Intimate partner violence and physical health consequences: policy and practice implications

Extensive research indicates that intimate partner violence (IPV) poses a significant risk to the physical health of women. IPV is associated with increased mortality, injury and disability, worse general health, chronic pain, substance abuse, reproductive disorders, and poorer pregnancy outcomes. IPV is also associated with an overuse of health services and unmet need for services, as well as strained relationships with providers. The body of IPV research has several critical gaps. There are almost no longitudinal studies of IPV and health. Most studies are clustered into a few specialties, with almost no research in the areas of allied health, dentistry, or management. A common definition of IPV is still not used. Finally, with some notable exceptions, there has been little success in moving the health care system to routinely screen women for IPV.     

Intimate partner violence, PTSD, and adverse health outcomes

The high prevalence of adverse health outcomes related to intimate partner violence (IPV) is well documented. Yet we know little about the pathways that lead to adverse health outcomes. Research concerning the psychological, biological, neurological, behavioral, and physiological alterations following exposure to IPV--many of which are associated with posttraumatic stress disorder (PTSD)--represents a promising area of empirical discovery. New technologies and interdisciplinary collaborative efforts are required to integrate diverse methodologies and to apply new findings to improving the health and well being of those affected by IPV. This article focuses on victimization by IPV and addresses the most important research findings in the last 20 years (health and mental health burden of IPV), the most important research issue for the next decade (pathways between IPV and adverse health outcomes), and the most promising methodological innovation for the study of IPV (integrated, interdisciplinary, biobehavioral methodology).     

Intimate partner violence victimization and household financial strain

Most scholars agree that low socio-economic status is associated with an elevated risk for violent victimization as well as offending. Nevertheless, it has been suggested that certain forms of violence—particularly intimate partner violence (IPV)—are more equally distributed in the population, not concentrating on the lower social strata as strongly as other forms of violence. In this paper, we examine the association between financial strain, measured on the household level, and two different types of victimization: IPV and violence committed by a person unknown to the victim. The analysis is based on the 2013 sweep of Finnish National Crime Victim Survey (n = 6,999), a nationally representative survey incorporating a mix of postal and web-based survey methodology. Multivariate analyses indicate that the risk for both kinds of victimization is highest among those who report financial difficulties. Moreover, the association between IPV and financial strain appears stronger when less serious violent incidences are excluded from the analysis.     

Intimate partner violence perpetration by court-ordered men: distinctions among subtypes of physical violence, sexual violence, psychological abuse, and stalking

This study continues previous work documenting the structure of violence perpetrated by males against their female intimate partners. It assesses the construct validity of a measurement model depicting associations among eight subtypes of perpetration: moderate physical violence, severe physical violence, forced or coerced sexual violence, sexual violence where consent was not possible, emotional/verbal psychological abuse, dominance/isolation psychological abuse, interactional contacts/surveillance related stalking, and stalking involving mediated contacts. Data were obtained from a sample of 340 men arrested for physical assault of a female spouse or partner, and court ordered into batterer intervention programs. Men were surveyed before starting the intervention. Confirmatory factor analyses (CFA) supported the validity of model as evidenced by good model to data fit and satisfaction of requirements for fit statistics. In addition, the eight factor solution was characterized by a slightly better model to data fit than a four factor higher order solution described in the author's previous work. Latent variable correlations across the broader categories of intimate partner violence (IPV) revealed that the violence subtypes were mostly moderately positively correlated and ranged from .381 (emotional/verbal psychological abuse with interactional contacts/surveillance related stalking) to .795 (dominance/isolation psychological with abuse with forced sex). Future studies should determine whether there are distinct risk factors and health outcomes associated with each of the eight IPV perpetration subtypes and identify possible patterns of co-occurrence.     

Intimate partner violence among pregnant and parenting Latina adolescents

The purpose of this study was to examine the nature and extent of mutual violence among a sample of pregnant and parenting Latina adolescent females and their partners. The sample consisted of 73 Latina adolescent females between the ages of 14 and 20 who were referred to a community-based organization for case management, education, and psychosocial support for pregnant and parenting adolescents. They completed the Conflict Tactics Scale (CTS-2) as part of a pretest to evaluate this intervention program. A small number (12 out of 73; 16%) reported no use of aggressive conflict tactics. Eighty-four percent (61 out of 73) of the study respondents reported using at least one form of minor psychological aggression and 62% (45 out of 73) reported using at least one form of minor physical assault over the past 6 months. Mutuality of conflict was high, especially in cases of minor assault by partner. There was no difference in severity or chronicity of conflict between those who were pregnant and those who were not. Female respondents reported that they and their partners engaged in comparable levels of sexual coercion. Discussion of the context of psychological, physical, and sexual aggression in adolescent relationships suggests alternative approaches to prevention of intimate partner violence among adolescents.     

Intimate partner violence and unintended pregnancy among bangladeshi women

This study examined the relationship between intimate partner violence (IPV) and unintended pregnancy using data from women reporting IPV in the 2007 Bangladesh Demographic Health Survey. The analysis included 4,695 married women, aged 15 to 40 years, who had at least one birth in the last 5 years. Bivariate and multiple logistic regression analyses were performed to assess the relationship between IPV and pregnancy. About one third (30.4%) of women were abused physically and/or sexually and about one third (30.9%) of their births in the last 5 years were unintended. Compared with women who suffered no IPV, women who were abused sexually had a 1.64-fold increased risk of unintended pregnancy, which is higher than those who suffered physical abuse only (odds ratio: 1.35). The prevalence of unintended pregnancy among those who experienced severe physical violence was 1.60 times higher than those who reported no abuse. The findings indicate a significant relationship between IPV and unintended pregnancy among Bangladeshi women.     

Intimate partner violence and miscarriage: examination of the role of physical and psychological abuse and posttraumatic stress disorder

Despite research documenting high rates of violence during pregnancy, few studies have examined the impact of physical abuse, psychological abuse, and posttraumatic stress disorder (PTSD) on miscarriage. Secondary analysis of data collected by the Chicago Women's Health Risk Study permitted an exploration of the relationships among physical abuse, psychological abuse, PTSD, and miscarriage among 118 primarily ethnic minority women. The interaction between maximum severity of abuse and age provided the best multivariate predictor of miscarriage rate, accounting for 26.9% of the variance between live birth and miscarriage outcome. Mean scores of psychological abuse, physical violence, forced sex, and PTSD were significantly higher in the miscarriage group than in the live birth group. Women who experience physical violence and psychological abuse during pregnancy may be at greater risk for miscarriage. Prospective studies can confirm findings and determine underlying mechanisms. Routine screening for traumatic stress and PTSD may reduce rates of miscarriage.     

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.     

Intimate partner violence among male and female Russian university students

This article reports data from three Russian sites of the International Dating Violence Study. Using a sample of 338 university students (54% female) from three Russian university sites, four different types of partner violence are examined: physical assault, physical injury, sexual coercion, and psychological aggression. High prevalence rates were found for all types of violence, aggression, and coercion. Consistent with previous research, male and female students were about equally likely to be victims and perpetrators of all violent and aggressive actions. Recommendations for prevention are made in the conclusions.     

Mental and physical health symptoms of family court intimate partner violence petitioners

This paper explores the impact of intimate partner violence on victim health and proposes interdisciplinary coordination between legal and mental health services as a means to assist victims. Data was collected from 95 female petitioners at an upstate New York Domestic Violence Intensive Intervention Court (DVIIC). Study participants completed surveys on physical health, mental health, and social functioning. Survey results demonstrated decreased mental health and social functioning as well as a strong willingness to utilize court-based mental health services if offered. Findings from this study support court-based settings as appropriate sites for addressing mental health needs through collaborative efforts between legal and mental health professionals.     

Intimate partner violence and alcohol problems in interethnic and intraethnic couples

Despite the growing number of interethnic marriages in the United States, few studies have examined intimate partner violence (IPV) in interethnic couples. This article examined past-year occurrences of IPV across interethnic and intraethnic couples and tested correlates of IPV specifically in interethnic couples. Data were from a national survey of couples 18 years of age and older from the 48 contiguous states. Interethnic couples (n = 116) included partners from different ethnic backgrounds, including Black-White, Hispanic-White, and Black-Hispanic couples. White (n = 555), Black (n = 358), and Hispanic (n = 527) intraethnic couples included partners with the same ethnicity. Data analyses were prevalence rates and logistic regressions. The analysis showed that interethnic couples were comparatively younger and had shorter relationships than intraethnic White, Black, and Hispanic couples. Male partners in interethnic couples had higher rates of binge drinking and alcohol problems compared with male partners in intraethnic couples. Past-year prevalence rates for any occurrence of IPV and acts of severe IPV were higher for interethnic couples relative to intraethnic couples. Most occurrences of IPV for interethnic couples were mutual. Factors predicting IPV among interethnic couples included marital status, couples' age, male alcohol problems, and female impulsivity. Mounting evidence points to interethnic couples as a high-risk group for IPV. Interethnic couples may be at greater risk for IPV because of their younger age, binge drinking, and alcohol problems. Future research could build on this study by examining cohort effects and regional differences in IPV for interethnic couples and the risk for IPV across interethnic couples of different ethnic compositions.     

Intimate partner violence against older women in Germany: prevalence and associated factors

Violence against women is a recognized human rights and public health issue, with significant impacts on women's life and health. Until now, several studies, most of them relying on small scale samples, have explored the prevalence and health effects of intimate partner violence against older women, whereas few have examined what actually puts older women at risk of intimate partner violence. This study is based on a secondary analysis of the first national survey on violence against women in Germany, looking at the prevalence and associated factors for physical and for sexual violence by the current partners of women aged 50 to 65 and women aged 66 to 86 years. The prevalence of violence in women's current relationships was 12% and 5%, respectively. In both age groups, women who had experienced violence during childhood and nonpartner physical or sexual violence after the age of 16 had higher odds of experiencing current partner violence. Current partner violence was associated only with women and their partner's level of education and women's vocational training among women aged 66 to 86 years. Relationships where one or both partners drank heavily in recent months were associated with higher odds of violence among women aged 50 to 65. Future studies on intimate partner violence need to recognize that women above reproductive risk are also at risk of current partner violence.     

Intimate partner violence and the justice system: an examination of the interface

Women entering the court system face a challenging experience, in part, because a courtroom can be an intimidating and difficult place for any person, and in part because women victimized by crimes in which the offender is known to them face distinctive difficulties when they seek the court's remedies. The interface is also made more challenging for women as the literature offers disparate findings as to the efficacy of criminal justice responses and civil remedies. This article briefly explores the unique characteristics of intimate partner violence cases that influence the interface of these victims with the court system. Areviewis provided of research on the criminal justice interventions in cases of intimate partner violence; and research on the efficacy of civil protective orders.     

A special police unit: Intimate partner violence and perceived helpfulness of services received

To evaluate the perceived effectiveness of domestic violence assistance offered by a special unit of an urban police department, 90 women having filed assault, stalking, or harassment charges on an intimate were interviewed. Threats of abuse, physical abuse, and stalking were measured—86% of the women reported experiencing severe abuse and 60% of the women had been stalked. On follow-up interview—41% of the women reported the abuse had stopped, while 7% said the abuse had decreased. Half of the women had used information provided by the unit, with 86% of the women considering police services received as being helpful. Authors' Note: Pam Willson, Ph.D., is a post-doctoral research associate at Texas Woman's University in Houston. Judith McFarlane, Dr. PH, currently holds the Parry Chair in Health Promotion and Disease Prevention at the University. Ann Malecha, Ph.D., is assistant professor of nursing at the University. Dorothy Lemmey, Ph.D., is associate professor of Nursing at Lakeland College.     

Intimate partner violence in the U.S. general population: progress and future directions

This article reviews survey research on intimate partner violence (IPV) in the U.S. general population. Results from survey research conducted over the past quarter century are briefly summarized. Three additional national studies related to injuries, crime victimization, and homicide among intimate partners in the United States are also considered. The article emphasizes the progress that has been made in general population survey research related to IPV. It concludes with a discussion of the current controversies and future directions for survey research of IPV in the U.S. general population.     

Intimate partner violence, social support, and employment in the post-welfare reform era

This prospective study used 3 years of longitudinal data to explore relationships among intimate partner violence (IPV), perceived emotional and material social support, employment stability, and job turnover among current and former female welfare recipients in the immediate post-welfare reform era. Higher levels of current IPV and lower levels of current social support predicted less stable future employment; however, current employment stability did not predict either future IPV or future social support. Current social support did not predict future IPV, and perceived social support did not mediate the relationship between IPV and employment stability during a 3-year period.