Detecting ongoing intimate partner violence in the emergency department using a simple 4-question screen: the OVAT

We wanted to prospectively evaluate the use of a brief screening tool for ongoing intimate partner violence (IPV), the OVAT, and to validate this tool against the present Index of Spouse Abuse (ISA). The design was a prospective survey during randomized 4-hour shifts in an urban emergency department setting. The scale consists of four questions developed based on our previous work. The ISA was compared as the gold standard for detection of present (ongoing) IPV. Of 362 eligible patients presenting during 75 randomized 4-hour shifts, 306 (85%) completed the study. The prevalence of ongoing IPV using the OVAT was 31% (95% CI 26% to 36%). For the ISA, the prevalence was 20% (95% CI 16% to 25%). Compared with the ISA, the sensitivity of the OVAT in detecting ongoing IPV was 86%, specificity 83%, negative predictive value 96%, positive predictive value 56%, with an accuracy of 84%. In conclusion, four brief questions can detect ongoing IPV to aid in identifying the victim.     

Comparing violence over the life span in samples of same-sex and opposite-sex cohabitants

Using data from a nationally representative telephone survey that was conducted from November 1995 to May 1996, this study compares lifetime experiences with violent victimization among men and women with a history of same-sex cohabitation and their counterparts with a history of marriage and/or opposite-sex cohabitation only. The study found that respondents who had lived with a same-sex intimate partner were significantly more likely than respondents who had married or lived with an opposite-sex partner only to have been: (a) raped as minors and adults; (b) physically assaulted as children by adult caretakers; and (c) physically assaulted as adults by all types of perpetrators, including intimate partners. The study also confirms previous reports that intimate partner violence is more prevalent among gay male couples than heterosexual couples. However, it contradicts reports that intimate partner violence is more prevalent among lesbian couples than heterosexual couples. Overall study findings suggest that intimate partner violence is perpetrated primarily by men, whether against same-sex or opposite-sex partners.     

Perceptions of Intimate Partner Violence,Age, and Self-Enhancement Bias

Educational programs in human service professions such as social work, criminal justice, psychology, and public administration stress the importance of recognizing domestic/intimate partner violence as well as elder abuse. Students' abilities to recognize domestic violence in older couples have not been well-investigated. In this study, three vignettes were developed (Pat and Lee at age 75, Pat and Lee at age 30, Imagine yourself with Lee at age 75) in which intimate partner violence was perpetrated by the character Lee. Twenty-five items followed each vignette. When the variables of educational standing (graduate/undergraduate), ethnicity, and academic major were controlled, there were significant differences between the vignettes in 14 of 25 items (General Linear Model, F = 1.552, df = 50, p = .012). More than three out of four respondents for each vignette identified this as domestic violence and believed there was potential for serious harm. However, respondents were less likely to believe that a 75-year-old partner would know when to terminate a relationship in which there was intimate partner violence. Respondents who were asked to imagine themselves with Lee at 75 were likely to perceive Lee as more dangerous than respondents for the other vignettes. Implications are considered for educators.     

Perceptions of intimate partner violence, age, and self-enhancement bias

Educational programs in human service professions such as social work, criminal justice, psychology, and public administration stress the importance of recognizing domestic/intimate partner violence as well as elder abuse. Students' abilities to recognize domestic violence in older couples have not been well-investigated. In this study, three vignettes were developed (Pat and Lee at age 75, Pat and Lee at age 30, Imagine yourself with Lee at age 75) in which intimate partner violence was perpetrated by the character Lee. Twenty-five items followed each vignette. When the variables of educational standing (graduate/undergraduate), ethnicity, and academic major were controlled, there were significant differences between the vignettes in 14 of 25 items (General Linear Model, F = 1.552, df = 50, p = .012). More than three out of four respondents for each vignette identified this as domestic violence and believed there was potential for serious harm. However, respondents were less likely to believe that a 75-year-old partner would know when to terminate a relationship in which there was intimate partner violence. Respondents who were asked to imagine themselves with Lee at 75 were likely to perceive Lee as more dangerous than respondents for the other vignettes. Implications are considered for educators.     

The Impacts of Education,Adverse Childhood Experience,and Nativity on Intimate Partner Violence

This paper tested an implication of household bargaining theory, that women with higher human capital experience less intimate partner violence. Relying on a single source of income imposes a barrier to leaving an abusive relationship. Women with higher human capital are better equipped to leave a relationship, which allows them to tolerate less violence in a relationship. Using a California health survey dataset, we found that more educated women were less likely to experience spousal violence. We used the detailed nature of the data to control for commonly omitted variables such as adverse childhood experiences. In addition, we found that the effect of education on intimate partner violence varied by nativity (US-born vs. foreign-born) and was smaller for foreign-born women. Drawing from the literature on the returns to education by race, we hypothesized that foreign-born women have a lower return on human capital, which in turn moderated the effect of education on household bargaining power.     

Intimate partner physical assault before and during pregnancy: how does it relate to women's psychological vulnerability?

Most studies of intimate partner violence tend to be behaviorally focused, with scant attention paid to women's perception of vulnerability in their relationships. Since past research has linked such feelings and cognitions to women's health problems, it is important to examine multiple aspects of relationships when studying partner violence. Therefore, this study examines women's perceptions of vulnerability as they relate to their experiences of physical assault by their partner before and during pregnancy. A sample of 86 prenatal care patients were interviewed. The women reported their experiences of partner physical assault using the Conflict Tactics Scale 2, and they reported their perceptions concerning their relationships using the Women's Experiences with Battering Scale. Bivariate and multivariate analyses found that experiencing intimate partner physical assault was highly predictive of women's perceptions of vulnerability and loss of control in their relationships, with women who have been in physically violent relationships for longer periods of time being the most likely to express such feelings. Given that previous research has found such perceptions tied to negative health outcomes, clinicians are urged to evaluate their female patients' feelings of vulnerability as well as their experiences of intimate partner physical assault.     

Patterns of intimate partner violence in young adult couples: nonviolent, unilaterally violent, and mutually violent couples

This study examined nonviolent (NV), unilaterally violent (UV), and mutually violent (MV) patterns of perpetrated intimate partner violence in relation to dyadic relationship quality and partner injury. The respondents were 1,294 young adult, Add Health partners (AHP) and their non-Add Health partners (NAHP), in dating, engaged, or in marital relationships, who were participants in Wave III of the National Longitudinal Study of Adolescent Health (Add Health). Using both partner reports of perpetration to classify intimate partner violence (IPV) patterns resulted in 25% of couples with a MV pattern, and 75% of couples with a UV pattern; among those couples (41%) reporting any perpetrated IPV. Results also showed poorer relationship quality and higher partner sensation-seeking scores among MV and UV couples when contrasted with NV couples. Those couples with MV patterns were more likely to contain partner injury than those with UV patterns.     

Services and Intimate Partner Violence in the United States: A County‐Level Analysis

Despite the prevalence of intimate partner violence and its social costs, we show that many counties lack services to help victims and that community resources play a significant role in determining the likelihood of service provision. Because resources are often generated at the local level and state and federal funding usually require a grant proposal, services for victims of intimate partner violence are more likely to be available in well‐resourced areas with a major college or university in the county. Analysis of the changes in the provision of services since the Violence Against Women Act was introduced suggests that funding needs to be specifically targeted to underserved areas.     

Straighten Up and Act Like a Lady: A Qualitative Study of Lesbian Survivors of Intimate Partner Violence

Although scholars have been studying domestic violence for decades now, it is only recently that domestic violence occurring in non-heterosexual relationships has received noteworthy attention. Several researchers have called for further study of lesbian intimate partner violence (IPV) and the experiences of lesbian survivors. This exploratory study was designed to uncover the experiences of lesbian survivors in regards to their background of violence, perception of lesbian community attitudes, and experience with seeking help. Using modified grounded theory, I was able to expose several recurring themes in the data, including the following: history of violence; gendered belief of violence; the reality of lesbian intimate partner violence; help seeking and the silence surrounding lesbian intimate partner violence in the lesbian community; and the roles of homophobia and heterosexism in lesbian intimate partner violence. Survivors repeatedly reported feeling silenced, isolated, and helpless due to the lack of acknowledgment of and support for lesbian survivors of intimate partner violence in their communities. The purpose of this study is to explore the experiences of women who have endured violence at the hands of their same-sex intimate partners.     

Intimate partner violence and child abuse: a child‐centred perspective

A substantial body of literature assessing the impact of intimate partner violence on children and associations between intimate partner violence and child abuse now exists. Central to knowledge about these areas of practice and research is a robust, child‐centred consideration of some of the more challenging conceptual issues they give rise to. In this paper, we aim to stimulate debate by presenting a critical, child‐centred perspective on the intersection between intimate partner violence and child abuse. Initially, we provide the context for the review by presenting a brief overview of the literature. We then consider three central issues from a child‐centred perspective. We discuss the language used to describe children forced to live with intimate partner violence, and the importance of hearing children's perspectives on their experiences of such conflict. Finally, we consider similarities and differences between the intimate partner violence and child abuse fields from a child‐centred viewpoint. We conclude that increasing conceptual clarity around these issues will enhance research in the field, and ultimately improve interventions designed to protect children forced to live with intimate partner violence. Copyright © 2009 John Wiley & Sons, Ltd.     

Is Partner Violence Worse in the Context of Control?

M. P. Johnson’s (1995) proposal that there are two qualitatively distinct types of intimate partner violence—intimate terrorism and situational couple violence—has been an influential explanation for disparate findings on sex symmetry in domestic violence. This study examines whether this typology increases our ability to explain variations in the negative outcomes of partner violence as compared with the use of a continuous measure of violence. This study also considers whether the use of control to differentiate between types of violence helps to explain the negative consequences of partner violence. The results, based on analyses of data on 4,575 married women from National Violence Against Women survey, indicate mixed support for Johnson’s argument for a qualitative distinction between IT and SCV.     

Utility of Hospital Emergency Department Data for Studying Intimate Partner Violence

The authors examine 12 months of emergency department visit data (N= 2,521) from the National Electronic Injury Surveillance System All Injury Program and explore its utility for measuring and studying intimate partner violence. Given the dearth of national data on intimate partner violence–related injury and its potential value for public health surveillance and prevention, the data set appears promising for estimating national rates of emergency department visits. Missing perpetrator‐patient relationship data limit estimation of intimate partner–related hospital visits for injury and pain, which precludes national rate estimation at this time, but the data are still useful for describing documented intimate partner violence cases and may be helpful in designing prevention strategies.     

Gender differences in the relationship between intimate partner violence victimization and the perception of dating situations among college students

Although the prevalence and severity of dating violence among college students is well known, the relationship between past victimization and perceptions of future dating situations has not been examined. Using both qualitative and quantitative research methods, this study investigated gender differences in the relationship between intimate partner violence victimization and the perceptions of dating situations. The study found that the more psychological, physical, or sexual violence that was experienced by females, the more likely they perceived dating situations as inappropriate. Males, on the other hand, were more likely to report aggressive behaviors in dating situations only if victimized by sexual violence. Implications for professionals working with college students or community prevention programs are discussed.     

Assessment of Intimate Partner Violence by Child Welfare Services

The purpose of this study was to describe policy and practice with respect to the assessment of intimate partner violence in a sample of child welfare agencies located throughout the United States and to examine the relationship of contextual characteristics and assessment practices. Telephone interviews were conducted with key informants from child welfare agencies. A snowball interviewing strategy was used to identify the best informant in each agency. Almost all of the participating agencies conducted some assessment of intimate partner violence, with most reporting that the majority of screening or assessment occurred during investigation of referrals. However, only 43.1% reported that all of the families referred to the child welfare system were assessed for intimate partner violence, and 52.8% indicated they had a written policy pertaining to screening and assessment of the problem. There was little relationship between county or agency characteristics and assessment practices. Additional research is needed to determine factors that influence assessment practices and to identify strategies to support and extend efforts to identify intimate partner violence and provide appropriate services for families in the child welfare system.     

A review of research on women's use of violence with male intimate partners

This article provides a review of research literature on women who use violence with intimate partners. The central purpose is to inform service providers in the military and civilian communities who work with domestically violent women. The major points of this review are as follows: (a) women's violence usually occurs in the context of violence against them by their male partners; (b) in general, women and men perpetrate equivalent levels of physical and psychological aggression, but evidence suggests that men perpetrate sexual abuse, coercive control, and stalking more frequently than women and that women also are much more frequently injured during domestic violence incidents; (c) women and men are equally likely to initiate physical violence in relationships involving less serious "situational couple violence," and in relationships in which serious and very violent "intimate terrorism" occurs, men are much more likely to be perpetrators and women victims; (d) women's physical violence is more likely than men's violence to be motivated by self-defense and fear, whereas men's physical violence is more likely than women's to be driven by control motives; (e) studies of couples in mutually violent relationships find more negative effects for women than for men; and (f) because of the many differences in behaviors and motivations between women's and men's violence, interventions based on male models of partner violence are likely not effective for many women.     

Attitudinal acceptance of intimate partner violence among U.S. adults

Attitudinal acceptance of intimate partner violence (IPV) is an important correlate of violent behavior. This study examined acceptance of IPV using data collected from a nationally representative telephone survey of 5,238 adults. Multivariable logistic regression analyses were used to test for associations between sociodemographic characteristics, exposure to violence, question order, and acceptance of hitting a spouse or boyfriend/girlfriend under specific circumstances. Depending on the circumstance examined, acceptance of IPV was significantly higher among participants who were male and younger than 35; were non-White; were divorced, separated, or had never married; had not completed high school; had a low household income; or were victims of violence within the past 12 months. Participants were more accepting of women hitting men; they also were consistently more likely to report tolerance of IPV if they were asked first about women hitting men rather than men hitting women. Reports of IPV tolerance need to be interpreted within the context of the survey. Efforts to change IPV attitudes can be tailored to specific IPV circumstances and subgroups, and these efforts should emphasize that the use of physical violence is unacceptable to both genders.     

Intimate partner violence: the effect of gender and contextual factors on community perceptions of harm, and suggested victim and criminal justice responses

Using a vignette to depict physical violence by an intimate partner, a 2 (perpetrator gender) X 2 (participant gender) X 2 (frequency) X 2 (intent to cause harm) between subjects factorial design was used to examine under what circumstances individuals perceive: an incident should be illegal, the extent of harm, and appropriate victim and criminal justice responses. There were 868 participants from the Brisbane (Australia) community (48.5% males). The actions of male perpetrators were viewed more seriously and the victims were recommended to seek more forms of assistance when the perpetrator was male. There were few differences in perceptions of violence according to participant gender. The frequency of the violence affected the participant's responses but the intentions of the perpetrator did not. Results are discussed in terms of stereotypes of intimate partner violence (IPV) and the implications for help-seeking behavior by victims.     

Validation of a Measure of Intimate Partner Abuse With Couples Participating in Divorce Mediation

Critics of court mandated divorce mediation have raised awareness of the need for screening measures to assess intimate partner abuse. This study validates a new instrument that is a revised version of the Partner Abuse Scales developed by Walter Hudson in the 1990s. The Relationship Behavior Rating Scale (RBRS) correlates highly with the original scales and subscales developed from the original and RBRS items have equally high reliability. The new scale is a reliable measure for intimate partner abuse in divorce mediation.     

Intimate Partner Violence: Modifying an Internet-Based Safety Decision Aid to a New Zealand Context

Women experiencing intimate partner violence face complex decisions in navigating their safety. In a feasibility study, we examined the suitability of an intimate partner violence interactive online decision aid developed in the United States for its application in New Zealand, particularly with regard to cultural appropriateness. We conducted focus group sessions with women who experienced partner violence and focus group sessions with service providers. Women completed the U.S. online decision aid tool and provided feedback on the safety decision criteria, content, and design. Considering the findings from the focus group sessions the decision aid was modified. We reflect on the process of balancing women's stories with technical limitations and constraints of a replication study.     

Multiple approaches to understanding and preventing elder abuse: Introduction to the cross-disciplinary National Institutes of Health workshop

ABSTRACT

On October 30, 2015, the National Institutes of Health (NIH) convened a workshop, “Multiple Approaches to Understanding and Preventing Elder Abuse,” in Bethesda, Maryland. The workshop brought together experts from across disciplines to discuss research challenges, opportunities, and lessons learned from other fields. Participants included experts in elder abuse, child abuse, intimate partner violence (IPV), emergency medicine, and neuroscience. In this special issue of the Journal of Elder Abuse and Neglect, participants address topics explored before, during, and after the day-long workshop.