Does the relationship between depression and intimate partner aggression vary by gender, victim-perpetrator role, and aggression severity?

Bidirectional Violence in Intimate Relationships: A Systematic Review

Intimate partner violence is a public health problem with significant consequences at different levels. Over the years, the literature has shown that most violence is not unidirectional and perpetrated by men against women but rather bidirectional, in which both couple elements may be victims, perpetrators, or both. In this systematic literature review, we aimed to systematize the empirical knowledge to assess the prevalence of bidirectional violence, the most reported types of violence, and the influence of sex and sexual orientation on this phenomenon. The search for this systematic review was conducted in four databases, and we included studies that showed the prevalence of bidirectional violence in samples aged over 18 years, in articles written in English or Portuguese, and published between 2012 and 2022. In the qualitative synthesis, 42 empirical studies were included. The results showed that bidirectional violence is the most common pattern of violence, with psychological violence being the most reported type of bidirectional violence; men and women reported bidirectional violence at similar rates, and homosexual couples reported higher percentages of bidirectional violence than heterosexual couples. These results contradict the patriarchalist view of violence that assigns the exclusivity role of the victim to women and of the perpetrator to men, demonstrating that violence occurs regardless of sex or sexual orientation. The practical implications and future directions at the level of public policies to give visibility to the phenomenon will be duly discussed.

Past-year intimate partner violence perpetration among people with and without depression: an individual participant data (IPD) meta-mediation analysis

PURPOSE

To investigate whether (1) depression is associated with increased risk of past-year intimate partner violence (IPV) perpetration, disaggregated by sex, after controlling for potential confounders; (2) observed associations are mediated by alcohol misuse or past-year IPV victimisation.

METHODS

Systematic review and individual participant data (IPD) meta-mediation analysis of general population surveys of participants aged 16 years or older, that were conducted in a high-income country setting, and measured mental disorder and IPV perpetration in the last 12 months.

RESULTS

Four datasets contributed to meta-mediation analyses, with a combined sample of 12,679 participants. Depression was associated with a 7.4% and 4.8% proportion increase of past-year physical IPV perpetration among women and men, respectively. We found no evidence of mediation by alcohol misuse. Among women, past-year IPV victimisation mediated 45% of the total effect of depression on past-year IPV perpetration. Past-year severe IPV victimisation mediated 60% of the total effect of depression on past-year severe IPV perpetration. We could not investigate IPV victimisation as a mediator among men due to perfect prediction.

CONCLUSIONS

Mental health services, criminal justice services, and domestic violence perpetrator programmes should be aware that depression is associated with increased risk of IPV perpetration. Interventions to reduce IPV victimisation might help prevent IPV perpetration by women. Data collection on mental disorder and IPV perpetration should be strengthened in future population-based surveys, with greater consistency of data collection across surveys, as only four studies were able to contribute to the meta-mediation analysis.

Childhood Community Risk Factors on Intimate Partner Violence Perpetration and Victimization Among College Students

The study examined the effect of community environments, such as community cohesion, community safety, and community poverty, in childhood on the likelihood of Intimate Partner Violence (IPV) perpetration and victimization in young adulthood. The study used the cross-sectional survey data of 2,082 college students collected in 2016-2017 from six universities in the U.S. and the data for the childhood community environment from the 2007-2011 American Community Survey. Hierarchical regressions were performed separately by gender to 1) assess the effects of community factors in addition to individual factors for IPV perpetration and victimization, and to 2) identify the interaction effect of community cohesion with community poverty on IPV perpetration and victimization. Community factors of community cohesion and community poverty were significantly correlated to different types of IPV. For IPV perpetration, only community cohesion was significant for, the interaction effect between community cohesion and poverty showed that higher community cohesion lowered the risk of community poverty on later IPV perpetration in both genders. For IPV victimization, only female students were affected by community poverty, whereas none of the community factors had an impact on male students. The findings imply the significance of early interventions and policies strengthening the community environment, especially community cohesion, for preventing IPV. The findings also suggest that assessing risk and protective factors on IPV in multiple contexts during childhood is important to develop effective programs preventing IPV.

Selective targeting of chronic social stress-induced activated neurons identifies neurogenesis-related genes to be associated with resilience in female mice

Prolonged social stress is a major cause for depression in humans and is associated with a wide range of subsequent pathophysiological changes such as elevated blood pressure. A routinely used model for investigating this kind of stress in mice is the chronic social defeat paradigm where a smaller intruder is exposed to an aggressive inhabitant of a home cage. This model is restricted to males and includes a high proportion of physical stress that might e.g., interfere with immunological aspects of the stress. The prevalence of depression in humans is even higher in women than in men. Therefore, expanding models to female individuals is desirable. We here tested the social instability model as a tool for administering chronic social stress to female C57BL/6J mice and analyzed short-term as well as long-lasting effects. Animals were housed in groups of four and were shuffled two times a week, resulting in a permanent re-structuration of their social hierarchy. While directly after the stress exposure, serum corticosterone was elevated, increased body weight and fat deposits were observed in stressed mice even one year after discontinuation of the stress. At the behavioral level, animals could be stratified into resilient and susceptible animals directly post-stress, but those subgroups were not distinguishable any more in the long-term analysis. To identify molecular contributors to resilience in the here presented social instability induced stress model, Arc-activity dependent trapping of neurons was conducted in Arc-creERT2/sun1sfGFP mice. RNA samples derived from activated nuclei from the ventral hippocampus, a brain region involved in stress-regulation during attacks or explorative behavior of mice, were subjected to a neurogenesis pathway array. While several genes were differentially regulated by stress, in particular, artemin, a neurotrophic factor was upregulated in resilient versus susceptible individuals.

Bidirectional Violence Is Associated with Poor Engagement in HIV Care and Treatment in Malawian Couples

Growing evidence suggests that intimate partner violence (IPV) is a barrier to engagement in HIV care. Bidirectional IPV-being both a perpetrator and victim-may be the most common pattern of IPV, yet no research has examined its effect on engagement in care, which could identify couples in most need of interventions. Married couples (N = 211) with at least one partner on antiretroviral therapy were recruited from HIV clinic waiting rooms in Zomba, Malawi. Partners completed separate surveys on physical, sexual, and emotional IPV, medication adherence, and appointment attendance. We created categorical variables indicating no violence, perpetrator-only, victim-only, and bidirectional violence. Generalized estimating equation regression models tested for associations between IPV and engagement in care. The bidirectional pattern represented 25.4%, 35.5%, and 34.0% of all physical, sexual, and emotional IPV. Physical IPV victimization-only (adjusted odds ratio [AOR]: 0.28, 95% confidence interval [CI]: 0.08, 0.92) was associated with lower adherence, but the association was stronger for bidirectional physical IPV (AOR: 0.10, 95% CI: 0.02, 0.51). Bidirectional sexual IPV was also associated with lower adherence (AOR: 0.14, 95% CI: 0.02, 0.80). Bidirectional physical IPV (AOR: 4.04, 94% CI: 1.35, 12.14) and emotional IPV (AOR: 3.78, 95% CI: 1.78, 8.05) were associated with missing 1+ appointment. Interventions to address the health effects of bidirectional IPV, which may be greater than victim-only or perpetrator-only IPV, should intervene with both partners to break cycles of violence. Couple-based interventions may be a viable option by intervening on both partners' trauma and aggression simultaneously.

Development and Validation of the Drama Triangle Scale: Are You a Victim, Rescuer, or Persecutor?

The drama triangle is a theoretical framework to describe and understand the roles (Victim, Rescuer, and Persecutor) that people assume and perpetuate in interpersonal relationships, especially in contexts of "drama" or conflict. The Drama Triangle scale was developed, validated, and psychometrically scrutinized across three independent samples of adults. In Study 1 (N = 326), the initial pool of items was generated based on reviewing the literature. Exploratory factor analysis supported the three-factor structure of Victim (damsel in distress), Rescuer (hero), and Persecutor (villain) roles. In Study 2 (N = 342), confirmatory factor analysis (CFA) produced satisfactory fit indices. In Study 3 (N = 301), another CFA successfully cross-validated the final set of items. Furthermore, tests of convergent, discriminant, and criterion validities evaluated this scale against previously validated external measures of attachment styles, anxiety, stress, depression, positive emotions, and negative emotions. The drama triangle subscales tended to be associated with non-secure attachment styles and higher anxiety, stress, depression, and negative emotions, but results varied depending on the specific drama subscale. The Victim subscale was most strongly connected with undesirable outcomes, supporting the theoretical premise that Victims receive blame from Persecutors and help from Rescuers. This measurement instrument helps to conceptualize, measure, and understand the drama roles of Victim, Rescuer, and Persecutor that people enact in interpersonal relationships. The scale offers theoretical and applied implications for administration in future research on interpersonal conflict, aggression, violence, and other domains.

Examining the Relationships Between Childhood Exposure to Intimate Partner Violence, the Dark Tetrad of Personality, and Violence Perpetration in Adulthood

Intimate partner violence (IPV) is a major international public health concern that poses significant mental and physical health risks for affected individuals. To improve prevention efforts, it is imperative that researchers and government bodies understand risk factors for IPV. One such risk factor concerns the extent to which violence is intergenerational, such that exposure to violence predisposes individuals to engage in violence toward intimate partners. The purpose of this research is to assess childhood exposure to violence as a risk factor for perpetration of IPV in adulthood, and to evaluate the Dark Tetrad personality traits as mediators in this relationship. We recruited 153 men and 246 women (age range = 18-73, M_age = 33.50, SD_age = 10.26) through Amazon's Mechanical Turk to complete a series of questionnaires and an open-ended IPV perpetration assessment. Results showed no relationship between IPV perpetration and childhood IPV exposure, indicating that mediation analyses were not possible. Possible explanations are discussed. Follow-up exploratory analyses demonstrated that gender moderated the relationships between childhood IPV exposure and levels of Factor 1 psychopathy and Machiavellianism. Specifically, men who were exposed to IPV in childhood were more likely to develop higher levels of Factor 1 psychopathy and Machiavellianism, whereas women were not. Overall, our findings highlight the importance of providing researchers and clinicians with a greater understanding of environmental events preceding maladaptive trait development. It is also important for researchers and clinicians to consider gender differences in pathways between exposure to IPV and subsequent development of dark personality traits. Theoretical and practical implications are discussed.

Internalizing and externalizing symptoms and aggression and violence in men and women

Literature linking aggressive behavior across internalizing and externalizing disorders support the co-occurrence of aggression and various mental health diagnoses. However, research has yet to examine relationships between aggression and dimensional psychopathology models that cut across diagnostic boundaries (e.g., internalizing, externalizing composites) and capture shared liability across common disorders. The role of gender has also been largely ignored in prior work, despite evidence that men and women manifest psychopathology differently. The present study examined cross-sectional and longitudinal relationships between psychopathology composites (i.e., Internalizing, Externalizing) and different manifestations of physical aggression (i.e., aggressive traits, general violence, physical intimate partner violence, and self-directed aggression), as well as moderation by gender. Internalizing (INT) and Externalizing (EXT) lifetime symptoms and various physically aggressive behaviors were assessed at baseline and at 6 months and 1 year follow up in a sample of 319 adults with violence and/or substance use histories. Cross-sectional results showed that INT was associated with all forms of aggression, and women showed stronger relationships between INT and both physical intimate partner violence (IPV) and self-directed aggression. EXT was specifically linked to general violence, and a stronger relationship between EXT and self-directed aggression emerged in men compared to women. Longitudinal relationships were mostly small and nonsignificant. Results support the co-occurrence of aggression with distinct forms of psychopathology, as well as gender-dependent relationships, but do not support the predictive validity of symptom composites in aggression risk. Findings implicate the need for aggression interventions tailored within gender.

Sexual Agreements and Intimate Partner Violence Among Male Couples in the U.S.: An Analysis of Dyadic Data

Prior research with male couples has focused on how sexual agreements can influence relationship dynamics, sexual risk taking, and health promoting behaviors. Little is known about the association between sexual agreements and the experience or perpetration of intimate partner violence (IPV) in this population. Our study sought to evaluate these associations using dyadic data from a sample of 386 male couples residing in the U.S. Both partners independently reported on their relationship characteristics, sexual agreements, and specific acts reflecting physical, emotional, controlling, and monitoring IPV in separate surveys. Participants were more likely to have experienced IPV in the past year if they were in a relationship for ≥ 3 years versus < 3 years (aOR = 1.62, 95% CI = 1.03-2.53). Among 278 couples who had formulated sexual agreements, men who concurred with their partners on being in an "open" relationship were less likely to have experienced IPV versus those in a "closed" relationship (aOR = 0.47, 95% CI = 0.25-0.89). However, participants were more likely to have experienced IPV if their partners believed they had previously broken their sexual agreement (aOR = 2.79, 95% CI = 1.03-7.52). The verbal explicitness and duration of sexual agreements were not associated with either experiencing or perpetrating IPV in the past year. However, increasing levels of depressive symptomatology were associated with a greater likelihood of both experiencing and perpetrating IPV. Our findings highlight the need to prioritize dyadic interventions for male couples that focus on skills building around enhancing mutual communication and negotiating sexual agreements to reduce IPV.

The Role of Social Support on Depression Among Vulnerable Caregivers Reporting Bidirectional Physical Violence

Intimate partner violence (IPV) is a public health concern found across genders, socioeconomic strata, cultures, and ethnicities. While IPV is traditionally examined from either the victim or initiator role, it is also important to consider relationships in which both partners experience and demonstrate violence. The current study examined the relation between IPV chronicity and depression among 403 female caregivers with young children. Specifically, the current study examined the association between bidirectional IPV and depression. Furthermore, the impact of social support on depression levels among those caregivers was assessed. Results suggest that of those couples who experienced violence, bidirectional IPV was reported significantly more frequently than unidirectional IPV only. No significant differences in depression were found between those reporting bidirectional versus unidirectional IPV. Among those involved in bidirectional IPV, having greater social support was associated with significantly lower depression levels. Findings suggest that both initiation and experiences of IPV should be assessed among caregivers of vulnerable children. The potential impact of social support was also identified in this study. Clinicians may consider assessing family violence broadly, including bidirectional IPV, particularly among parents of young children with other adverse life conditions. Development and sustainment of healthy relationships through social support may facilitate adjustment for the caregivers.

Effects of emotion regulation and perpetrator-victim roles in intimate partner violence on mental health problems among men who have sex with men in China

AIMS

This study assessed the relationships between different perpetrator-victim roles in intimate partner violence (IPV), emotion regulation (ER) and mental health problems among men who have sex with men (MSM) in China.

METHODS

From April to June 2019, 1233 participants were approached via gay-friendly non-governmental organisations in 15 cities across mainland China.

RESULTS

Of the total, 578 eligible participants completed an anonymous online survey. All participants provided informed consent and information about their violent perpetrator-victim role and mental health status. The results revealed a high prevalence of IPV in this study sample, with 32.7% of participants reporting IPV victimisation and 32.5% of participants reporting IPV perpetration during their lifetime. A total of 81 (14.0%) participants were suicidal, 309 (53.5%) participants reported poor general mental health and 208 (36.0%) had significant depressive symptoms. Adjusted logistic regression models revealed that both physical victimisation (adjusted odds ratio [ORa] = 3.22, 95% confidence interval [CI] = 1.11-9.32) and sexual victimisation (ORa = 2.90, 95% CI = 1.39-6.05) had positive associations with suicidality, and unidirectional and bidirectional psychological perpetration were associated with poor general mental health and significant depressive symptoms. Although high cognitive reappraisal showed a negative association with poor general mental health (ORa = 0.89，95% CI = 0.86-0.92), the correlation with victims of IPV was weaker than it was with non-victims.

CONCLUSIONS

This study revealed that different perpetrator-victim roles in different IPV situations should be considered comprehensively in research, prevention and intervention. ER is not enough to buffer the effects of IPV on the mental health of MSM victims.

The path from schizotypy to depression and aggression and the role of family stress

Background.

Schizotypy is a multidimensional construct that is linked to the vulnerability for psychosis. Positive schizotypy includes having paranormal beliefs. Negative schizotypy includes social anhedonia. Disorganized schizotypy includes social anxiety and communication disorder. Schizotypy relates to depression and aggression. Family stress from high expressed emotion (EE; a rating of criticism, hostility, and emotional overinvolvement in a close relative toward a person showing signs of mental disorder) may mediate the link between schizotypy, depression and aggression. This study tested, using path analyses, the hypotheses that schizotypy predicts depression and aggression through high perceived EE as criticism and irritability (hypothesis 1) and praise and intrusiveness in a close relative (hypothesis 2).

Methods.

One hundred and four healthy participants listened to and rated the self-relevance of standard criticism and standard praise that denote EE. Participants rated their level of schizotypy, depression, aggression, and perceived EE in self-report questionnaires. Two path models tested the hypotheses.

Results.

Disorganized schizotypy, more than positive schizotypy, predicted the path to depression and aggression when perceived criticism and perceived EE-irritability were mediators. Disorganised schizotypy, more than negative schizotypy, predicted the path to depression and aggression when perceived praise and perceived EE-intrusiveness were mediators.

Conclusions.

Greater perceived criticism and less perceived praise in family communication explain the path from disorganized schizotypy (more so than positive or negative schizotypy) to depression and aggression. These findings indicate a need to consider the thought disorder-EE link as a potential contributor to depression and aggression in people with schizophrenia.

Association between stigma towards HIV and MSM and intimate partner violence among newly HIV-diagnosed Chinese men who have sex with men

BACKGROUND

HIV- and MSM-related stigma are well documented as common for Chinese men who have sex with men (MSM) living with HIV, yet there is sparse literature on intimate partner violence (IPV) and its relationship with stigma in this vulnerable population. To evaluate the association between HIV-stigma and stigma related to homosexuality and IPV among newly HIV-diagnosed MSM in China.

METHODS

Data were collected in the baseline survey among newly HIV-diagnosed Chinese MSM in a randomized clinical trial via face-to-face interviews. Univariate logistic and multivariate logistic regression analyses were performed to assess the associations between IPV and HIV- and MSM-related stigma.

RESULTS

Of 367 newly HIV-diagnosed Chinese MSM, 23.7% experienced any IPV, including 16.6% physical, 7.4% psychological and 5.2% sexual IPV. Positive associations were found between HIV- and MSM-related stigma and IPV. Men with high HIV-related stigma (score ≥ 27) were 1.67 times as likely to experience any IPV as those with low stigma (adjusted odds ratio [AOR]: 1.67, 95% confidence interval [CI]: 1.02-2.76). Men with high MSM-related stigma (score ≥ 6) were 1.99 times as likely to experience any IPV as those with low stigma (AOR: 1.99, 95% CI: 1.18-3.36).

CONCLUSIONS

HIV- and MSM-related stigmas was positively associated with IPV experiences among newly diagnosed MSM in China. The manner in which stigma may exacerbate IPV, and/or the influence of IPV on worsening stigma should be further evaluated. The high prevalence of IPV and stigma in this population suggests that interventions should be taken to reduce stigma and prevent this risky behavior among MSM.

Depression and Intimate Partner Violence Among African American Women Living in Impoverished Inner-City Neighborhoods

Mental health correlates of intimate partner violence (IPV) victimization including negative physical and mental health outcomes are well documented. However, certain subgroups of African American women, such as those living in impoverished, urban communities, are underrepresented in most studies and may experience IPV at higher rates. Furthermore, the circumstances of this women including poverty makes them at risk to IPV and its consequences. The present study estimated the prevalence of IPV victimization and its association with depression in a sample of low-income African American women participating in the Mobile Youth and Poverty Study. Participants in this study were caregivers of adolescents living in extremely impoverished conditions and were part of the Mobile Youth Survey, a community-based, longitudinal, multiple cohort survey conducted between the years 1998 and 2011. Data for the current study were collected between the years 2001 and 2010. The dependent variable was depressive symptoms as measured by the Center for Epidemiological Studies-Depression Scale (CES-D). The independent variable was IPV measured using a subsample of items from the Conflict Tactics Scale. Nearly three quarters (73.6%, n = 489) of the sample experienced some form of IPV and 49.1% (n = 326) had a CES-D depression score of 16 or greater indicating mild to severe depression symptoms. The highest proportion of women who met the CES-D criteria for depression were those experiencing the most severe IPV irrespective of category (i.e., physical, psychological, or combined). Logistic regression analyses showed that women reporting the most severe abuse, irrespective of category, were significantly more likely to meet the CES-D criteria for depression. In addition, low education and receipt of economic assistance were significantly associated with depressive symptoms. The combination of poor economic conditions and IPV may predispose African American women living in impoverished, urban communities to mental health outcomes such as depression.

The Role of Depression in the Relationship Between Psychological and Physical Intimate Partner Violence

Physical and psychological intimate partner violence (IPV) are significant public health concerns often associated with negative consequences for individuals, families, and society. Because IPV occurs within an interpersonal relationship, it is important to better understand how each partner's depressive symptoms, marital satisfaction, and psychological and physical IPV are interlinked. The purpose of this study was to identify actor and partner effects in a dyadic data analysis association between marital satisfaction and depressive symptoms, its links to psychological IPV, and then to physical IPV. Guided by the social information processing model, this study has implications for understanding the processes leading to various types of IPV in people seeking couples therapy. Using cross-sectional data from 126 heterosexual couples, we conducted an actor-partner interdependence model (APIM) to test actor and partner effects. Indirect actor and partner effects were also assessed. More depressive symptoms were associated with lower marital satisfaction. More depressive symptoms were generally linked with increased perpetration of psychological and physical IPV. Psychological IPV was associated with an individual's use of physical IPV. Effect sizes were moderate to large in magnitude. Four specific indirect effects were identified from depressive symptoms to psychological IPV to physical IPV. Depressive symptoms may be an important factor related to psychological and physical IPV for males and females. Implications include assessing for and treating depression in both partners, and discussing preferred ways of supporting each other that do not include psychological or physical IPV.

Risk Factors for Concordance Between Partners in Assault Among University Student Couples

Based on information 11,408 university students provided on perpetration of physical assault in a romantic relationship, they were classified into three Dyadic Concordance Types (DCTs). We then examined six risk factors drawn from previous literature of partner violence: physical abuse as a child, antisocial personality characteristics, alcohol abuse, coercive control, chronic denigration in a relationship, and patriarchy at the societal level. We hypothesized that some risk factors for assault are different dependent on the DCT. Using multinomial logistic regression, we found that some risk factors were associated with an increase in the risk of a couple being in the Male Only assaulted DCT more than the other two DCTs (e.g., men who were high in antisocial personality characteristics). Other risk factors were found to be associated with a greater increase in the risk a couple being in the Both assaulted DCTs (e.g., chronic denigration). These results suggest that theories about the etiology of partner violence should take into account whether the couple is Male Only, Female Only, and Both assaulted. Identification of the DCTs of cases can be helpful in focusing research, treatment, and prevention of partner violence in a way that better reflects the actual situation.

Posttraumatic Stress Disorder and Depression in Men and Women Who Perpetrate Intimate Partner Violence

Poor mental health is a risk factor for intimate partner violence (IPV) perpetration. Literature suggests that gender differences play a role in this association. The aims of this study were to examine the: 1) prevalence of IPV perpetrated by men and women; and 2) association between symptoms of depression or posttraumatic stress disorder (PTSD) and IPV perpetration among men and women. A convenience sample of 210 people living in three peri-urban areas in South Africa completed self-report questionnaires that assessed symptoms of common mental health disorders and IPV. Gender differences were not found with regard to perpetrating physical assault and psychological aggression, although men were more likely than women to report perpetration of sexual coercion (42.9% vs. 23.8%). Men who reported higher symptoms of PTSD were 3 times (OR = 2.63, p = .023) more likely to report perpetrating sexual coercion, when controlling for demographic characteristics and symptoms of depression, than men who reported lower levels of PTSD. Women who reported moderate to severe symptoms of depression were 4 times (OR = 3.9, p = .01) more likely to report perpetrating physical assault, when controlling for demographic characteristics and symptoms of PTSD, than women who reported minimal to mild symptoms of depression. Findings add further support for differences in rates of IPV perpetration, and poor mental health as a risk for IPV perpetration. Interventions aimed at reducing IPV perpetration in the South African setting will only be marginally effective if gender-specific interventions are not developed that consider co-occurring symptoms of PTSD and depression.

Intimate partner violence and incidence of depression in married women: A longitudinal study of a nationally representative sample

BACKGROUND

Intimate partner violence (IPV) has a serious detrimental effect on mental health outcomes. We aimed to investigate the association of verbal or physical IPV with incidence of depressive symptoms in both married women and men according to the victim-perpetrator role. The potential mediating role of verbal or physical IPV in the association between satisfaction level with family relationships or childhood adversity and the incidence of depressive symptoms in married adults was also explored.

METHODS

The Korea Welfare Panel Study (KOWEPS) in 2006 and 2007 dataset was analyzed for 9217 married respondents aged 19 years or older. Physical and verbal IPV was assessed according to victim-perpetrator role in 2006. Depressive symptoms were evaluated by the Center for Epidemiologic Studies Depression Scale, 11-item version in 2006 and 2007. Association of IPV with incidental depressive symptoms was investigated with logistic regression analysis fully-adjusted for all potential confounding factors.

RESULTS

The bidirectional role of verbal IPV and victimization by physical IPV led to incidence of depressive symptoms in married women. Verbal IPV significantly mediated the association between satisfaction level with the family relationship and incidental depressive symptoms in women.

LIMITATIONS

We did not investigate the influence of premorbid depressive symptoms on new-onset IPV.

CONCLUSIONS

This study is the first to demonstrate that gender and the victim-perpetrator role are critical moderating factors in the association between IPV and depressive symptom incidence using a nationally representative sample.

Examining Associations Between Strangulation and Depressive Symptoms in Women With Intimate Partner Violence Histories

Intimate partner violence (IPV) is associated with poor mental health outcomes among women. Studies on IPV and mental health show that experiencing more than one type of IPV often enhances women's depression or depressive symptoms. However, most of these studies conceptualize IPV as physical, psychological, or sexual violence. Little is known about specific experiences of severe IPV, such as strangulation, that put victims at greater risk of lethality and serious injury and their association with women's depression. This study examined associations between IPV, strangulation, and depression among women using secondary data collected for a randomized clinical trial testing an integrated HIV-IPV prevention intervention for abused women. Women were recruited from healthcare service delivery organizations, Department of Health and Human Services, and family court. Women (n = 175) completed assessments on IPV, strangulation, mental health, social support, and self-esteem. The majority reported strangulation (n = 103) and depressive symptoms (n = 101). Women who experienced strangulation also reported more severe physical (p < .001), sexual (p < .001), and psychological (p < .001) abuse. However, in multivariate logistic regression with sociodemographics, violence variables, and strangulation, none of these variables were associated with a higher risk for depressive symptoms. Social support had a protective effect on depressive symptoms. Findings suggest strangulation is prevalent among abused women seeking services, warranting screening, assessment, and referral in these settings.

Psychological Predictors of Sexual Intimate Partner Violence against Black and Hispanic Women

Background: Although various types of intimate partner violence (IPV) tend to co-occur, risk factors of each type of IPV may differ. At the same time, most of the existing literature on risk factors of IPV among minorities has used a cross-sectional design and has focused on physical rather than sexual IPV. We conducted the current study to compare Black and Hispanic women for psychological predators of change in sexual IPV over time. Methods: Using data from the Fragile Families and Child Wellbeing Study (FFCWS), this study followed 561 Black and 475 Hispanic women with their male partners for four years. Independent variables included male partners' depression, anxiety, problem alcohol use, and male-to-female physical and psychological IPV perpetration. The dependent variable was sexual IPV reported by female partners, measured at baseline, two years, and four years later. Covariates included age, income, marital status and educational level. We used a multi-group latent growth curve model (LGCM) to explain intercept, linear, and quadratic slopes, which represent the baseline, and linear and curvilinear trajectories of male-to-female sexual IPV, where groups were defined based on ethnicity. Results: Psychological IPV was associated with sexual IPV at baseline among both ethnic groups. The male partner's depression was a risk factor for an increase in sexual IPV over time among Black but not Hispanic women. Anxiety, problem alcohol use and physical IPV did not have an effect on the baseline or change in sexual IPV over time. Psychological IPV was not associated with an increase in sexual IPV over time in either ethnic groups. Conclusions: There is a need for screening of sexual IPV in the presence of psychological IPV among minority women. There is also a need for screening and treatment of male partners' depression as a strategy to reduce sexual IPV among Black women.

Synergistic Effects of Depression and Poor Impulse Control on Physical Partner Violence; A National Study in United States

Background

Although major depressive disorder (MDD) also increases the risk of Intimate Partner Violence (IPV) perpetration, poor mental health has been mostly conceptualized as a consequence of IPV victimization rather than a risk factor for IPV perpetration. Poor impulse control is another IPV risk factor. Building on a risk / risk framework, this study investigates additive and multiplicative effects of male partners' MDD and poor impulse control on physical IPV victimization reported by female partner.

Methods

This national longitudinal study followed a random sample of 2,500 male and female cohabiting partners for two years in United States. Data came from the Fragile Families and Child Wellbeing Study (FFCWS). Male partner's MDD was the independent variable. Baseline socio-demographic factors (age, relation status, education level, income, and minority status) and Generalized Anxiety Disorder (GAD), and Alcohol Use Disorder (AUD) were covariates. Outcome was female partner's physical IPV victimization measured at baseline and two years later. Male partner's impulse control was the moderator. Model I tested independent effects of MDD and impulse control on physical IPV. Model II used multi-group structural equation model to test the effect of MDD in those with low and poor impulse control. All participants provided written consent and SPSS and AMOS were used for data analysis.

Results

In Model 1 that tested additive effects of SES, GAD, AUD, MDD, and poor impulse control did not show main effects of MDD or impulse control on an increase in perpetration of physical IPV over two years. Model 2 showed that MDD predicts an increase in perpetration of physical IPV of men with poor impulse control, but not men with high impulse control.

Conclusion

Based on the findings, poor impulse control and MDD have synergistic effects on IPV committed by men. Given the synergistic effects of psychological determinants of IPV, there is a need for prevention of IPV in male partners who have multiple risk factors such as MDD and poor impulse control. Self-regulation trainings of depressed men with poor impulse control may reduce IPV risk among men.

Relationship Satisfaction Mediates the Link Between Partner Aggression and Relationship Dissolution: The Importance of Considering Severity

Physically and psychologically aggressive behaviors between members of a couple often lead to relationship dissatisfaction and dissolution. The current study utilized data from 346 clinical couples to investigate associations between psychological and moderate physical aggression and relationship dissolution, and whether relationship satisfaction acts as a mediator of these associations. Results from two series of Actor-Partner Interdependence Models (APIMs) were considered in which cases of severe aggression were initially removed from the analytic sample and then were included for secondary analyses. The first series of models showed that dyadic physical aggression was a weak predictor of the male partner's steps taken to leave the relationship and was not associated with the female's steps. Dyadic psychological aggression, however, was related to steps taken toward leaving by both partners, accounting for approximately 14% of the variance. Relationship satisfaction mediated associations between physical and psychological partner aggression and steps taken to leave. Findings from the second series of models, including cases of severe aggression, showed a significant association between dyadic physical aggression and the female's steps toward leaving. Moreover, relationship satisfaction no longer fully mediated associations between psychological or physical aggression and relationship dissolution risk. The importance of considering severity of physical partner aggression in research and clinical practice is discussed.

Childhood sexual abuse and substance abuse: A gender paradox?

We examine associations between childhood sexual abuse (CSA) and substance abuse, the role of mental health indicators as mediators in these associations and whether or not associations differ by gender. Data are from 14,063 respondents aged 18-76 years from the 2004-2005 Canadian Gender, Alcohol, and Culture: An International Study (GENACIS). Multiple logistic regression models were used to examine associations between CSA and substance abuse variables, controlling for socio-demographic factors. Odds were adjusted by indicators of mental health to assess if these variables mediated associations between CSA and substance abuse. Tests of interactions between sex and CSA were conducted to see if gender differences exist in associations. In 2004/2005, CSA was reported by 14% of women and 5% of men. CSA was associated with heavy drinking, hazardous drinking, and the use of marijuana, other illicit drugs, and off-label drugs. Associations were only very marginally attenuated when controlling for depression and self-perceived emotional/mental health. In all cases previously observed significant associations persisted. Evidence of gender differences in associations between CSA and substance abuse was negligible. Preventing CSA may also reduce substance abuse.

Psychological and relational correlates of intimate partner violence profiles among pregnant adolescent couples

We sought to identify relationship and individual psychological factors that related to four profiles of intimate partner violence (IPV) among pregnant adolescent couples: no IPV, male IPV victim only, female IPV victim only, mutual IPV, and how associations differ by sex. Using data from a longitudinal study of pregnant adolescents and partners (n = 291 couples), we used a multivariate profile analysis using multivariate analysis of covariance with between and within-subjects effects to compare IPV groups and sex on relationship and psychological factors. Analyses were conducted at the couple level, with IPV groups as a between-subjects couple level variable and sex as a within-subjects variable that allowed us to model and compare the outcomes of both partners while controlling for the correlated nature of the data. Analyses controlled for age, race, income, relationship duration, and gestational age. Among couples, 64% had no IPV; 23% male IPV victim only; 7% mutual IPV; 5% female IPV victim only. Relationship (F = 3.61, P < .001) and psychological (F = 3.17, P < .001) factors differed by IPV group, overall. Attachment anxiety, attachment avoidance, relationship equity, perceived partner infidelity, depression, stress, and hostility each differed by IPV profile (all P < .01). Attachment anxiety, equity, depression and stress had a significant IPV profile by sex interaction (all P < .05). Couples with mutual IPV had the least healthy relationship and psychological characteristics; couples with no IPV had the healthiest characteristics. Females in mutually violent relationships were at particularly high risk. Couple-level interventions focused on relational issues might protect young families from developing IPV behaviors. Aggr. Behav. 43:26-36, 2017. © 2016 Wiley Periodicals, Inc.

The Effect of Gender and Perpetrator-Victim Role on Mental Health Outcomes and Risk Behaviors Associated With Intimate Partner Violence

Intimate partner violence (IPV) is a major public health concern. Previous studies have consistently shown that IPV is tied by to a variety of detrimental consequences for affected individuals, including negative mental health outcomes. However, the differential impact of gender and perpetrator-victim role (i.e., whether an individual is the perpetrator or victim of violence or both) remains largely understudied in the academic literature. Thus, the purpose of the present study was to describe a variety of mental health outcomes and risk behaviors among men and women experiencing no violence, perpetration-only, victimization-only, and bidirectional violence. Data from Waves 3 and 4 of the National Longitudinal Study of Adolescent Health (N = 7,187) were used. Participants provided information on their perpetrator-victim role and on a variety of factors related to mental health (depression, suicidality, alcohol use, illegal drug use, and relationship satisfaction). For all outcomes, prevalence and severity generally tended to be highest among individuals affected by bidirectional IPV and lowest among individuals not affected by any violence (independent of gender). The present findings highlight that IPV and negative mental health outcomes and risk behaviors should be addressed as co-occurring problems in research, prevention, and treatment. In addition, all gender-role combinations should be addressed to better understand and address all potential effects of IPV. According to the present findings, couples affected by bidirectional violence are at particularly high risk of developing mental health disorders. Thus, policy makers and clinicians should predominantly target couples as well as individuals who are not only the victims but also the perpetrators of IPV and pay particular attention to potential signs of mental health distress these individuals might exhibit.

Service user and family member perspectives on services for mental health, substance use/addiction, and violence: a qualitative study of their goals, experiences and recommendations

BACKGROUND

Mental health and substance use disorders (MSD) are significant public health concerns that often co-occur with violence. To improve services that address MSD and violence [MSD(V)], it is critical to understand the perspectives of those most affected, people who have sought help for MSD(V) (i.e., "service users"), especially those with co-occurring issues, as well as their family members.

METHODS

We conducted structured interviews with 73 service users and 41 family members of service users in two Ontario communities (one urban, one rural) regarding their goals related to help-seeking, positive and negative experiences, and recommendations for improving systems of care.

RESULTS

Overall, participants expressed a need for services that: (1) are respectful, nonjudgmental, and supportive, help service users to feel more 'normal' and include education to reduce stigma; (2) are accessible, varied and publicly funded, thereby meeting individual needs and addressing equity concerns at a systems level; and (3) are coordinated, holistic and inclusive of family members who often support service users.

CONCLUSIONS

The findings provide a rich understanding of how service users and their families perceive services for MSD(V) issues and identify key ways to better meet their needs.

A critical review of chronic traumatic encephalopathy

Chronic traumatic encephalopathy (CTE) has been described in the literature as a neurodegenerative disease with: (i) localized neuronal and glial accumulations of phosphorylated tau (p-tau) involving perivascular areas of the cerebral cortex, sulcal depths, and with a preference for neurons within superficial cortical laminae; (ii) multifocal axonal varicosities and axonal loss involving deep cortex and subcortical white matter; (iii) relative absence of beta-amyloid deposits; (iv) TDP-43 immunoreactive inclusions and neurites; and (v) broad and diverse clinical features. Some of the pathological findings reported in the literature may be encountered with age and other neurodegenerative diseases. However, the focality of the p-tau cortical findings in particular, and the regional distribution, are believed to be unique to CTE. The described clinical features in recent cases are very similar to how depression manifests in middle-aged men and with frontotemporal dementia as the disease progresses. It has not been established that the described tau pathology, especially in small amounts, can cause complex changes in behavior such as depression, substance abuse, suicidality, personality changes, or cognitive impairment. Future studies will help determine the extent to which the neuropathology is causally related to the diverse clinical features.

Emotional Distress, Alcohol Use, and Bidirectional Partner Violence Among Lesbian Women

This study examined the relationship between emotional distress (defined as depression, brooding, and negative affect), alcohol outcomes, and bidirectional intimate partner violence among lesbian women. Results lend support to the self-medication hypothesis, which predicts that lesbian women who experience more emotional distress are more likely to drink to cope, and in turn report more alcohol use, problem drinking, and alcohol-related problems. These alcohol outcomes were, in turn, associated with bidirectional partner violence (BPV). These results offer preliminary evidence that, similar to findings for heterosexual women, emotional distress, alcohol use, and particularly, alcohol-related problems are risk factors for BPV among lesbian women.

Anger, hostility, internalizing negative emotions, and intimate partner violence perpetration: A meta-analytic review

Prior reviews have identified elevated trait anger as a risk factor for intimate partner violence (IPV) perpetration. Given that 10 years have passed since the last comprehensive review of this literature, we provide an updated meta-analytic review examining associations among anger, hostility, internalizing negative emotions, and IPV for male and female perpetrators. One hundred and five effect sizes from 64 independent samples (61 studies) were included for analysis. IPV perpetration was moderately associated with the constructs of anger, hostility, and internalizing negative emotions. This association appeared stronger for those who perpetrated moderate to severe IPV compared to those who perpetrated low to moderate IPV, and did not vary across perpetrator sex, measurement method, relationship type, or perpetrator population. Implications and limitations of findings were reviewed in the context of theoretical models of IPV, and future directions for empirical and clinical endeavors were proposed.

Adverse childhood experiences and intimate partner aggression in the US: sex differences and similarities in psychosocial mediation

Six in ten people in the general population have been exposed to adverse childhood experiences (ACEs). Intimate partner violence (IPV) is a major public health problem in the US. The main objective of this study was to assess sex differences in the role of posttraumatic stress disorder (PTSD), substance abuse, and depression as mediators in the association between ACEs and intimate partner aggression. Data were obtained from Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Structural equation modeling was used to determine the mediational role of PTSD, substance abuse and depression in the association between ACE constructs (neglect, physical/psychological abuse, sexual abuse, parental violence, and parental incarceration/psychopathology) and intimate partner aggression. Among men, PTSD mediated the relationship between sexual abuse and intimate partner aggression. However, among men and women, substance abuse mediated the relationship between physical and psychological abuse and intimate partner aggression. IPV programs geared towards aggressors should address abuse (sexual, physical and psychological), which occurred during childhood and recent substance abuse and PTSD. These programs should be implemented for men and women. Programs aimed at preventing abuse of children may help to reduce rates of depression and PTSD in adulthood, and subsequent intimate partner aggression.

Suicidal Ideation of Probationers. Gender Differences

BACKGROUND

Gender is often related to different life stressors and mental health disorders, but a limited amount of research examines risks of suicidal ideation of probationers by gender.

AIMS

The aim of this study was to examine gender differences in suicidal ideation of probationers.

METHOD

Using a national sample of 3,014 male and 1,306 female probationers with data from the National Survey on Drug Use and Health (2009-2011), multivariate regression analysis was conducted.

RESULTS

Male and female probationers display similar demographic characteristics although their life circumstances and experiences seem different. Female probationers in the study were more likely to experience financial, psychological, and residential stressors than male probationers were. Female probationers were also more likely to have received medical and/or psychiatric treatments. Female probationers were exposed to more suicidal ideation risks than male probationers were. Additionally, no protective factors to suicidal ideation were found for female probationers.

CONCLUSION

The findings suggest that a gender-specific approach to suicidal ideation of probationers may lessen the prevalence of suicidal ideation of this largely neglected population.

Intimate partner victimization, poor relationship quality, and depressive symptoms during young adulthood

Using longitudinal data from the Toledo Adolescent Relationships Study (n = 927), we examined physical victimization, poor quality, and depression among young adults in casually dating, exclusively dating, cohabiting, and marital relationships. In multivariate models, victimization was a risk factor for depression with the inclusion of prior depression, family factors reflecting the intergenerational transmission of violence, sociodemographic background, and relationship characteristics including union status. With the inclusion of indicators of poor relational quality, victimization was not a significant predictor of depression. Arguing and poor communication influenced victimization and depression. Associations between victimization and depression did not differ by gender, nor were the effects of poor quality on depression conditional on gender. Thus, victimization occurs within relationships characterized by a range of negative dynamics. Multifaceted relationship-centered prevention efforts are more useful than focusing only on the use of aggression with a partner.

Risk factors associated with different types of intimate partner violence (IPV): an emergency department study

BACKGROUND

Domestic intimate partner violence (IPV) is a serious health care concern, which may be mitigated by early detection, screening, and intervention.

OBJECTIVES

We examine posited predictors in IPV and non-IPV groups, and in four different IPV profiles. Possible factors include 1) alcohol use, 2) drug use, 3) depression, 4) impulsivity, 5) age, and 6) any childhood experience in observing parental violence. We also introduce a new "Five Steps in Screening for IPV" quick reference tool, which may assist emergency physicians in detection and treatment.

METHODS

This was a cross-sectional study using survey data from 412 inner-city emergency department patients. Associations were explored using a chi-squared test of independence, independent-samples t-tests, and a one-way analysis of variance.

RESULTS

Nearly 16% had experienced IPV. As a group, they were younger, and more depressed and impulsive than the non-IPV group. They were more likely to engage in binge drinking, use drugs, and had more childhood exposure to violence. In the IPV group, 31% were perpetrators, 20% victims, and 49% both victims and perpetrators. The latter group was younger, more impulsive and depressed, used drugs, and was more likely to have observed parental violence as a child.

CONCLUSION

Correlates in groups affected by IPV indicate the same general risk factors, which seem to more acutely affect those who are both perpetrators and victims. Alcohol and drug use, depressive symptoms, and childhood exposure to violence may be factors and signs for which emergency physicians should screen in the context of IPV.

Adult experience of mental health outcomes as a result of intimate partner violence victimisation: a systematic review

BACKGROUND

Intimate partner violence (IPV) has been known to adversely affect the mental health of victims. Research has tended to focus on the mental health impact of physical violence rather than considering other forms of violence.

OBJECTIVE

To systematically review the literature in order to identify the impact of all types of IPV victimisation on various mental health outcomes.

METHOD

A systematic review of 11 electronic databases (2004-2014) was conducted. Fifty eight papers were identified and later described and reviewed in relation to the main objective.

RESULTS

Main findings suggest that IPV can have increasing adverse effects on the mental health of victims in comparison with those who have never experienced IPV or those experiencing other traumatic events. The most significant outcomes were associations between IPV experiences with depression, posttraumatic stress disorder, and anxiety. Findings confirm previous observations that the severity and extent of IPV exposure can increase mental health symptoms. The effect of psychological violence on mental health is more prominent than originally thought. Individual differences such as gender and childhood experience of violence also increase IPV risk and affect mental health outcomes in diverse ways.

CONCLUSIONS

Psychological violence should be considered as a more serious form of IPV which can affect the mental health of victims. Experiencing more than one form of IPV can increase severity of outcomes. Researchers should look at IPV as a multi-dimensional experience. A uniformed definition and measure of IPV could help advance knowledge and understanding of this disparaging global issue.