In 2002/2003, the Queensland Government released a decision that Alcohol Management Plans (AMPs) were to be introduced to most Indigenous communities in Cape York, Australia, in an effort to address ...violence generally and specifically violence against women and children. By 2008, increased restrictions brought total prohibition in some communities and tightened restrictions in others. This project provides a pre-/postprohibition comparison and analysis of injuries, injuries that involved alcohol and verified police reported assaults. Supporting this are rich community survey data which together aim to elicit the effect restricting alcohol had on violent activity in the communities, particularly for women.
•Prolonged Exposure (PE) was provided to each partner in a couple diagnosed with PTSD.•Both partners did not meet diagnostic criteria for PTSD at the end of treatment.•The couple expressed benefits ...to completing PE at the same time as their partner.•Treating couples with PTSD using PE concurrently may enhance treatment outcomes.
Research on the links between intimate relationships and PTSD and the treatments for PTSD tend to be limited to couples in which only one partner within the dyad has PTSD. No investigations, to our knowledge, have empirically examined the simultaneous provision of evidence-based PTSD treatment to both partners in an intimate relationship diagnosed with PTSD. The current case study describes two partners in a different-sex relationship, both diagnosed with current PTSD, who received individual Prolonged Exposure (PE) therapy at the same time as part of a larger randomized clinical trial. Each partner received ten, 90-minute individual sessions of PE therapy by two separate clinicians trained in PE followed by a 1-month follow-up. The findings demonstrated significant pre- to posttreatment reductions in PTSD symptoms as measured by the Clinician Administered PTSD Scale-5 (CAPS-5) for the male partner (Δ = 18) and the female partner (Δ = 24). Both partners achieved diagnostic remission of PTSD by end of treatment. In addition, both partners expressed enhancements in relationship functioning that they experienced while receiving PE therapy concurrently. Clinical considerations for the provision of concurrent PE to partners in an intimate relationship are discussed. The positive findings from this case study may inform future research in this much-needed area of treatment for couples where both partners are suffering from PTSD.
This study aims to determine the prevalence, and trends over time, of Western Australian (WA) mothers who were victims of intimate partner violence (IPV) requiring hospital admission. The study ...investigated the prevalence of all mothers and the specific prevalence of Aboriginal and non-Aboriginal mothers. A population-based cohort study using de-identified linked health data of mothers of children born from 1990 to 2009 in WA was carried out. The prevalence of hospitalizations for IPV in mothers of children born in the period 1990-2009 (per 1,000 births) was calculated. Results indicate that the overall prevalence of hospital admissions for mothers assaulted 12 months prior to their child’s birth month increased in the period 1990-2009, from 2.7 to 7.7 per 1,000 births. There was also an increase in the overall prevalence of hospital admissions of mothers who were assaulted 12 months prior to the birth month and 36 months after the birth month, from 8.9 per 1,000 births in 1990 to 19.4 per 1,000 births in 2009. In addition, being Aboriginal, having a mother <30 years of age, and being of low SES significantly increased the odds of having a mother with an IPV admission. This study highlights that while there has been an increase in the prevalence of IPV admissions for mothers of children born from 1990 to 2009 in WA, the level of prevalence has remained persistent for the last decade for the whole population. However, non-Aboriginal mothers have seen an increase in prevalence in the last decade. This increase is associated with the introduction of the Z63.0 code in International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM). This study highlights the importance of prioritizing groups for targeted early intervention and prevention as well as the need for culturally appropriate strategies to reduce the burden of interpersonal violence.
This study extends existing world society research on ideational diffusion by going beyond examinations of national policy change to investigate the spread of ideas among nonelite individuals. ...Specifically, I test whether recent trends in women's attitudes about intimate partner violence are converging toward global cultural scripts. Results suggest that global norms regarding violence against women are reaching citizens worldwide, including in some of the least privileged parts of the globe. During the first decade of the 2000s, women in 23 of the 26 countries studied became more likely to reject intimate partner violence. Structural socioeconomic or demographic changes, such as urbanization, rising educational attainment, increasing media access, and cohort replacement, fail to explain the majority of the observed trend. Rather, women of all ages and social locations became less likely to accept justifications for intimate partner violence. The near uniformity of the trend and speed of the change in attitudes about intimate partner violence suggest that global cultural diffusion has played an important role.
Aims
To examine the temporal association between the experience of different types of intimate partner violence (IPV) in early adulthood (21 years) and substance use disorders in young adulthood ...(30 years).
Design
Prospective birth cohort study using data from the Mater‐University of Queensland Study of Pregnancy (MUSP).
Setting
Brisbane, Australia.
Participants
A total of 1353 people (822 females and 531 males).
Measurements
IPV was measured using the Composite Abuse Scale (CAS) and alcohol, substance and nicotine use disorders were assessed using the Composite International Diagnostic Interview (CIDI).
Findings
In females, the experience of different forms of IPV at 21 years remained a robust risk factor for subsequent alcohol use disorder adjusted odds ratios (aORs) ranged from 1.6 to 2.6 (all P < 0.05), substance use disorder aORs ranged from 2.1 to 4.0 (all P < 0.001) and nicotine use disorder aORs ranged from 2.0 to 2.4 (all P < 0.05) at 30 years, even after controlling for antecedent substance disorders. However, in males only physical and emotional abuse (but not harassment) were significant in predicting alcohol use disorder aORs ranged from 1.4 to 1.8 (all P < 0.05) and drug use disorder aORs ranged from 1.6 to 2.0 (all P < 0.05) in the fully adjusted model.
Conclusion
Intimate partner violence (IPV) in early adulthood is robustly associated with alcohol, substance and nicotine use disorders in women, whereas in men the association is clear for only some forms of IPV and types of disorder.
Aims
To determine the interpersonal and structural factors associated with receptive syringe sharing (RSS) among female sex workers who inject drugs (FSW‐IDU), a group at high risk of HIV/hepatitis C ...virus (HCV) acquisition.
Design
Sex workers And Police Promoting Health In Risky Environments (SAPPHIRE) study, a prospective cohort study.
Setting
Baltimore, MD, USA
Participants
One hundred and eighty FSW‐IDU; mean age = 33 years, 77.1% white and 62.9% in a relationship/married.
Measurements
Surveys were conducted between April 2016 and February 2018. The main outcome was recent RSS (past 3 months). In addition to socio‐demographic characteristics and drug use behaviors, we assessed factors at the interpersonal level, including injection practices, intimate partner and client drug use and exposure to violence. Structural‐level factors included methods of syringe access.
Findings
Nearly all FSW‐IDU used heroin (97.1%) or crack cocaine (89.7%). Recent RSS was reported by 18.3%. Syringes were accessed from needle exchange programs (64.6%), pharmacies (29.7%), street sellers (30.3%) or personal networks (29.1%). Some FSW‐IDU had clients or intimate partners who injected drugs (26.3 and 26.9%, respectively). Longitudinal factors independently associated with RSS in the multi‐level mixed‐effects model were recent client violence adjusted odds ratio (aOR) = 2.17, 95% confidence interval (CI) = 1.09–4.33, having an intimate partner who injected drugs (aOR = 2.18, 95% CI = 0.98–4.85), being injected by others (aOR = 4.95, 95% CI = 2.42–10.10) and obtaining syringes from a street seller (aOR = 1.88, 95% CI = 0.94–3.78) or from a member of their personal network (aOR = 4.43, 95% CI = 2.21–8.90).
Conclusions
Client violence, intimate partner injection drug use, being injected by others and obtaining syringes from personal connections appear to increase parenteral HIV/HCV risk among female sex workers who inject drugs.
Background: At least half a million women are victims of intimate partner violence in the United States annually, resulting in substantial harm. However, the etiology of violence to intimate partners ...is not well understood. Witnessing such violence in childhood has been proposed as a principal cause of adulthood perpetration, yet it remains unknown whether the association between witnessing intimate partner violence and adulthood perpetration is causal. Method: We conducted a propensity-score analysis of intimate partner violence perpetration to determine whether childhood witnessing is associated with perpetration in adulthood, independent of a wide range of potential confounding variables, and therefore might be a causal factor. We used data from 14,564 U.S. men ages 20 and older from the 2004-2005 wave of the National Epidemiologic Survey on Alcohol and Related Conditions. Results: Nearly 4% of men reported violent behavior toward an intimate partner in the past year. In unadjusted models, we found a strong association between childhood witnessing of intimate partner violence and adulthood perpetration (for witnessing any intimate partner violence, risk ratio RR = 2.6 95% confidence interval = 2.1-3.2; for witnessing frequent or serious violence, 3.0 2.3-3.9). In propensity-score models, the association was substantially attenuated (for witnessing any intimate partner violence, adjusted RR = 1.6 1.2-2.0; for witnessing frequent or serious violence, 1.6 1.2-2.3). Conclusions: Men who witness intimate partner violence in childhood are more likely to commit such acts in adulthood, compared with men who are otherwise similar with respect to a large range of potential confounders. Etiological models of intimate partner violence perpetration should consider a constellation of childhood factors.
intimate partner violence is a significant global health problem but remains largely hidden. Understanding decisions about whether or not to disclose violence in response to routine enquiry in health ...settings can inform safe and responsive systems. Elevated rates of violence and systematic disadvantage found among Indigenous women globally, can impact on their decisions to disclose violence. This study aimed to test, among Indigenous women, a model for decisions on whether to disclose intimate partner violence in the context of antenatal routine screening.
we employed Qualitative Configurative Analysis, a method developed for the social sciences to study complex phenomena with intermediate sample sizes. Data were drawn from single semi- structured interviews with Indigenous women 28+ weeks pregnant attending antenatal care. Interviews addressed decisions to disclose recent intimate partner violence in the context of routine enquiry during the antenatal care. Interview transcripts were binary coded for conditions identified a priori from the model being tested and also from themes identified within the current study and analysed using Qualitative Configurative Analysis to determine causal conditions for the outcome of disclosure or non-disclosure of violence experienced.
five Aboriginal and Maternal Infant Health Services (two urban and three regional), and one mainstream hospital, in New South Wales, Australia.
indigenous women who had experienced partner violence in the previous year and who had been asked about this as part of an antenatal booking-in visit. Of the 12 participants six had elected to disclose their experience of violence to the midwife, and six had chosen not to do so.
pathways to disclosure and non-disclosure were mapped using Qualitative Configurative Analysis. Conditions relevant to decisions to disclose were similar to the conditions for non-Aboriginal women found in our earlier study. Unique to Aboriginal women's decisions to disclose abuse was cultural safety. Cultural safety included elements we titled: Borrowed trust, Build the relationship first, Come at it slowly and People like me are here. The absence of cultural safety Its absence was also a factor in decisions not to disclose experiences of violence by this group of women.
cultural safety was central to Indigenous women's decision to disclose violence and processes for creating safety are identified. Other forms of safety which influenced disclosure included: safety from detection by the abuser; safety from shame; and safety from institutional control. Disclosure was promoted by direct asking by the midwife and a perception of care. Non-disclosure was associated with a lack of care and a lack of all four types of safety. Experiences of institutional racism were associated with Indigenous women's perceived risk of control by others, particularly child protection services.
policies to ask abuse questions at first visits and models where continuity of care is not maintained, are problematic for Aboriginal women, among whom relationship building is important as is ample warning about questions to be asked. Strategies are needed to build cultural safety to counter widespread racism and promote safe opportunities for Indigenous women to disclose intimate partner violence and receive support. Elements of cultural safety are necessary for vulnerable or marginalised populations to fully utilise available health services.
•Globally Indigenous women experience higher levels of intimate partner violence.•Disclosure of partner abuse was mapped using Qualitative Configurative Analysis.•Cultural safety was critical to Aboriginal women’s decisions to disclose their abuse.•Fears of child protection intervention disrupts Aboriginal women's engagement with antenatal care.•Experiences of institutional racism when using mainstream services were common for Aboriginal women in this study.
Despite the growing population of immigrant women in the United States and their greater vulnerability to intimate partner violence (IPV), there are no culturally competent instruments to assess the ...risk of homicide and future violence among abused immigrant women. The current study modifies the Danger Assessment (DA), a risk assessment instrument aimed at identifying victims of IPV who are at risk for lethal violence by an intimate or exintimate partner, for use with immigrant women. A secondary analysis was conducted with 148 immigrant women who participated in a longitudinal risk assessment study. The 20 original DA items and an additional 12 risk items were tested using relative risk ratios for their association with any or severe IPV at a follow-up interview. Predictive validity was tested with the receiver operating characteristic curve. Results indicate support for a revised Danger Assessment for Immigrant Women (DA-1) consisting of 26 items. The DA-I predicts any and severe IPV at a nine-month follow-up significantly better than the original DA and women's predictions of risk. The DA-I is a culturally competent risk assessment that can be used to assess the risk of reassault and severe IPV to assist immigrant women with safety planning.
The authors examined the relations among intimate partner violence (IPV), maternal depressive symptoms, and maternal harsh intrusive parenting. Using a cross-lagged, autoregressive path model, they ...sought to clarify the directionality of the relations among these 3 variables over the first 2 years of the child ' s life. The results indicated that, in this diverse sample of families living in predominantly low-income rural communities (N = 705), higher levels of early IPV were associated with increases in maternal depressive symptoms, which in turn were associated with increases in maternal harsh intrusive parenting behaviors. These findings suggest that interventions aimed at improving the parenting of women exposed to domestic violence may want to simultaneously target IPV and depressive symptomatology.
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