The effects and costs of intimate partner violence for work organizations

This study examines the productivity-related effects and costs of intimate partner violence (IPV) on the workplace. Specifically, it explores whether IPV victims and nonvictims differ in the number of work hours missed due to absenteeism, tardiness, and work distraction and the costs for employers from these missed work hours. The research involved a Web-based survey of 823 male and 1,550 female employees in three midsized organizations. Employees who reported lifetime IPV victimization, but not current victimization, missed more hours of work because of absenteeism than did nonvictims. Current victims, but not lifetime victims, were more likely to be distracted at work than nonvictims. Organization costs due to absenteeism and tardiness were greater for lifetime victims than nonvictims; however, no difference in costs was found for current victims. Overall, we found that IPV has negative effects on organizations, but that the nature and cost of these effects vary by type of victimization.     

A forensic medicine perspective on recurring episodes of intimate partner violence

During a three year period, 418 victims of intimate partner violence (IPV) were examined and their injuries documented at the Center for Victims of Violence (CVV) in Hamburg, Germany. All victims were questioned if their acute injuries were attributable to recurring acts of violence by the same intimate partner. The victims' experiences with recurring IPV were analyzed and associated risk factors as well as findings of acute physical injuries were integrated into the assesment. Overall, women were significantly more often victims of recurring episodes of IPV than men. In 35.4% of cases, victims of recurring IPV sustained injuries to three or more body regions. However, women who were victimized during a single act of violence, presented with the same distribution of injuries in only 21.1% of cases (p = 0.01). The results emphasize the fact that IPV often manifests itself in a spiraling escalation of physical violence. Furthermore, blunt force trauma to the head was diagnosed significantly more often (p = 0.05). The risk of sustaining a head injury was equally high for women who experienced a first-time violent episode by their ex-partner as it was for married women or women living in a non-marital partnership during recurring episodes of IPV. In an effort to reduce the increased risk for victims of IPV, health care personnel are highly encouraged to partake in forensic medicine based continuing education. This preventative measure may prepare clinicians to recognize IPV earlier as well as to treat and advise clients appropriately.     

Evaluation of a Health Care Provider Training Program to Identify and Help Partner Violence Victims

This study tested four hypotheses about the impact of a 3-h domestic violence training program with 752 health care providers on attitudes and values related to screening and helping partner violence victims. Hypotheses 1, 2, and 3 were that training would be related to: 1) increased self-efficacy to identify and help partner violence victims, 2) increased endorsement of the role of health care providers and settings for helping partner violence victims, and 3) increased comfort making appropriate community referrals to help partner violence victims. Hypothesis 4 was that training effects would be moderated by prior training and by prior experience with helping a victim. Following training, health care providers reported increased self-efficacy, increased comfort making appropriate community referrals, and increased valuation of health care providers and the health care system as having an important role in stopping domestic violence. Hypothesis 4 was also supported. Prior training and/or experience with an abuse victim predicted smaller changes in the dependent variables. These gains held at a 6-month follow-up. Implications for training curriculum design are discussed, in addition to institutional policy implications for determining the benefits versus costs of universal training, including staff who demonstrate prior training or experience with battered victims. Study limitations and future research directions, including the need to measure performance and policy compliance will also be outlined.     

Mining Electronic Health Records Data: Domestic Violence and Adverse Health Effects

Intimate partner violence (IPV) often culminates in acute physical injury, sexual assault, and mental health issues. It is crucial to understand the healthcare habits of victims to develop interventions that can drastically improve a victim’s quality of life and prevent future abuse. The objective of this study is to mine de-identified and aggregated Electronic Health Record data to identify women’s health issues that are potentially associated with IPV. In this study we compared health issues of female domestic abuse victims to female non-domestic abuse victims. The Domestic abuse population contained 5870 patients, while the Non-Domestic Abuse population contained 14,315,140 patients. Explorys provides National Big Data from the entire USA. Statistical analysis identified 2429 terms as significantly more prevalent among victims of domestic abuse, compared to the general population. These terms were classified into broad categories, including acute injury, chronic conditions, substance abuse, mental health, disorders, gynecological and pregnancy related problems.     

College Women’s Experiences of Dating Violence in Casual and Exclusive Relationships

Using a sample of female college students involved in a current dating relationship, we investigate the nature of violence in these intimate relationships to better understand the concept of violence mutuality. To do so we explore womens’ experiences with violence as both perpetrators and victims and examine the prevalence, chronicity, and severity of violence experienced by young women. We also examine whether there are differences in experiences of violence for women in casual versus exclusive dating relationships. Our findings suggest that when violence is present in a dating relationship it is likely to occur within a mutually violent relationship where women are both victims and perpetrators of violence. More importantly, within these mutually violent relationships, women reported being more likely to perpetrate violence at higher rates than they experience as victims. We find no notable differences in experiences with violence among those in casual versus exclusive relationships. The methodological limitations and policy implications of our findings are discussed.     

Intimate partner violence during pregnancy and mothers' child abuse potential

This research examines whether women who have experienced intimate partner violence (IPV) during pregnancy have a higher child abuse potential than women who have not experienced IPV. Data were analyzed from a longitudinal investigation of IPV during pregnancy. This study recruited 88 pregnant women during prenatal care and followed them for 1(1/2) years. IPV was assessed using the Conflict Tactics Scale 2 (CTS2). The woman's potential for child abuse was assessed using the Child Abuse Potential Inventory (CAPI). There was a significant positive association between IPV and child abuse potential scores (p = .003), even after controlling for sociodemographics. The odds of having a high level of child abuse potential were 3 times greater for women who were victims of IPV compared to nonvictims. Higher child abuse potential scores of the victimized women resulted mainly from the Distress and Problems with Others CAPI scales.     

Domestic Violence Against Women: Systematic Review of Prevalence Studies

To systematically review the worldwide evidence on the prevalence of domestic violence against women, to evaluate the quality of studies, and to account for variation in prevalence between studies, using consistent definitions and explicit, rigorous methods. Systematic review of prevalence studies on domestic violence against women. Literature searches of 6 databases were undertaken for the period 1995 to 2006. Medline, Embase, Cinahl, ASSIA, ISI, and International Bibliography of the Social Sciences were searched, supplemented by hand searching of the reference lists from studies retrieved and specialized interdisciplinary journals on violence. A total of 134 studies in English on the prevalence of domestic violence against women, including women aged 18 to 65 years, but excluding women with specific disabilities or diseases, containing primary, empirical research data, were included in the systematic review. Studies were scored on eight pre-determined criteria and stratified according to the total quality score. The majority of the sudies were conducted in North America (41%), followed by Europe (20%). 56% of studies were population-based, and 17% were carried out either in primary or community health care settings. There was considerable heterogeneity both between and within geographical locations, health care settings, and study quality The prevalence of lifetime domestic violence varies from 1.9% in Washington, US, to 70% in Hispanic Latinas in Southeast US. Only 12% scored a maximum of 8 on our quality criteria, with 27% studies scored 7, and 17% scored 6. The mean lifetime prevalence of all types of violence was found to be highest in studies conducted in psychiatric and obstetric/gynecology clinics. Results of this review emphasize that violence against women has reached epidemic proportions in many societies. Accurate measurement of the prevalence of domestic violence remains problematic and further culturally sensitive research is required to develop more effective preventive policies and programs.     

Identification of violence in Turkish health care settings

This study sought to investigate the contributing factors to and frequency of violence against health care workers (HCWs) working in western Turkey. The population is composed of a random sample of 1,209 HCWs from 34 health care workplaces. Written questionnaires were given to HCWs at all sites, where staff were instructed to register all types of violence they had experienced. In all, 49.5% of HCWs reported having experienced verbal, physical, or verbal and physical violence, with this total being made up of 39.6% men and 60.4% women. A larger percentage (69.6%) of general practitioners reported experiencing verbal abuse and physical violence by patients and patients' family members or friends. Younger workers, inexperienced staff, and those in emergency services were more likely to report violence. Violence directed toward HCWs is a common occupational hazard. Public health authorities should plan preventive interventions based on the findings of this study.     

Opinions and Experiences of Primary Healthcare Providers Regarding Violence against Women: a Systematic Review of Qualitative Studies

The aim of this systematic review of qualitative studies is to explore the opinions and experiences of primary care providers regarding violence against women. Structured searches were conducted in nine bibliographic databases (March 2016). Study identification, critical appraisal (using the CASP tool), and analyses (thematic synthesis) were conducted. 46 qualitative studies were selected. Three main themes were identified: 1) Defining violence against women and its causes; 2) Awareness of violence against women and disclosure, with subthemes: 2.1.) Barriers experienced by primary care providers; 2.2) Facilitators for providing appropriate help; 3) Actions taken by providers to help women. Violence against women was generally considered as an unacceptable act with important health consequences. Barriers to address violence against women included organizational factors, providers’ subjective feelings and perceived role, and providers’ perceptions about women facing violence against women. Facilitators included a trusting relationship with women, attentive non-judgmental listening, participate in the community, team-work and continuing education. Providing emotional support and offering information about resources were the main actions taken by primary care providers. Women-centred care, respecting women’s decision making processes and a biopsychosocial approach may provide direction to more compassionate and supportive care while strengthening primary healthcare response.     

Injuries due to deliberate violence in areas of Denmark. V. Violence against women and children. Copenhagen Study Group

As part of an European-South American study of deliberate violence cases of violence against women greater than or equal to 15 years of age and violence against and among children under the age of 15 years were registered at 3 Danish emergency wards and at the Institute of Forensic Medicine in Copenhagen. 352 cases of violence against women and 46 cases of violence against children were registered in the three emergency wards corresponding to rates of about 1.6/1000 per year for women, 0.6/1000 per year for boys and 0.7/1000 per year for girls in a provincial/rural district, the catchment region of Holbaek County Hospital, 3.4/1000 per year for women, 2.8/1000 per year for boys and 0.6/1000 per year for girls in a mainly middle income area of the metropolis Copenhagen, the catchment region of Frederiksberg Hospital, and 4.0/1000 per year for women, 4.0/1000 per year for boys and 0.9/1000 per year for girls in a mainly low income area of Copenhagen, the catchment region of the Rigshospital. Nineteen live adult female victims and 17 dead adult female victims of violence were registered in the Institute of Forensic Medicine in Copenhagen, where also one was registered as a victim of homicide. Nearly half of the adult live female victims of violence had been injured at home while this was the case for approximately three fourth of the dead victims. In 35% of the live cases the husband was the aggressor and in 12% a former cohabitant. In 71% of the homicide cases the husband was the aggressor. The live women appeared to have fewer but more serious lesions than men. The pattern of deliberate violence against women appears to be associated with socio-economic and cultural factors. In cases with a preceding quarrel there is statistically a link to alcohol intoxication. In half of the cases of violence against children the aggressor was known to the victim, in 15% the aggressor was one of the parents, while 42% of the cases were violence among children. The pattern of violence according to sex, and the distribution and severity of lesions for 10-14 years old children showed resemblance to the situation for adults. The lesions were more serious in young infant victims, especially boys, than in adult victims.     

Electronic jail revisited

Our study examines the prevalence and consequences of criminal victimization in a quota sample of homeless adults. This already besieged population experienced considerably higher rates of victimization than the general population and those in poverty. A majority of homeless victims could not identify their offender and were the victims of a violent crime. Although we found clear differences between the homeless and the comparison populations in the victimization episode, our results also suggest significant differences between homeless victims and homeless nonvictims. Victims had higher incomes and a greater fear of the streets, were more depressed, had a history of mental hospitalization, and experienced more physical symptoms. Finally, victimization was not a significant predictor of homeless persons' depression and mastery in our sample, unlike the cases of other, more specific samples and the general population. We argue that homelessness may be such an overwhelming life circumstance that single life events and their effect on mental health are masked by this ultimate state of victimization.     

Poly- and Distinct- Victimization in Histories of Violence Against Women

We report results from pre-testing an Europe-wide Survey on Violence against Women. A questionnaire on women’s experiences of stalking, harassment, psychological, physical, and sexual violence by non-, ex-, and current partners was tested on 10 known victims of violence in intimate relations and 20 randomly selected women. Multiple Correspondence Analysis uncovered two profiles of victimization: women poly-victimized in multiple life ambits and women distinctly victimized in only some of them. Known-victims of intimate partner’s violence (IPV) were more likely to be poly-victimized than randomly selected women. Heterogeneity in women’s socio-economic conditions could only partly account for IPV’s over-representation among poly-victimized women. This gave more credence to an interpretation that highlights the role played by previous traumatic experiences of victimization on re-victimization.     

DIFFERENTIAL POLICE TREATMENT OF MALE-ON-FEMALE SPOUSAL VIOLENCE*

Recent studies of police response to violence in which men attack women with whom they have a history of shared intimacy have not addressed the issue that inspired research in the first place: the “leniency thesis” that police treat men who beat their spouses less punitively than other violent offenders. In addition, research examining the deterrent effects of various police treatments of misdemeanor domestic violence is not responsive to complaints that abused women are denied protection of law when they have been victims of serious, felony-grade, abuse by their spouses. This research analyzes the response of the Chester, Pennsylvania, police to 392 consecutively reported felony-grade assaults by persons whose identities were known to victims and police. Results confirm the leniency thesis. Tabular analysis demonstrates that arrests occurred in 13% of male-on-female spousal assaults and 28% of other assaults. Logit analysis indicates that this difference in police response is not attributable to other variables that might be expected to result in differential treatment. We conclude that the practices and results reported by research conducted in progressive police jurisdictions that volunteer to participate in studies of police response to violence against women may not be generalizable to the great majority of U.S. police agencies that have not welcomed such study.     

“They Arrested Me—And I Was the Victim”: Women’s Experiences With Getting Arrested in the Context of Domestic Violence

Since the implementation of mandatory and pro-arrest policies, there has been a sharp increase in the number of women arrested for violence against intimate partners; many of these women are also victims of intimate partner violence (IPV). Through questionnaires and interviews, this study uncovers the experience of getting arrested from the perspective of women who were both victims of IPV and arrested in IPV-related incidents. Women reported that their arrest was unexpected, led to multiple losses and collateral consequences, and served as a turning point in their relationships. Findings support emergency intervention services that include alternatives to arrest for women experiencing IPV.     

Nursing Students' Attitudes Toward Victims of Domestic Violence as Predicted by Selected Individual and Relationship Variables

Access to quality health care for victims of abuse is often limited by the attitudes of health care professionals. Data collected from female nursing students (n = 155) revealed that those students with more egalitarian sex-role beliefs and a greater sense of control over life events were more sympathetic to battered women than those students with more traditional sex-role attitudes and less perceived control. Sex-role egalitarianism was found to be the best predictor of attitudes toward victims of domestic violence. Implications for health care practitioners and policy makers are presented.     

Victims of Intimate Partner Violence. The Physician’s Intervention in the Portuguese National Health Service

This study intends to characterize the current situation in Portugal regarding intimate partner violence (IPV) disclosure by the victims and its detection and report by the National Health Service (NHS) professionals, in order to promote the health and protection of the former. We interviewed 101 adult victims of IPV who sought care in the NHS. The results reveal that a relevant number of victims did not disclose the abuse to NHS physicians (18.8 %). According to the victims, in 57.9 % of the cases, physicians did not suspect IPV. In cases where there actually was suspicion (based on specific evidence and markers) or where there was no concealment of such type of violence, 52.3 % of the physicians did not inform the victims about the risks this situation posed to them, 89.8 % did not mention their obligation to denounce the case (as it is foreseen by the Portuguese law), and the number of injuries they described was lower than the one described in the forensic medical reports.     

Mental disorder in violent women in secure settings: Potential relevance to risk for future violence

The relevance to women of common violence risk factors identified in men has in many instances yet to be established. Consequently, there is a reluctance to accept without question the application to women of practices relating to violence risk assessment and management developed from research into men. This study examines mental disorder in women who are violent in order comment on its relevance to the practice of violence risk assessment and management. A sample of 95 violent women in high secure prison and forensic psychiatric care were assessed. Structured assessments of Axis I and II mental disorders and psychopathy were undertaken on all women and conviction histories were recorded. Very high levels of psychiatric morbidity were noted and patterns in comorbidity were detected. Among Axis I conditions, psychotic disorders and disorders of mood co-occurred at a very high rate. Among the Axis II conditions, dimensional ratings of borderline personality disorder (PD) correlated with dimensional ratings of avoidant, dependent and paranoid PDs while ratings of antisocial PD correlated with those of narcissistic, histrionic and obsessive–compulsive PDs. Women who had been incarcerated for a major violent offence were four times more likely to have a diagnosis of borderline PD than women whose index offence was one of minor violence. A number of the findings reported are in contrast to those reported in similar studies of men. Findings suggest that practitioners are right to question the application to women of knowledge derived from research into men. The practice of violence risk assessment and management with women should emphasise the development of individual risk formulations and responding to psychiatric comorbidity should be the rule rather than the exception with this population.     

Screening for intimate partner violence in orthopedic patients: a comparison of three screening tools

Accurately identifying victims of intimate partner violence (IPV) can be a challenge for clinicians and clinical researchers. Multiple instruments have been developed and validated to identify IPV in patients presenting to health care practitioners, including the Woman Abuse Screening Tool (WAST) and the Partner Violence Screen (PVS). The purpose of the current study is to determine if female patients attending an outpatient orthopaedic fracture clinic who screen positive for IPV using three direct questions (direct questioning) also screen positive on the WAST and PVS. We conducted a prevalence study at two Level I trauma centres to determine the prevalence of IPV in female patients presenting to orthopaedic fracture clinics for treatment of injuries. We used three methods to determine the prevalence of IPV; 1) direct questioning, 2) WAST, and 3) PVS. We compared the prevalence rates across the three screening tools. Ninety-four women screened positive for IPV using any method. The prevalence of IPV was 30.5% when a direct questioning approach was utilized, 12.4% using the WAST, and 9.2% using the PVS. The WAST identified 37.2% (35/94) of the IPV victims detected and the PVS identified 27.7% (53/94) of the IPV victims detected, whereas direct questioning identified 89.4% of the IPV victims. Identification of IPV may be under-estimated by the WAST and PVS screening tools. Our findings suggest direct questioning may increase the frequency of disclosure of IPV among women attending outpatient orthopaedic clinics.