Methods for estimating medical expenditures attributable to intimate partner violence

This article compares three methods for estimating the medical cost burden of intimate partner violence against U.S. adult women (18 years and older), 1 year postvictimization. To compute the estimates, prevalence data from the National Violence Against Women Survey are combined with cost data from the Medical Expenditure Panel Survey, the Medicare 5% sample, and published studies and with relative risk estimates from published studies. Results are compared and reasons for difference are explored, including the advantages and disadvantages of each approach. Estimates of the medical cost burden of intimate partner violence within the first 12 months after victimization range from USD 2.3 billion to USD 7.0 billion, depending on the method used. Although limited to women victimized in the last year, each method reveals that intimate partner violence imposes a substantial burden on the health care system. Among the approaches, there is no clear gold standard nor any evidence of bias.     

Factors related to willingness to help survivors of intimate partner violence

Although researchers have found that survivors of intimate partner violence seek support from a multitude of sources, ranging from professionals to informal support networks, little is known about the extent to which community members reach out to help survivors. This study explored the type of support provided to survivors and various factors that relate to individuals' willingness to help. Survivors were more likely to be helped by women, younger individuals, those who strongly endorsed criminal justice interventions for perpetrators, and those who perceived intimate partner violence as a frequently occurring issue in their communities. Two additional factors were found to relate to an individual's likelihood of assisting others, including witnessing intimate partner violence as a child and prior victimization. Further research is needed in this area to explore helper, survivor, and contextual characteristics that may affect one's likelihood to offer assistance to survivors.     

Alcohol intoxicated eyewitnesses' memory of intimate partner violence

Alcohol affects memory in many, and mostly negative, ways. This is a problem in legal contexts as many witnesses are alcohol intoxicated when taking part of the critical event. However, research is sparse regarding how, and under what circumstances, the reports of alcohol intoxicated witnesses differ from those of sober witnesses. This study investigated whether alcohol intoxicated and sober eyewitnesses differ regarding completeness, accuracy, and type of information reported, as well as whether gender influenced these variables. Eighty-seven healthy men (n = 44) and women (n = 43) received either an alcoholic beverage (0.7 g/kg) or a control (juice) in a laboratory setting before viewing a film picturing intimate partner violence. Ten minutes after viewing the film, they were interviewed. Reports by alcohol intoxicated women were less complete, but as accurate, as sober women's. In contrast, intoxicated and sober men did not differ regarding completeness or accuracy. Furthermore, compared with sober women, intoxicated women reported fewer actions but no difference was found between the groups regarding reported objects. At this moderate dose, alcohol affected women's reports more than men's, which may be because alcohol affects attention and memory consolidation more clearly at a lower dose for women than for men.     

Impact of emergency department intimate partner violence intervention

The objective of the study is to assess the impact of emergency department (ED) intimate partner violence (IPV) counseling and resource referrals on patient-perceived safety and safety planning. ED patients with risk factors were offered consultation with trained IPV advocacy counselors who completed safety assessments, provided resource referrals, and helped patients develop safety plans. Patients were contacted after ED intervention to assess progress and further assist in IPV counseling. Over 96% of patients perceived an increase in their safety after the intervention, and approximately 50% had completed a portion of their safety plan. Legal assistance and/or law enforcement were considered the most beneficial resource referrals. Although follow-up was limited, this study appears to demonstrate that an ED IPV intervention program may be useful in helping IPV victims achieve safer living environments and access local resources.     

Characteristics of victims coarrested for intimate partner violence

This study evaluated the frequency of coarrest in female victims who utilized 911 for intimate partner violence (IPV) and any patterns or circumstances that increased the likelihood of coarrest. All cases of police-documented IPV where a female IPV victim was arrested in conjunction with the perpetrator were included. Each incident report was reviewed to determine demographic characteristics of the victim, weapon and substance involvement, presence of children, and violence severity. Of IPV victims, 9% (131 of 1,489) were arrested. Having a weapon, alcohol use, not being married, and older age were associated with increased likelihood of arrest (p < .001). The presence of a child decreased the likelihood of victim arrest (p < .001). Race, prior incidents of IPV, offender restraining order, and incident severity were not significantly associated with coarrest. Although coarrest occurred in a minority of cases, it may deter victims from contacting police for future incidents of police.     

Depressive symptoms in women experiencing intimate partner violence

The study was a cross-sectional examination of African American women positive for intimate partner violence (IPV) who presented to the medical or psychiatric emergency department (ED) for treatment. African American women with a recent history of IPV who presented following an attempted suicide (n = 100) were compared to demographically comparable African American women who were IPV positive who had not attempted suicide and presented for treatment of another condition(n= 100). Women completed face-to-face interviews on several measures, including demographics and the Beck Depression Inventory-II (BDI-II). Overall, there were no demographic differences between cases and controls. Attempters reported statistically significant higher scores on all 21 BDI-II items than did nonattempters. Four BDI-II items had effect size values in the medium range: sadness, self-dislike, suicidal thoughts, and feelings of worthlessness. These four items can be used as a brief screen in the ED to detect female patients positive for IPV at increased risk for suicidal behavior.     

Methodological review of intimate partner violence prevention research

The authors present a methodological review of empirical program evaluation research in the area of intimate partner violence prevention. The authors adapted and utilized criterion-based rating forms to standardize the evaluation of the methodological strengths and weaknesses of each study. The findings indicate that the limited amount of empirical research related to intimate partner violence prevention demonstrates some consistent methodological strengths and limitations. The authors conclude with a presentation of recommendations for further research in the area of intimate partner violence prevention.     

The sex ratio and male-on-female intimate partner violence

Two divergent perspectives have been articulated in the literature regarding the effect that an unbalanced sex ratio is speculated to have on male-on-female intimate partner violence. Evolutionary psychology proffers that a high sex ratio (i.e., more men than women in the population) propagates competition among males for female mates. This competition for female mates is thought to engender sexual jealousy among men, which in turn results in male-on-female intimate partner violence. In contrast, the Guttentag and Secord thesis argues that a high sex ratio acts to attenuate rather than amplify male-on-female intimate partner violence because the relatively small number of women in the population makes them more highly valued and respected by men. Using data culled from the Federal Bureau of Investigation's National Incident-Based Reporting System (NIBRS) and the Census, we investigate the relationship between the sex ratio and male-on-female intimate partner violence. We define male-on-female intimate partner violence as violence occurring within a marriage or boyfriend/girlfriend type relationship. Multivariate regression results furnish evidence supporting evolutionary psychology by demonstrating that a high sex ratio increases male-on-female intimate partner violence. Results also show that male-on-female intimate partner violence is higher in cities where more women work. Such a finding further buttresses the logic associated with evolutionary psychology because participation in the workforce is theorized to afford a woman a greater opportunity to meet and interact with men other than her husband or boyfriend.     

Persistence of intimate partner violence among families referred to child welfare

The purpose of this study is to examine the longitudinal course of intimate partner violence (IPV) among female caregivers of children receiving child welfare services. Data are derived from the National Survey of Child and Adolescent Well-Being, a national probability study of children investigated for child abuse and neglect in the United States. Caregivers (n = 861) are interviewed about demographic characteristics, mental health, substance use, and physical violence by a partner at the close of the investigation and at an 18-month follow-up. Polychotomous logistic regression examines the associations of severe and minor IPV controlling for caregiver and environmental characteristics. The results suggest that factors related to initial risk for IPV do not affect the continuation of IPV and that patterns of IPV differ for racial and ethnic groups.     

Gender symmetry in the self-reporting of intimate partner violence

Research has not conclusively determined whether men and women are equally likely to commit intimate partner violence (IPV). One explanation for the disparity in previous findings may be gender-based differences in reporting styles. The present study investigated whether there was any gender difference in self-reported IPV prevalence. A total of 3,740 Chinese couples from a representative population in Hong Kong were interviewed. Self-reports of men-to-women and women-to-men IPV between spouses were compared. Gender was controlled for to evaluate whether age, education, the Chinese concept of face, and other violence-related characteristics would affect the self-reporting of IPV. Findings supported gender symmetry in self-reported IPV prevalence as well as a moderate interspousal agreement in the self-reports. After adjustment for covariates, face was a significant factor predicting the interspousal differences in both men-to-women and women-to-men physical IPV.     

Trends in intimate partner violence: 1980-2008

Research on trends in partner violence has primarily relied on official measures of victimization focusing primarily on women's risk for intimate partner homicide. The current study uses 28 years of data from the National Crime Victimization Survey (NCVS) to examine the trends of intimate partner violence against female victims and identify variation in women's risk as a function of race and employment. Although it has been theorized that employment is correlated with the risk of intimate partner victimization for women, research has not thoroughly addressed this in a longitudinal context. In addition, research has not explored the extent to which intimate partner violence is correlated with the combined variables of race and employment. The authors find that between 1980 and the mid-2000s employment is associated with an increase in women's risk for intimate partner violence. However, the conclusion that the rate of victimization is higher for employed women appears to be partly contingent on the victims' race. The trend for non-White unemployed women appears to be relatively comparable to both White and non-White employed women, at least for the first 15 years of the series.     

Older women and intimate partner violence: effective interventions

Women above the age of 60 who have experienced intimate partner violence (IPV) have specific needs compared with younger victims. More research is emerging that assists counselors and other helping professionals with identification of these needs and aids to promote the mental health and well-being of this population. Professionals must consider the generational values held by older IPV victims and understand how values may impact decision making. Integrating safety planning and risk assessment into the counseling process is vital. Older IPV victims may seek counseling for posttraumatic stress or depressive symptoms as a result of the abuse. Others may participate in counseling for issues unrelated to IPV. Therefore, a thorough assessment process should include questions related to relationship dynamics so that the counselor has a complete understanding of all factors impacting the client's functioning. Helping professionals must also have an understanding of available community resources, as well as barriers that these clients face as they take steps toward recovery from trauma. This research uses qualitative analysis of case studies to assist helping professionals in understanding the most effective interventions when working with this population.We found that a contextual approach focusing on the restoration of self-confidence is a constructive means of initiating recovery from trauma.     

Gender symmetry, sexism, and intimate partner violence

This study of a predominantly Hispanic sample of 92 male and 140 female college students examines both gender symmetry in intimate partner violence (IPV) and inconsistent relationships found in previous studies between sexist attitudes and IPV. Results indicate that although comparable numbers of men and women perpetrate and are victimized in their relationships with intimate partners, the path models suggest that women's violence tends to be in reaction to male violence, whereas men tend to initiate violence and then their partners respond with violence. Benevolent sexism was shown to have a protective effect against men's violence toward partners. Findings highlight the importance of studying women's violence not only in the context of men's violence but also within a broader sociocultural context.     

Using indirect questions to detect intimate partner violence: the SAFE-T questionnaire

A screening instrument for detecting intimate partner violence (IPV) was developed using indirect questions. The authors identified 5 of 18 items studied that clearly distinguished victims of IPV from a random group of health conference attendees with a sensitivity of 85% and a specificity of 87%. This 5-item instrument (SAFE-T) was then tested on 435 women presenting to three emergency departments and the results compared to a direct question regarding current abuse. The SAFE-T questions detected only 54% of the women who admitted being abused and correctly classified 81% of the women who said they were not victims. The 1-year prevalence of IPV in this sample of women presenting to an emergency department was 11.6%. The authors conclude that indirect questioning of women appears to be more effective at ruling out IPV in an emergency department population and may be less useful for women "early" in an abusive relationship.     

Revisiting the role of communication in adolescent intimate partner violence

A growing literature suggests that communication strategies can promote or inhibit intimate partner violence (IPV). Research on communication is still needed on a group ripe for early IPV intervention: high school-aged adolescents. This article revisits our previous analyses of young female reproductive clinic patients (Messinger, Davidson, & Rickert, 2011) by examining how the adolescent and young adult respondents differ. To explore replicability of the adolescent results across populations, they are compared to 487 adolescent female students sampled from four urban high schools. Across samples, all communication strategies were used more frequently within violent relationships. Multivariate analysis identified escalating strategies used and received as being positively associated with physical violence used and received in all three samples. Regarding verbal reasoning and temporary conflict avoidance, substantial differences appeared between the young adult and adolescent clinic samples, and results from the adolescent clinic sample were largely replicated with the adolescent school sample, suggesting that young adult samples in this literature are not adequate proxies for adolescents.     

Detection of intimate partner violence in a general medicine practice

In this study, an assessment phase is undertaken to determine intimate partner violence (IPV) prevalence. An anonymous survey is followed by a chart review documenting identification of IPV. Two methods are attempted to increase assessment/documentation of IPV: a physician educational intervention and a nursing routine inquiry intervention in one quadrant of the practice. The IPV physician educational intervention includes didactic sessions, an IPV counselor, and resource information. The routine inquiry intervention involves nurses screening female patients for IPV at check-in. IPV is found to be prevalent in a general medicine clinic. An enhanced educational intervention does not increase IPV documentation. A routine inquiry intervention significantly increases documentation of lifetime IPV but does not impact current IPV identification.     

Perceptions of help resources for victims of intimate partner violence

Intimate partner violence (IPV) constitutes a major public health problem in the United States. This cross-sectional survey of 108 emergency department (ED) care providers and 146 ED visitors at three metropolitan EDs compared the beliefs of ED health care providers with those of community members about the relative benefits of the helpfulness of resources for IPV victims using hypothetical case scenarios. Although providers generally indicated that help resources were helpful in all scenarios, visitors were more discriminating, showing less support for resources in the lower-risk scenario. Regarding differences between groups, visitors selected police and attorneys more frequently than providers as a helpful resource, whereas providers selected shelters and counselors more frequently than visitors. Adjustment for previous experience with IPV did not change these results. Understanding the differences between health care providers' and community members' perceptions of resources for victims of IPV may improve the effectiveness of referral to IPV resources.