered alongside more traditionally studied forms of IPV in order to fully understand the complex nature of violence. This study makes a novel contribution to the literature by assessing multiple forms of IPV including psychological, physical, sexual, economic and technology-facilitated IPV and their relationship with symptoms of depression and anxiety in migrant women, disaggregated by IPV type.

Methods

A cross-sectional survey of migrant women living in the Valencian Community of Spain was conducted, to assess experiences of IPV and symptoms of mental health. Regression analysis from the Bayesian perspective was performed.

Results

1,998 women accessed the survey. They had an average age of 37, and came predominantly from Europe (49%), namely Western Europe, followed by Latin America (38%). The majority had been in Spain between 1 and 3 years, and 80% had resident status. A total of 1,156 responded to questions on violence and mental health. Results showed that the prevalence of IPV was high, with 59% of women reporting any experience of violence. Economic abuse was the most commonly reported form of violence, and showed the strongest relationship with symptoms of depression. Sexual violence was the strongest predictor of anxiety. In both cases, in the presence of violence, the odds of having more severe symptoms of depression and anxiety increases by over 2.25. Technology-facilitated abuse was as detrimental to women's mental health as face-to-face violence.

Discussion

The findings from the study are relevant to researchers, policy-makers and service providers. They highlight the complex nature of IPV experiences faced by migrant women and the importance of understanding how different types of IPV can impact migrant mental health, in order to ensure survivors receive adequate care.

Screening for Intimate Partner Violence Experience and Use in the Veterans Health Administration

Importance

The practice of screening women for intimate partner violence (IPV) in health care settings has been a critical part of responding to this major public health problem. Yet, IPV prevention would be enhanced with detection efforts that extend beyond screening for IPV experiences to identifying those who use violence in relationships as well.

Objective

To determine rates of IPV experiences and use (ie, among perpetrators of IPV) and factors associated with disclosures among adult patients seeking mental health services at the Veterans Health Administration.

Design, Setting, and Participants

This cross-sectional study used electronic medical record data drawn from a quality improvement initiative at 5 Veterans Health Administration medical centers conducted between November 2021 and February 2022 to examine IPV disclosures following concurrent screening for IPV experience and use. Participants included patients engaged in mental health services. Data were analyzed in April and May 2023.

Exposure

Mental health clinicians were trained to screen for IPV experience and use concurrently and instructed to screen all patients encountered through routine mental health care visits during a 3-month period.

Main Outcomes and Measures

Outcomes of interest were past-year prevalence of IPV use and experience, sociodemographic characteristics, and clinical diagnoses among screened patients.

Results

A total of 200 patients were offered IPV screening. Of 155 participants (mean [SD] age, 52.45 [15.65] years; 124 [80.0%] men) with completed screenings, 74 (47.7%) denied past-year IPV experience and use, 76 (49.0%) endorsed past-year IPV experience, and 72 (46.4%) endorsed past-year IPV use, including 67 participants (43.2%) who reported IPV experience and use concurrently; only 9 participants (5.8%) endorsed unidirectional IPV experiences and 5 participants (3.2%) endorsed unidirectional IPV use. Patients who reported past-year IPV experience and use were younger than those who denied IPV (experience: mean difference, -7.34 [95% CI, 2.51-12.17] years; use: mean difference, -7.20 [95% CI, 2.40-12.00] years). Patients with a posttraumatic stress disorder diagnosis were more likely to report IPV use (43 patients [59.7%]) than those without a posttraumatic stress disorder diagnosis (29 patients [40.3%]; odds ratio, 2.14; [95% CI, 1.12-4.06]). No other demographic characteristics or clinical diagnoses were associated with IPV use or experience.

Conclusions and Relevance

In this cross-sectional study of IPV rates and associated factors, screening for IPV found high rates of both IPV experience and use among patients receiving mental health care. These findings highlight the benefit of screening for IPV experience and use concurrently across gender and age. Additionally, the associations found between PTSD and IPV use underscore the importance of strengthening and developing additional targeted treatment for IPV.

Prevalence and risk factors for nonconsensual distribution of intimate images among Italian young adults: Implications for prevention and intervention

Nonconsensual distribution of intimate images (NCII), also known as revenge porn, has become a significant social issue in recent years, with severe consequences for victims. The present study aimed to investigate the prevalence and predictors of NCII victimization among young Italian adults, focusing on the role of sexting, intimate partner violence (IPV), impulsivity, and self-disclosure. An online survey was conducted among a sample of 2047 Italian young adults (F = 29.3 %, M = 53.4 %, Not Indicated=16.9 %; mean age = 24.4, SD = 4.4) using a convenience sample recruited through internet. The survey included questions on NCII victimization, sexting behavior, sextortion, and IPV. Our findings showed that 33.9 % of respondents reported engaging in sexting behavior, with females being three times more likely to engage in sexting than males. Furthermore, 3.3 % of participants reported being victims of NCII, with over one-third of victims experiencing three or more types of NCII victimization. Multiple regression analysis revealed that sexting and IPV were significant predictors of NCII victimization, and the interaction effect between self-disclosure and impulsivity was also a significant predictor. This study contributes to the understanding of NCII in Italy and highlights the need for interventions and prevention strategies to address both NCII and IPV, given their strong continuity. The results also suggest that the relationship between self-disclosure, impulsivity, IPV, and NCII victimization is complex and requires further investigation, suggesting a scenario where the climate of violence may impair the victim's decision-making.

Evidence of Gender Asymmetry in Intimate Partner Violence Experience at the Population-Level

Claims of "gender symmetry" in intimate partner violence (IPV) prevalence are contested, with resolution of the issue complicated by methodological and measurement challenges. This study explores gendered differences in the distribution of IPV exposure at the population-level, considering multiple types of IPV exposure. The subjects comprised of 1,431 ever-partnered women and 1,355 ever-partnered men. Data from a nationally representative population-based cross-sectional survey were used to compare men and women's IPV experiences. Twenty-three IPV acts were assessed across IPV types (moderate physical, severe physical, sexual, psychological, controlling behaviors, economic). Proportions were presented by gender for the number of individual IPV acts experienced per IPV type, and the frequency of these acts (none, once, few times, or many times). A composite exposure score was developed to assess the number of acts and their frequency within types by comparing scores in tertiles and across types by correlations. Women reported greater overall prevalence of 20 of the 23 individual IPV acts assessed. Across all assessed acts, women comprised a substantially greater proportion of those who reported experiencing individual acts "many times." Women experienced more severe and more frequent IPV than men based on self-reported experience of IPV acts, and by the frequency with which acts were experienced. Significant differences between men and women's exposure scores were observed for all six assessed types, with greater proportions of women scoring in the upper tertiles. This study provides evidence of gender asymmetry in experiences of IPV at the population level. While men do experience IPV victimization, there remains need for directed and substantial resource allocation for intervention and therapeutic responses to women's exposure to IPV, and for primary prevention with men. Going forward, IPV measurement tools that consider frequency, severity, or co-occurring types of IPV are needed.

Panorama of Intimate Partner Violence Against Women in Brazil and its Association With Self-Perception of Health: Findings From a National Representative Survey

Intimate partner violence (IPV) is a challenge in Brazil. The country holds one of the highest rates of femicide in the world, most of which are preceded by IPV. We conducted a cross-sectional study with 34,334 women, aged 18 to 59 years, from the 2019 Brazilian National Health Survey to analyze the prevalence of IPV and its subtypes among the Brazilian adult women in the last 12 months, encompassing their health consequences and the use of health services resulting from IPV. We also used logistic regression models to estimate the association of sociodemographic characteristics and self-perceived health status with IPV. The prevalence of IPV among Brazilian adult women in the last 12 months was 7.6% (95% confidence interval [CI] [7.0, 8.2]). Women aged 18 to 39 years, not married, and with income of up to 1 minimum wage (MW), had higher odds of suffering IPV. Among those who reported health consequences due to IPV, 69% reported psychological consequences, and 13.9% sought health care, mostly in primary or secondary health care services in the Brazilian Unified Health System (41.9%). Regarding the self-perceived health variables, women who reported eating problems (odds ratio [OR]  =  1.29; [1.01, 1.65]), lack of interest/absence of pleasure (OR  =  1.41; [1.11, 1.79]), depressive feelings (OR  =  1.39; [1.03, 1.88]), feeling of failure (OR = 1.75; [1.36, 2.24]), and suicidal thoughts (OR = 1.73; [1.25, 2.41]) had greater odds of reporting IPV compared to those who did not report these same perceptions. The results show that younger, divorced or single, low-income women with eating problems and mental health disorders were more likely to suffer IPV. IPV often led to health problems, and many abused women sought support from public health services. Health professionals must be trained to identify and care for these women, thereby acting as allies in preventing and reducing IPV.

Mental health trajectories of women experiencing differing patterns of intimate partner violence across the first 10 years of motherhood

Intimate partner violence is commonly experienced by women and associated with poor mental health outcomes. Evidence regarding the patterns of IPV across time, and the associated long term course of depressive symptoms is lacking. The current study aimed to (a) identify patterns of physical and emotional IPV experienced by women over the 10 years since having their first child, and (b) identify trajectories depressive symptoms across the 10-year period for each pattern of IPV exposure. Data was drawn from the Mothers' and Young People's Study (MYPS), a longitudinal study of 1507 mothers and their first born child. Data was collected during pregnancy and at one, four, and ten years postpartum. Using Latent Class Analysis, four distinct classes of IPV were identified: (1) Minimal IPV, (2) Early IPV exposure, (3) Increasing IPV, and (4) Persistent IPV. Latent growth modelling revealed that all classes characterised by some IPV exposure experienced elevated trajectories of depressive symptoms in comparison to the minimal IPV class. Those experiencing increasing and persistent IPV experienced the most severe course of depressive symptoms.

Examining the Role of Interpersonal Violence in Racial Disparities in Breastfeeding in North Dakota (ND PRAMS 2017-2019)

BACKGROUND

The 2019 overall breastfeeding initiation rate in the US was 84.1%, yet only 76.6% of American Indian (AI) women initiated breastfeeding. In North Dakota (ND), AI women have greater exposure to interpersonal violence than other racial/ethnic groups. Stress associated with interpersonal violence may interfere with processes important to breastfeeding. We explored whether interpersonal violence partially explains racial/ethnic disparities in breastfeeding in ND.

METHODS

Data for 2161 women were drawn from the 2017-2019 ND Pregnancy Risk Assessment Monitoring System. Breastfeeding questions in PRAMS have been tested among diverse populations. Breastfeeding initiation was self-report to "Did you ever breastfeed or pump breast milk to feed your new baby, even for a short period?" (yes/no). Breastfeeding duration (2 months; 6 months) was self-reported how many weeks or months of breastmilk feeding. Interpersonal violence for both 12 months before and during pregnancy based on self-report (yes/no) of violence from a husband/partner, family member, someone else, or ex-husband/partner. An "Any violence" variable was created if participants reported "yes" to any violence. Logistic regression models estimated crude and adjusted odds ratios (OR) and 95% confidence intervals (95% CI) for breastfeeding outcomes among AI and Other Race women compared to White women. Sequential models were adjusted for interpersonal violence (husband/partner, family member, someone else, ex-husband/partner, or any).

RESULTS

AI women had 45% reduced odds of initiating breastfeeding (OR: 0.55, 95% CI: 0.36, 0.82) compared to white women. Including interpersonal violence during pregnancy did not change results. Similar patterns were observed for all breastfeeding outcomes and all interpersonal violence exposures.

DISCUSSION

Interpersonal violence does not explain the disparity in breastfeeding in ND. Considering cultural ties to the tradition of breastfeeding and the role of colonization may provide a better understanding of breastfeeding among AI populations.

Association Between Women's Exposure to Intimate Partner Violence and Self-reported Health Outcomes in New Zealand

Importance

Intimate partner violence (IPV) is increasingly recognized as a contributing factor for long-term health problems; however, few studies have assessed these health outcomes using consistent and comprehensive IPV measures or representative population-based samples.

Objective

To examine associations between women's lifetime IPV exposure and self-reported health outcomes.

Design, Setting, and Participants

The cross-sectional, retrospective 2019 New Zealand Family Violence Study, adapted from the World Health Organization's Multi-Country Study on Violence Against Women, assessed data from 1431 ever-partnered women (63.7% of eligible women contacted) in New Zealand. The survey was conducted from March 2017 to March 2019, across 3 regions, which accounted for approximately 40% of the New Zealand population. Data analysis was performed from March to June 2022.

Exposures

Exposures were lifetime IPV by types (physical [severe/any], sexual, psychological, controlling behaviors, and economic abuse), any IPV (at least 1 type), and number of IPV types.

Main Outcomes and Measures

Outcome measures were poor general health, recent pain or discomfort, recent pain medication use, frequent pain medication use, recent health care consultation, any diagnosed physical health condition, and any diagnosed mental health condition. Weighted proportions were used to describe the prevalence of IPV by sociodemographic characteristics; bivariate and multivariable logistic regressions were used for the odds of experiencing health outcomes by IPV exposure.

Results

The sample comprised 1431 ever-partnered women (mean [SD] age, 52.2 [17.1] years). The sample was closely comparable with New Zealand's ethnic and area deprivation composition, although younger women were slightly underrepresented. More than half of the women (54.7%) reported any lifetime IPV exposure, of whom 58.8% experienced 2 or more IPV types. Compared with all other sociodemographic subgroups, women who reported food insecurity had the highest IPV prevalence for any IPV (69.9%) and all specific types. Exposure to any IPV and specific IPV types was significantly associated with increased likelihood of reporting adverse health outcomes. Compared with those unexposed to IPV, women who experienced any IPV were more likely to report poor general health (adjusted odds ratio [AOR], 2.02; 95% CI, 1.46-2.78), recent pain or discomfort (AOR, 1.81; 95% CI, 1.34-2.46), recent health care consultation (AOR, 1.29; 95% CI, 1.01-1.65), any diagnosed physical health condition (AOR, 1.49; 95% CI, 1.13-1.96), and any mental health condition (AOR, 2.78; 95% CI, 2.05-3.77). Findings suggested a cumulative or dose-response association because women who experienced multiple IPV types were more likely to report poorer health outcomes.

Conclusions and Relevance

In this cross-sectional study of women in New Zealand, IPV exposure was prevalent and associated with an increased likelihood of experiencing adverse health. Health care systems need to be mobilized to address IPV as a priority health issue.

Relationship between Sexual Violence and the Health of Spanish Women-A National Population-Based Study

BACKGROUND

Health consequences are likely to be different when sexual violence is analysed independently from other types of violence. It is also likely that different health consequences will result in the cases of partner or ex-partner sexual violence, non-partner sexual violence and sexual harassment.

METHODS

This study is based on the 2019 Macro-survey of Violence against Women conducted by the Spanish Ministry of Equality on a sample of 9568 women aged 16 years or older. Odds ratios were calculated, and multinomial logistic regression analyses were performed.

RESULTS

The present study estimates that 4 out of 10 surveyed women had experienced some form of sexual violence in their lifetime. Sexual harassment is the most frequently reported form of this violence, while intimate partner sexual violence is the form with the most unfavourable sociodemographic characteristics and the worst health impact indicators, such as a greater likelihood of suicidal behaviour.

CONCLUSIONS

Sexual violence is a widespread, under-studied problem with negative health impacts. Women exposed to intimate partner violence are the most vulnerable and at risk. It is advised that responses and comprehensive care plans be developed that place special emphasis on the protection of victims' mental health.

Association Between Men's Exposure to Intimate Partner Violence and Self-reported Health Outcomes in New Zealand

Importance

Health implications of intimate partner violence (IPV) against men is relatively underexplored, although substantial evidence has identified associations between IPV and long-term physical health problems for women. Given the gendered differences in IPV exposure patterns, exploration of men's IPV exposure and health outcomes using population-based samples is needed.

Objective

To assess the association between men's lifetime IPV exposure and self-reported health outcomes.

Design, Setting, and Participants

This cross-sectional study analyzed data from the 2019 New Zealand Family Violence Study, which was conducted across 3 regions of New Zealand. The representative sample included ever-partnered men aged 16 years or older. Data analysis was performed between May and September 2022.

Exposures

Lifetime IPV against men by types (physical [severe or any], sexual, psychological, controlling behaviors, and economic abuse), any IPV (at least 1 type), and number of IPV types experienced.

Main Outcomes and Measures

The 7 health outcomes were poor general health, recent pain or discomfort, recent use of pain medication, frequent use of pain medication, recent health care consultation, any diagnosed physical health condition, and any diagnosed mental health condition.

Results

The sample comprised 1355 ever-partnered men (mean [SD] age, 51.3 [16.9] years), who predominantly identified as heterosexual (96.9%; 95% CI, 95.7%-97.8%). Half of the sample (49.9%) reported experiencing any lifetime IPV, of whom 62.1% reported at least 2 types. Of all sociodemographic subgroups, unemployed men had the greatest prevalence of reporting exposure to any IPV (69.2%) and all IPV types. After adjustment for sociodemographic factors, men's exposure to any lifetime IPV was associated with an increased likelihood of reporting 4 of the 7 assessed health outcomes: poor general health (adjusted odds ratio [AOR], 1.78; 95% CI, 1.34-2.38), recent pain or discomfort (AOR, 1.65; 95% CI, 1.21-2.25), recent use of pain medication (AOR, 1.27; 95% CI, 1.00-1.62), and any diagnosed mental health condition (AOR, 1.66; 95% CI, 1.11-2.49). Specific IPV types were inconsistently associated with poor health outcomes. Any physical IPV exposure was associated with poor general health (AOR, 1.80; 95% CI, 1.33-2.43), recent pain or discomfort (AOR, 2.23; 95% CI, 1.64-3.04), and frequent use of pain medication (AOR, 1.69; 95% CI, 1.08-2.63), which appeared to be associated with exposure to severe physical IPV. Exposure to sexual IPV, controlling behaviors, and economic abuse was not associated with any assessed outcomes after sociodemographic adjustment. Experience of a higher number of IPV types did not show a clear stepwise association with number of health outcomes.

Conclusions and Relevance

Results of this study indicate that exposure to IPV can adversely affect men's health but is not consistently a factor in men's poor health at the population level. These findings do not warrant routine inquiry for IPV against men in clinical settings, although appropriate care is needed if IPV against men is identified.

Can Women Shelters Help Reduce Symptoms of PTSD and C-PTSD? Trajectories of PTSD Symptom Development Following Partner- and Family-Related Violence

BACKGROUND

To protect women from Intimate partner violence (IPV), women's shelters should not only provide emergency safety from IPV exposure, but also prolonged support that empowers women to build a life free from violence. The present study aims to investigate individual symptom development in association with residency at a women's shelter.

METHOD

Data were collected at four different timepoints, that is, enrolment (T1, N = 150), 3-months residency (T2, = 110), 6-months residency (T3, N = 68) and after relocation (T4, N = 63). Women were included from four Danish women's shelters. The International Trauma Questionnaire (ITQ) was applied to test for post-traumatic stress disorder (PTSD) and Complex-PTSD (C-PTSD) at all timepoints. A paired sample t-test was used to test the mean symptom development, and a Latent Class Growth Analysis (LCGA) was applied to test for different classes of PTSD-trajectories. Logistic regression was applied to predict class membership from shelter-related variables and symptom severity, that is, length of residency, psychological counselling, revictimization and key symptoms of C-PTSD.

RESULTS

The prevalence of PTSD (31%) and C-PTSD (37.9%) was high at enrolment. Although t-tests suggested a significant decline in symptoms at follow-up, the LCGA revealed different classes of symptom development. The two-class model was found to be the best representation of data with low-symptom- and high-symptom profiles, respectively. Overall, the largest decline in symptoms occurred within the first 3 months of residency. Revictimization was high and was further found to predict class membership. However, when included in a multiple regression only symptom severity predicted the high-symptoms profile class.

DISCUSSION

Psychological treatment focussing on PTSD and C-PTSD is important for the women's future well-being and safety. Reports on revictimization was alarmingly high, which emphasises a continuing need to protect women from psychological violence within the shelters. These findings should be replicated in larger samples before we can draw any conclusion.