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.     

Bruise Documentation,Race and Barriers to Seeking Legal Relief for Intimate Partner Violence Survivors: a Retrospective Qualitative Study

Documentation of physical injuries from intimate partner violence (IPV) is critically important when a victim seeks legal help. Bruising, a common IPV injury, is often less visible on victims of color. This retrospective qualitative study is focused on IPV survivors’ and service providers’ experiences with the complex interrelationship between IPV injury, bruise documentation, race and legal assistance. Focus group results with a racially diverse group of female IPV survivors and legal service providers indicate that all victims struggle with documenting their bruises, but for women of color, even documentation of visible bruising underrepresents the severity of their IPV injuries. Further, there are a number of social, logistic, and systemic barriers to injury documentation that may make legal relief for IPV difficult for all women, but particularly more difficult for women of color. Proposed solutions to address the gap include, improved documentation techniques, and greater education for legal service providers. Implications for the field of family violence generally and potential future research directions are also discussed.     

Help-Seeking Behavior of Female Victims of Intimate Partner Violence in Ghana: The Role of Trust and Perceived Risk of Injury

Although several studies have investigated the socio-cultural underpinnings of intimate partner violence (IPV) in Ghana, few explore the help-seeking behavior of the victims. This study examined the help-seeking behavior of female victims of IPV in Ghana. Specifically, it explored the role of perceived risk of injury and trust in determining whether and where victims seek help and their likelihood of seeking help in the event of future abuse. The study used nationally representative cross-sectional data (N =?1689) and logit regression techniques to address these research objectives. The majority of respondents who had suffered IPV had not sought help after experiencing violence. However, of these, a substantial proportion said they would do so in the future. Respondents with high perceived risk of injury from physical and emotional violence were significantly more likely to seek help from both formal and informal support networks than those who saw themselves at no risk. Those with high levels of trust in formal and informal institutions were more likely to seek help from these networks. Compared to those who did not, respondents who thought IPV should be kept private were less likely to seek help, especially in future abuse. Finding suggest policy makers should educate women about IPV, especially their risk of violence.     

Gender Differences in the Nature of the Intimate Partner Violence and Effects of Perpetrator Arrest on Revictimization

The majority of research on intimate partner violence (IPV) has addressed male-to-female violence, although a small but growing body of literature has developed that explores males victimized by female partners. This study used data from the National Crime Victimization Survey from 1987 to 2003 to examine male victimization by comparing the nature of violence to female victimization and by exploring the effect of perpetrator arrest on preventing revictimization. The sample was comprised of 2,462 female and 298 male victims. Study variables included gender, arrest, revictimization, type of violence, injury, and use of a weapon. Results showed that men were victimized by IPV less frequently than women and received fewer injuries, although they were more likely to experience more severe violence. Police arrested female perpetrators, but generally only if injury was involved; however, arrest did not reduce male victims’ chance of revictimization.     

Risk for Revictimization of Intimate Partner Violence by Multiple Partners: a Systematic Review

Are victims of intimate partner violence (IPV) by multiple partners (MP) different from victims of IPV by one partner? Are there different victim-related risk factors for IPV by MP? This systematic literature review identified seven empirical studies that related to these issues. The review findings indicated that (1) empirical research on IPV by MP appears to be scarce, with only limited recent development; (2) there were significant differences between women who had been subjected to IPV in a single relationship and women with IPV by MP; (3) IPV by MP was significantly associated with childhood domestic trauma, drug abuse, IPV characteristics, and attachment style; (4) regarding PTSD and personality disorders, the results were mixed and inconclusive; and (5) depression did not appear as a salient risk factor for IPV by MP. Interpretations must be made cautiously because of the wide diversity in measurement approaches. It is important that service personnel and researchers attend with increased awareness to women with IPV by MP.     

Prevalence of Intimate Partner Violence Victimization and Victims’ Relational and Sexual Well-Being

Research shows that experiences with intimate partner violence (IPV) harm victims’ individual well-being. Surprisingly, little is known about how IPV might impact on victims’ well-being at the relationship level. Based on a population-based study in Flanders (the Northern part of Belgium), this study concentrates on how lifetime experience with IPV impacts on victims’ relational and sexual well-being with their current partner. Ten percent of the population was confronted with physical violence and 56.7 % with psychological violence. Higher levels of IPV victimization corresponded with an adverse mental, relational (relationship satisfaction, attachment), and sexual (sexual satisfaction, sexual dysfunction, sexual communication) well-being in both women and men but except for the latter correlates, the effects were more pronounced for women than for men.     

Vulnerability Factors among Women Victimized by Intimate Partner Violence and the Presence of Children

This study aimed to a) examine the presence of children in relation to victim vulnerability factors and assessed risk for intimate partner violence (IPV) re-victimization, and b) examine the police response, in terms of risk management, in IPV cases with and without children, respectively. Data from a sample of 1407 women who had reported IPV victimization to the Swedish police was analyzed. The material consisted of risk assessments conducted by the police using the Swedish version of the Brief Spousal Assault Form for the Evaluation of Risk (B-SAFER) checklist, as well as the recommended risk management strategies. A series of chi-square tests of independence revealed that women with and without children, respectively, displayed different vulnerability factors to different extents. Women with children expressed more extreme fear of the perpetrator and were more likely to have an unsafe living situation, whereas women without children displayed more inconsistent attitudes or behaviors and health problems. However, binary logistic regression analyses showed that the victim vulnerability factors that were most strongly associated with an elevated risk rating for IPV re-victimization were generally the same for both groups of victims. Finally, the presence of children was related to a higher risk rating for imminent IPV re-victimization and to recommendations of more than standard levels of risk management strategies. The results indicate that the Swedish police consider the presence of children in relation to a victim’s risk for re-victimization as well as in terms of recommended risk management strategies.

     

Factor Structure and Reliability of the Revised Conflict Tactics Scales for Incarcerated Female Substance Abusers

Incarcerated women with a history of substance abuse often experience intimate partner violence (IPV), both as victims and as perpetrators. The issues surrounding partner violence and substance abuse are complex, and accurate assessment of this population's experience is critical to ensure proper treatment planning and program development. One of the most common instruments with which to measure IPV is the Conflict Tactics Scales (CTS). Unfortunately, very little published data exist on the revised version of the Conflict Tactics Scales (CTS2), and no data could be located in the literature using this scale with incarcerated women. The purpose of this investigation was to examine the underlying factor structure and reliability of the CTS2 for 359 incarcerated women who had voluntarily participated in a 1–year long substance abuse treatment program. Item analysis revealed a high level of reliability for the overall scale as well as for the individual subscales. Additionally, results from the confirmatory multiple group factor analysis support the 5 underlying subscales, and taken together indicate that the scale is acceptable to use with this population.     

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.     

“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.     

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.     

Characteristics of Callers to the Domestic Abuse Helpline for Men

Intimate partner violence (IPV) by women against men has been the subject of much debate. Feminists typically argue that IPV is committed only by men against women. Others argue that violence is a human problem and women also commit much IPV. To resolve these debates, IPV has been classified into two categories: common couple violence captured by population-based studies, and patriarchal terrorism, captured by studies of battered women. This typology ignores male victims of extreme IPV. The current study addresses this omission by describing 190 male callers to the Domestic Abuse Helpline for Men. All callers experienced physical abuse from their female partners, and a substantial minority feared their wives’ violence and were stalked. Over 90% experienced controlling behaviors, and several men reported frustrating experiences with the domestic violence system. Callers’ reports indicated that their female abusers had a history of trauma, alcohol/drug problems, mental illness, and homicidal and suicidal ideations.

Autobiographical Memory Impairment in Female Victims of Intimate Partner Violence

Although the health consequences of intimate partner violence (IPV) have been amply described, as of yet, no study has focused on autobiographical memory (AM), despite the fact that AM dysfunction has been shown to have an impact on everyday life. We assessed AM using a cue-word task in 25 female victims of IPV and 22 control women who had never been exposed to a traumatic event. The IPV group also completed measures of psychotraumatic symptoms. AM was impaired in the IPV victims. When the effect of cue-word valence was analyzed, decreased AM specificity was observed with negative cue-words. This exploratory study demonstrates AM dysfunction among female victims of IPV for the first time. The pattern is consistent with the AM impairment observed in victims of traumatic events.     

Personality Disorder Symptoms in Women as a Result of Chronic Intimate Male Partner Violence

This study explores the personality disorder symptoms of women victims of intimate male partner violence (IPV), after controlling for the contribution of experiences of childhood abuse. Victims of both physical and psychological violence (n = 73) or psychological violence alone (n = 53) were compared with non-abused control women (n = 52). Information about sociodemographic characteristics, childhood abuse, and personality characteristics (MCMI-II) was obtained through face-to-face structured interviews. Women victims of IPV had higher scores than controls in schizoid, avoidant, self-defeating personality scales, as well as in the three pathological personality scales (schizotypal, borderline and paranoid). Both physical and psychological IPV were strongly associated with personality disorder symptomatology, regardless of the effects of childhood abuse. These findings underscore the need to screen for personality disorder symptoms in women victims of IPV when dealing with therapeutic interventions.     

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.     

Severity of intimate partner violence and occurrence and frequency of police calls

This article evaluates whether female victims of severe physical, psychological, or sexual intimate partner violence (IPV) call police more often than other abused women. Abused women (431) reported frequency of contacting police (dependent variable), nature and severity of IPV experienced, and characteristics of themselves and their perpetrator (explanatory variables). A two-part regression model estimated likelihood of police contact among all participants and rate of contact among callers. Women with severe physical or psychological IPV or injury were more likely to call police than were other abused women. Among callers, women made 96% more calls if a weapon was involved, 58% more if they were severely sexually abused, and 40% more if they were severely physically abused. Women with children at home made 32% more calls. These results delineate the level and types of IPV and other characteristics of homes that make single and repeat calls to police.     

“I Didn’t Want To Put Them Through That”: The Influence Of Children on Victim Decision-making in Intimate Partner Violence Cases

For mothers, intimate partner violence (IPV) presents a concern not only for their own well-being but also for that of their children who are exposed to the violence and its aftermath. In focus groups with adult women (N = 39) across three jurisdictions who had experienced legal system intervention for IPV victimization, mothers raised unsolicited concerns about the negative effects of IPV exposure on their children. These comments were not prompted by the facilitator but were raised by women in all seven of the focus groups during discussions about motivations and barriers to participation in prosecution of their abusive partners. The overall message was that victims with children felt very conflicted. Children both facilitate and inhibit leaving the abusive relationship. Mothers wanted to spare their children from harmful effects of violence but also wanted to keep their families together and protect their children from potential agitation and instability caused by legal system involvement. Participants described how fears and threats of involvement from child protective services inhibited help-seeking while simultaneously voicing a desire for services that would help their children. More research is needed to help service providers understand the quagmire mothers who are victims of IPV encounter regarding their children’s wellbeing.     

Differences in female and male victims and perpetrators of partner violence with respect to WEB scores

Measurements of intimate partner violence (IPV) based on acts of violence have repeatedly found substantial bilateral violence between intimates. However, the context of this violence is not well defined by acts alone. The objective of this research was to compare differences in women and men within each IPV status category (victim, perpetrator, and both) with respect to levels of battering as defined by their scores on the Women's Experience With Battering Scale (WEB), which asks gender-neutral questions about the abuse of power and control and fear in an intimate relationship. In our study, women disclosed higher levels of battering on the WEB, despite IPV status (victimization or both victimization and perpetration). In addition, female IPV victims were 5 times more likely than their male counterparts to disclose high rates of battering on the WEB. Depressive symptoms, symptoms of posttraumatic stress disorder, African American race, and IPV victimization were independently associated with higher WEB scores.     

Intimate Partner Violence and Psychological Distress among Young Couples: Analysis of the Moderating Effect of Social Support

Young adults are more likely to experience intimate partner violence (IPV) than older adults. Little is known about the effect of confiding to others about sustained violence on the mental health of victims. The objective of this study was to explore the links between IPV, help-seeking behaviors and psychological distress by gender in a sample of 233 young couples.Our results indicate the frequency of sustained psychological violence, but not physical violence, was positively associated to distress. For women, seeking help from a greater number of confidents moderated the association between violence and psychological distress. For men, results showed that frequencies of physical and psychological violence were both positively linked to distress. However, unlike women, social support had no buffering effect on men’s distress. These findings increase our understanding of the effects of social support on young adults’ distress following episodes of IPV.