The differential effects of intimate terrorism and situational couple violence on mental health outcomes among abused Chinese women: a mixed-method study.

BACKGROUND: Distinctions have been made between the two main forms of intimate partner violence: intimate terrorism (IT) and situational couple violence (SCV), depending on whether the violence is part of a general pattern of control. Differential effects also exist between IT and SCV. However, the IT/SCV distinction and their differential effects have yet to be demonstrated in violent intimate relationships in China. We aimed to identify IT and SCV among Chinese women who reported partner violence in Hong Kong and to differentiate the effects of IT and SCV on their mental health outcomes. METHODS: A mixed-method design was used in a cross-sectional study to collect quantitative and qualitative data from women 18 years of age or older who had been victims of intimate partner violence in the past year. Six hundred and thirteen women were recruited from 18 districts in Hong Kong. Quantitative instruments were administered to assess intimate partner violence, control by an intimate partner, and mental health outcomes. Individual face-to-face interviews were conducted with 200 of the women to capture their experiences of intimate partner violence and the context in which it occurred. RESULTS: Of the 613 women, 215 (35.1%) were identified as victims of IT and 324 (52.9%) as victims of SCV. Compared to SCV victims, IT victims reported significantly more violence-related physical injury (p < 0.001), higher use of medical services (p < 0.001), and more symptoms of depression (p < 0.001) and posttraumatic stress disorder (p < 0.001). The interviews revealed two broadly different pictures with IT victims describing their relationship problems as serious and life-threatening, and physical violence was part of the controlling behaviors used by their partners. Such details were not reported by those in the SCV group. CONCLUSION: Our findings indicate that violence in intimate relationships in China is not a unitary phenomenon, and it has at least two forms, IT and SCV, which were shown to have differential effects on Chinese women. The findings regarding the IT/SCV distinction and their differential effects on mental health outcomes have implications for policy, research and practice. TRIAL REGISTRATION: Trial registration: ClinicalTrials.gov NCT01206192.

Intimate partner sexual aggression against Chinese women: a mixed methods study.

BACKGROUND: Although intimate partner sexual aggression has been shown to be associated with adverse mental health outcomes, there is scant information about sexual aggression in Chinese intimate relationships in general and about its mental health impact in particular. This article aimed to investigate sexual aggression in Chinese intimate relationships, including the use of force or threat of force and non-physical coercive tactics in unwanted sex. METHODS: The quantitative and qualitative data used in this paper were drawn from a prospective cohort study conducted in Hong Kong between September 2010 and September 2012. A total of 745 Chinese women aged 18 or older who had been in an intimate relationship in the preceding 12 months were recruited from sites in all districts of Hong Kong. Multiple logistic regression analysis, ordinary linear regression, and t-tests were used in quantitative analysis. Directed content analysis was used to analyze the transcripts of 59 women who revealed experiences of intimate partner sexual aggression in individual in-depth interviews. RESULTS: Of the 745 Chinese women in the study, 348 (46.7%) had experienced intimate partner physical violence in the past year, and 179 (24%) had experienced intimate partner physical violence and sexual aggression in the past year. Intimate partner sexual aggression significantly predicted PTSD and depressive symptoms after controlling for intimate partner physical violence. Among the 179 women reporting intimate partner physical violence and sexual coercion in the past year, 75 indicated that their partners used force or threat of force to make them have sex, and 104 of them reported that they gave in to sex because of non-physical coercive tactics used by their partners. Qualitative data revealed a variety of non-physical coercive tactics with different degrees of subtlety used to coerce women into unwanted sex with their partners. Chinese women experiencing physically forced sex had significantly more depressive symptoms and PTSD symptoms. CONCLUSIONS: Our findings indicate that sexual aggression in Chinese intimate relationships has specific mental health consequences over and above those associated with physical violence. Assessment of partner violence in Chinese relationships should include screening for sexual aggression in order to provide appropriate interventions. TRIAL REGISTRATION: ClinicalTrials gov NCT01206192.

Evaluating the Chinese Revised Controlling Behaviors Scale.

The present study evaluated the utility of the Chinese version of the Revised Controlling Behaviors Scale (C-CBS-R) as a measure of controlling behaviors in violent Chinese intimate relationships. Using a mixed-methods approach, in-depth, individual interviews were conducted with 200 Chinese women survivors to elicit qualitative data about their personal experiences of control in intimate relationships. The use of controlling behaviors was also assessed using the C-CBS-R. Interview accounts suggested that the experiences of 91 of the women were consistent with the description of coercive control according to Dutton and Goodman's conceptualization of coercion. Using the split-half validation procedure, a receiver operating characteristics (ROC) curve analysis was conducted with the first half of the sample. The area under the curve (AUC) for using the C-CBS-R to identify high control was .99, and the cutoff score of 1.145 maximized both sensitivity and specificity. Applying the cutoff score to the second half gave a sensitivity of 96% and a specificity of 95%. Overall, the C-CBS-R has demonstrated utility as a measure of controlling behaviors with a cutoff score for distinguishing high from low levels of control in violent Chinese intimate relationships.

The role of individual, interpersonal, and organizational factors in mitigating burnout among elderly Chinese volunteers.

OBJECTIVE: This study examined the role of individual, interpersonal, and organizational factors in mitigating burnout among elderly Chinese volunteers in Hong Kong. METHODS: A total of 295 elderly Chinese volunteers were individually interviewed on their demographic characteristics, voluntary service experience, physical health status, general self-efficacy, social support, satisfaction and perceived benefit from volunteer work, and burnout symptoms. Exploratory factor analysis was first performed to determine the underlying dimensions of burnout experience. Correlation analyses were then conducted to explore associations among major variables. Hierarchical regression analyses were also performed to unearth the relative contribution of various factors in predicting burnout among elderly volunteers. RESULTS: A two-factor structure of burnout, namely lack of personal accomplishment and emotional depletion, was found. Demographics, individual, interpersonal, and organizational factors were significant predictors of lack of personal accomplishment. In particular, personal accomplishment was best predicted by a long duration of voluntary work service and high levels of self-efficacy, work satisfaction, and perceived benefit. For emotional depletion, only demographics and individual factors were significant predictors. A low level of emotional depletion was best predicted by older age, a short duration of voluntary work experience, and good health. CONCLUSIONS: Burnout experience was evident among elderly Chinese volunteers. There were different predictors of affective and cognitive components of burnout. Findings have significant implications to attenuate burnout symptoms among elderly volunteers.