Association Between Domestic Violence and Mental Health Among Nepalese Women: Results from a Nationally Representative Sample.

This study aims to examine the association between exposure to domestic violence and mental health outcomes, such as symptoms of depression and anxiety among married women in Nepal. The 2022 Nepal Demographic and Health Survey was used. Descriptive, bivariate, and multivariate logistic regression analyses were employed. A complex sampling frame was used to ensure the accuracy of the sample. A total of 4,211 women aged 14 to 49 years were analyzed. Among women between the ages of 15 and 49, 22.8% experience anxiety, and 22.5% experience depressive symptoms. Nearly 50% of women who had experienced domestic violence had symptoms of anxiety and depression. At the multivariate level, in Model 1, the study found that wealthy women were less likely to have anxiety (OR = 0.75; 95% CI [0.58, 0.96] and depression (OR = 0.70; 95% CI [0.54, 0.91]) than poor women. Similarly, women of the former untouchable caste were more likely to have anxiety (OR = 1.51; 95% CI [1.14, 2.00]) and depression (OR = 1.20; 95% CI [0.91, 1.58]) than high-caste women. In Model 2, the odds of anxiety and depressive symptoms were 1.70 (95% CI [1.29, 2.24]) and 1.99 (95% CI [1.48, 2.67]), respectively, for those women who had experienced severe physical violence. The odds of experiencing anxiety and depression were 2.88 (95% CI [2.28, 3.64]) and 3.04 (95% CI [2.32, 3.98]) times, respectively, for those women who had experienced emotional abuse. Similarly, women who had been sexually assaulted had 2.34 (95% CI [1.72, 3.20]) and 1.67 times (95% CI [1.23, 2.26]) more likely to experience anxiety and depression than women who had never been sexually assaulted. We found a strong association between mental health problems and women's experience of domestic violence. To address the mental health of Nepalese women, it is critical to strengthen domestic violence prevention programs, especially those targeting the lowest social strata of the population.

The Role of Identity and Gender Beliefs in Self-Identification of Abuse for Male Victims of IPV.

Men experience numerous barriers in seeking help or resources after intimate partner violence (IPV) victimization, with one barrier being a reluctance or lack of ability to identify that they have been victims of IPV. This study examines factors relating to male victims of IPV self-identification of abuse. Using a gender socialization approach, demographics and facets of masculine honor ideology were tested to see whether they were significantly related to self-identifying as experiencing abuse in their relationship. Using a sample of 289 men, the frequency of individuals who self-identified as someone who had been in an abusive relationship was compared to the number of individuals who indicated IPV victimization on the Revised Conflict Tactics Scale (CTS2), and percentages of correct identification were calculated. In addition, a binary logistic regression was run to examine factors that were related to someone identifying as a victim of IPV compared to those that were not. When directly asked if they had ever experienced abuse in a romantic relationship, a total of 41 (14.2%) men self-identified as having been a victim of IPV. However, when examining scores on the CTS2, 69 (23.9%) reported some sexual IPV, 201 (69.6%) indicated psychological abuse, and 59 (20.4%) indicated physical abuse. Subscales of the Masculine Honor Belief Scale were not found to have a significant relationship with self-identification, but differences were found among types of IPV and demographics. Specifically, men who identify as LGBTQ+ were significantly more likely to identify when they experienced IPV victimization. Barriers to male self-identification and treatment are discussed.

Examination of parents' sensitivity levels to violence against children during the COVID-19: A post-pandemic evaluation.

PURPOSE: This study aimed to evaluate parents' thoughts, and sensitivity levels about violence against children during the COVID-19 period after the pandemic. DESIGN AND METHODS: The population of this descriptive, cross-sectional, correlational, and multicenter study consisted of parents registered in six family health centers in a city in southern Turkey. Study data were collected between April and November 2023 using information forms that included questions about parents' personal information, and their thoughts about violence against children during the pandemic and the Sensitivity to Violence Against Children Scale and analyzed. RESULTS: According to 42.3% of parents, children's exposure to violence increased during the pandemic; 64.7% stated that children experienced emotional violence the most. Parents who thought that there was a decrease in the reports of violence due to school closures, social distancing, and restriction of children's access to health, and social and legal services had higher SVACS mean scores than those who did not think so (p < 0.01). CONCLUSIONS: Most of the parents thought that children's exposure to violence increased and reports of violence decreased during the pandemic. In addition, parents' thoughts toward violence against children during the pandemic period were associated with their level of sensitivity to violence against children. IMPLICATIONS FOR PRACTICE: During the pandemic period, it is important that pediatric nurses, who are in direct contact with children, are in contact with parents and take an active role in the process in the prevention, early detection and reporting of violence against children.

COVID-Related Financial Issues Experienced by Women-Identifying Survivors of Intimate Partner Violence.

The COVID-19 pandemic has had significant impacts on the economic well-being of women, particularly those experiencing intimate partner violence (IPV). While some scholars have included common economic risk factors in their studies on COVID-related IPV experiences, fewer have looked specifically at the nature of the financial issues experienced. As such, the purpose of this study was to better understand the types of financial issues that survivors experienced because of the COVID-19 pandemic and their association with different forms of IPV. In July 2022, a sample of 571 women-identifying IPV survivors living in the United States participated in an online survey via Qualtrics panel service. The mean age of participants was 42, and 69% identified as White, non-Hispanic. On average, participants experienced approximately three COVID-related financial issues. After controlling for sociodemographic characteristics, economic abuse and economic abuse-related financial debt were both significantly associated with COVID-related financial issues. Study findings have important implications for economically supporting IPV survivors through research, policy, and practice.

A Brief Online Motivational Tool to Promote Early Help-Seeking in Men Using Abuse and Violence in Relationships: A Feasibility Trial.

Men's use of domestic violence is a major public health issue globally. However, the potential for technology to address this issue has been limited within research and practice. This study aimed to test the feasibility and acceptability of an online healthy relationship tool (BETTER MAN) for men who have used domestic violence to encourage help-seeking. A pre- and postsurvey with a 3-month follow-up was used. One hundred and forty men enrolled, with retention rates of 79% (111) immediately after BETTER MAN and 62% (86) at 3 months. Participants were diverse men (mean age of 32 years, 33% born outside Australia, 19% in same-sex relationships, and 2% Aboriginal or Torres Strait Islander). The majority (70%, 58) of men reported behaviors classified as moderate risk (e.g., checked partner's phone, picked on partner, and controlled money) and 24% (20) as high-risk behaviors (e.g., scared partner, physical force, and unwanted sexual activities). Post BETTER MAN, there was a significant increase in mean intention to contact counseling service (baseline 5.8, immediately 6.7, and 3-month follow-up 7.2) and mean confidence in the ability to seek help (baseline 3.7, immediately 5.1, and 3-month follow-up 7.2). Men's readiness to make changes in behavior median score significantly moved from baseline (5.9-I am not ready to take action), immediately (6.7-I am ready to make some changes), and 3-month follow-up (7.2-I have begun to change my behavior). At 3-month follow-up, 55% (47/86) of men reported accessing counseling services compared with 34% (46/140) of men at baseline. Findings suggest that it is feasible that BETTER MAN might work to engage men to seek help and is acceptable to men using domestic violence. However, a large-scale randomized controlled trial is needed to determine the effectiveness of BETTER MAN on help-seeking behaviors for men's use of domestic violence.

The Sounds of Silence: Making Sense of the Absence of Domestic Violence Victims Help Seeking During the COVID-19 Pandemic.

Increased concern was raised globally at the outbreak of COVID-19 that victims of domestic violence would be even more at risk when isolated with a violent partner and out of reach of support due to restrictions. Swedish staff in violence against women services prepared for increased calls for help. Instead, a worrying silence arose in a time and place of high uncertainty. This article analyzes the narratology of risk, when staff members in violence against women services, reflect upon their accounts, responses, and experiences, during the pandemic. The analysis is based on three themes, accounting for expected increased influx, making sense of silence and accounting for mobilization. The findings are discussed by applying the relational theory of risk.

Validation of Scales for Researching Stakeholders' Attitudes Toward Domestic Violence in China.

Domestic violence (DV) is a significant concern within China. Currently, there are few standardized measurement tools to gauge Chinese stakeholders' perceptions and beliefs concerning DV. This research sought to validate tools to be used with such stakeholders. Factor analyses were utilized on cross-sectional, survey data from a purposive sample of 683 Chinese DV professionals working in four institutions in Guangdong. Analyses developed three scales for measuring DV Definitions, DV Attitudes, and DV Policing. The development of these scales is beneficial to advance the already growing research related to DV in China in ways that are relevant to the Chinese context.

Insufficient criminal justice system response to the severity of domestic violence during the pandemic in Indonesia.

Domestic violence increased dramatically in Indonesia during the COVID-19 pandemic compared to the previous pandemic. This article analyses how Indonesia's criminal justice system responded to domestic violence during the pandemic. This article used secondary data gathered from various online resources and legal publications. This article demonstrated that during the pandemic, victims of domestic violence in Indonesia were unable to access justice due to two significant barriers. Before filing a formal complaint with the appropriate official, victims would prefer to discuss the matter with their relatives. Furthermore, the victims could not report their cases to the responsible official due to mobility constraints. This case demonstrates that in patriarchal societies, the criminal justice system could not handle domestic violence cases more effectively. As a result, the technical operation of the criminal justice system necessitates the development of a novel method of case filing. This article proposes that the Indonesian criminal justice system establish a complaint system based on social media to provide victims of domestic violence with prompt justice. Furthermore, the legal advocacy role of the community in assisting domestic violence victims is critical.

Evaluating the Functional Impairment of Assault Victims in a Judicial Context: A Multicentered Retrospective Study in Seven French Forensics Units.

Functional impairment is of major importance in the evaluation of assault victims. French law assesses the seriousness of the violence in terms of the functional impairment experienced by the victims, quantified by the duration of the victims' inability to fulfill their usual daily activities, measured in days of "total incapacity to work" (TIW). Significant variations in the duration of TIW have been reported depending on the examination centers or physician. To date, few studies, all monocentric, have focused on the determinants of this variability. We aimed to study the functional impairment of assault victims by searching for determinants of TIW. We conducted a retrospective multicenter study, including assault victims from seven forensic medicine units. The data were automatically extracted from the medical certificates drawn up and gathered within the ORFéAD database. Thirty-eight variables were studied, relating to the victim's characteristics, the circumstances of the examination and the assault, the physical and psychological symptoms, and the duration of TIW. A total of 5,663 victims were included, including 2,438 (43%) women. The median age was 32 years (min; max [10; 98]). The median duration of TIW was 2 days (min; max [0; 182]). Male gender, age, time to examination, examination center, traumatic injuries (ecchymosis, hematoma, wound, bone fracture), use of a weapon, and functional limitation were associated with the duration of TIW (p < .05). The associations formerly identified in a monocentric setting were confirmed and new determinants were identified. This study has allowed a better understanding of the factors influencing the evaluation of functional impairment and determination of the TIW of assault victims. This first study using ORféAD is intended to be supplemented by the participation of other forensic units, and the inclusion of other variables, such as violence type, victim categories, or the examining physician.

The effect of a digital intervention on symptoms of depression in pregnant women exposed to Intimate partner violence in Denmark and Spain (STOP study).

INTRODUCTION AND OBJECTIVE: Intimate Partner Violence (IPV) during pregnancy is a significant public health concern associated with adverse maternal and fetal health outcomes, including increased risk of depression. This study aimed to assess the effectiveness of a digital empowerment-based intervention in reducing symptoms of depression among IPV-exposed pregnant women. STUDY DESIGN: This intervention study was nested within a cohort study conducted in Denmark and Spain. Pregnant women attending antenatal care were digital screened for IPV using the Abuse Assessment Screen (AAS) and the Women's Abuse Screening Tool (WAST). Those screening positive were offered a digital intervention comprising 3-6 video consultations with trained IPV counsellors and access to a safety planning app. Changes in depression scores from baseline to follow-up were evaluated using mixed model regression. RESULTS: From February 2021-October 2022, 1,545 pregnant women (9.6 %) screened positive for IPV within our population (8.5 % in Denmark and 17.0 % in Spain) with 485 (31.4 %) meeting the criteria for the intervention. Of those eligible, 104 (21.4 %) accepted the intervention, and 55 completed it (13.1 %). Post-intervention, a significant reduction in Edinburgh Postnatal Depression Scale (EPDS) was found, with a mean difference of -3.9 (95 % CI: -5.3; -2.4), compared to the average pre-intervention score of 11.3. Stratifying the analyses across sociodemographic variables did not alter the overall result, indicating a reduction in EPDS scores irrespective of setting or sociodemographic factors. Notably, the intervention was most effective for women initially presenting with EPDS scores above the depression cut-off. CONCLUSION: The findings suggest that a brief digital intervention is associated with a reduction in depression symptoms among pregnant women exposed to IPV, particularly among those with high depressive scores. This highlights the potential of digital interventions in delivering counseling and shows efficacy when administered by both midwives and psychologists in diverse settings. However, the absence of a control group underscores the need for caution in interpreting the results.

The Role of Alcohol in Initial Help-Seeking Telephone Calls About Domestic Violence to the Police.

This article investigates how domestic violence and abuse (DVA), its underreporting and its links with alcohol consumption, manifest in and impact the outcome of help-seeking telephone calls to U.K.-based police services. Conversation analysis of call-takers' questions about alcohol found that they either (a) focused only on the perpetrator's drinking, and occurred after informing callers that help was being dispatched, or (b) targeted both victims' and perpetrators' drinking and complicated the decisions to dispatch police assistance. The article helps specify the communicative practices that may constitute victims' negative experiences of disclosing DVA to the police.

Health and social care staff's recognition of elder abuse perpetrated by family members of persons with dementia: a mixed-method study.

BACKGROUND: Health and social care staff play a significant role in detecting and reporting abuse among persons with dementia. However, they are often left to their own judgements which can lead to elder abuse not being detected or acted on. The aim was to explore what healthcare and social care staff consider elder abuse, and their experience of elder abuse perpetrated by family members of persons with dementia. METHODS: This mixed-method vignette study was conducted in Sweden during the year 2021. In total 39 staff working in dementia care were included. They first answered the Caregiver Scenario Questionnaire and then participated in a group interview. RESULTS: An inconsistency was revealed regarding whether a management strategy for behavioural difficulties included in the Caregiver Scenario Questionnaire should be considered an abusive act or not. No participants were able to identify all five abusive behaviour management strategies. Participants described witnessing 101 abusive acts including different types of abuse of a person with dementia, with emotional/psychological abuse and neglect being most common. CONCLUSIONS: Health and social care staff who work close to older persons are able to detect abuse perpetrated by family members. However, inconsistency in defining abusive acts demonstrates the uncertainty in identifying abuse. This may lead to abuse not being identified, but it also creates feelings of inadequacy among staff.

Young Women's Silencing-Type Behaviors in Heterosexual Relationships.

Feminist researchers have demonstrated that engagement in silencing of the self (i.e., self-restrictive and sacrificial behaviors reflecting how women "should" be in relationships) remains a prevalent strategy for relationship maintenance. However, little is known about (young) women silencing themselves in relationships where abuse is present. Young women's experiences of silencing and other partner-focused behaviors (e.g., sexual compliance) within their relationships were thus explored. Young, partnered women (Mage = 21; N = 146) completed an online survey and open-ended questions about their current intimate relationships. Comparing between groups (abuse, n = 108; non-abuse, n = 38), the former scored higher on measures of total self-silencing, sexual compliance, and non-constructive communication and lower on measures of constructive communication (all p < .001). A mixed inductive and deductive content analysis found that while the importance of communicating with their partner was a preferred strategy for conflict management, multiple participants still emphasized self-suppression as an important part of their experience of relational conflict. Also, most participants indicated feeling as though they could be their authentic selves in their relationships, which suggests that their silencing may be situational and strategic in nature. These findings nuance previous understandings of self-silencing as inherently harmful and instead frame it as something sporadic and done strategically. They also bring forth questions about the extent to which young women's emphasis on communication and insistence that they can be authentic are a product of changing societal expectations of women in today's society compared to the 1980s/1990s when much of the foundational work on self-silencing was being done.

Navigating Online and in-Person Support: Views and Experiences From Survivors of Intimate Partner Violence and Abuse.

Various types of in-person and online support are available to women intimate partner violence and abuse (IPVA) survivors. However, we know little about the interplay between them. We investigated the transitions and interactions between these types of help and how their use can be optimized, using a mixed-methods approach (survey N = 107; interviews N = 18). Significant but weak correlations were found for specific IPVA and support types. No significant correlations were found between online and in-person help types. Almost 60% of survey participants expressed interest in blended care. Integration and optimization of online and blended care options can increase outreach and provide an enhanced, tailored help-seeking and recovery journey.

The psychological impact on mothers who have experienced domestic violence when navigating the family court system: a scoping review.

The aim of this scoping review was to synthesise the literature to identify what the psychological impacts of family court processes were on mothers who had experienced DFV. Twenty-five articles met inclusion criteria with four themes capturing the findings: Perpetrators using the system as a mode of coercive control; Secondary victimisation as a result of interacting with the system; Required to relive their abuse; and, Long-term psychological consequences of having engaged with the system. Key findings were that perpetrators manipulated the system to perpetrate further abuse and continue/reassert their control. Secondary re-victimisation was common, with poor knowledge of DFV and limited understanding of coercive control tactics and how these were employed by perpetrators by legal professionals identified as contributing factors. This review suggests that mothers who engage with the family court system experience a range of short- and long-term psychological impacts and court processes facilitate ongoing abuse by the perpetrator.

Peer Support Work in the Context of Intimate Partner Violence: A Scoping Review.

Peer support models of service provision have become increasingly prevalent in recent decades across multiple health and human services fields. In this scoping review, we examine peer support work within the context of intimate partner violence (IPV) service provision, including an examination of how this approach is conceptualized, the mechanisms underlying it, the impact of professionalism, and the benefits and challenges experienced by IPV peer support workers (PSWs). Three social science databases were searched with keywords related to IPV and peer support work, with additional articles and materials identified via targeted Google searches. The final sample of materials meeting criteria for the study (i.e., focusing on trained peer workers and their experiences serving IPV survivor clients) includes 10 papers and reports published from 1983 to 2022. We find that peer support work is conceptualized as a holistic alternative to traditional forms of IPV service provision, and that PSWs are viewed as occupying a unique role in relation to clients that enhances their ability to provide comprehensive care. However, we also identify several challenges resulting from the increasing professionalization of the IPV field, including a lack of role clarity for PSWs, a need to balance structure and flexibility in peer work service settings, and skepticism toward PSWs from credentialed professionals. Lastly, we find that although PSWs experience advantages from providing services, including enhanced personal growth and healing, they also navigate challenges related to maintaining their own emotional well-being and would benefit from additional training and institutional support.

Machiavellianism and Intimate Partner Violence Perpetration: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis estimated the size of the relationship between Machiavellianism and intimate partner violence (IPV) perpetration. Further, we explored whether the strength of this relationship varied depending on IPV type (i.e., physical, psychological, sexual, and cyber), and perpetrator gender. Systematic searches of Medline Complete, PsycInfo, Scopus, and Web of Science databases were conducted on July 4, 2023. Studies were included if they were a peer-reviewed published paper or unpublished dissertation, in English, included a measure of Machiavellianism and IPV perpetration, and reported the relationship between these variables. Study quality was assessed using the AXIS tool. Nineteen studies (N = 9,464) were included in a random-effects meta-analysis revealing a significant, weak, positive correlation between Machiavellianism and IPV perpetration (r = .16, 95% CI [0.11, 0.21], p < .001). Machiavellianism had a significant, weak, positive relationship with cyber (r = .25, 95% CI [0.17, 0.32], p < .001), psychological (r = .20, 95% CI [0.15, 0.24], p < .001), and sexual IPV (r = .10, 95% CI [0.02, 0.19], p = .020). No significant relationship was found for physical IPV. There was no significant difference in the strength of the relationship between women and men. These findings are limited by the measures being self-report, heterogeneity across studies, and the cross-sectional nature of the included studies which limits the understanding of causal pathways. Nonetheless, this meta-analysis shows a link between Machiavellianism and IPV perpetration, and future research should examine how this knowledge may be used to reduce IPV perpetration.

Experience of Pelvic Examination and Uptake of Gynecological Care Following Domestic or Sexual Violence: a Systematic Review.

Pelvic examination, a routine practice for gynecological care, can cause anxiety and be considered traumatic. This study aimed to define the association between domestic or sexual violence and the experience of pelvic examination, as well as the uptake of gynecological care following domestic or sexual violence. Pubmed, Cochrane Library, ScienceDirect, and Google Scholar were searched, up to April 30, 2023. Cohort, cross-sectional, case-control studies and controlled trials assessing perception of pelvic examination or the use of gynecological care for women with a history of violence were selected and analyzed. Each study underwent a descriptive analysis and was assessed for bias using the Newcastle-Ottawa scale and the RoB2 tool. Twenty-three articles met the inclusion criteria. Eleven studies, including 7,329 women, investigated the experience of pelvic examination following lifetime or childhood sexual violence. Most reported an association between violence and adverse experiences of pelvic examination, such as discomfort, anxiety, distress, and pain perceptions. Ten studies, including 9,248 women, investigated the uptake of gynecological care following domestic or sexual violence and reported mixed results, such as a decreased or an increased uptake, particularly for acute symptoms. Two studies, including 1,304 women, examined both outcomes. The present study highlights the association between violence and adverse experiences of pelvic examination, as well as mixed results on the uptake of gynecological care. It argues for the necessity to screen for violence in consultations, particularly when considering a pelvic examination, to guarantee the utility of pelvic examinations, and to consider the traumatic impact of sexual violence in care.

An Integrative Model of Alcohol-Facilitated Intimate Partner Aggression Perpetration in Sexual and Gender Diverse Couples.

OBJECTIVE: Sexual and gender diverse (SGD) individuals are at heightened risk for intimate partner aggression (IPA) perpetration relative to their heterosexual and cisgender peers. Alcohol is a well-established cause of IPA perpetration in cisgender, heterosexual couples; however, minimal research has investigated the alcohol-IPA perpetration link in SGD couples. The relative lack of work in this area is a major barrier to addressing this health disparity. SGD individuals experience unique stressors related to their and/or their partner's intersecting minoritized identities that are critical to understanding alcohol-IPA etiology and informing culturally affirming intervention programming. METHOD: We advance prior work by members of the authorship team (see Parrott et al., 2023a; Shorey et al., 2019) to propose an integrative theoretical model that invokes (1) the I3 Model to organize risk and resilience factors at the individual and dyadic level, and (2) Alcohol Myopia Theory to explain the mechanism by which proximal alcohol use facilitates IPA as a function of individual differences in those factors. RESULTS: This integrative model provides a framework to understand how the confluence of stigma, minority stressors, proximal alcohol use, and other factors contribute to IPA perpetration in SGD couples. DISCUSSION: Application of this integrative model has potential to facilitate more rigorous research (e.g., intensive longitudinal designs, dyadic analysis) focused on putative risk and resilience factors across the social ecology. Further, the model provides guidance for intervention development by identifying how individual (e.g., minority stress), relationship (e.g., relationship functioning), and structural factors (e.g., SGD stigma) interactively contribute to alcohol-facilitated IPA perpetration.

Impacts of Peer Support on Coping and Cortisol Levels for Women Affected by Domestic Violence and Coercive Control.

PURPOSE: Gendered domestic violence and coercive control are prevalent public heath concerns in Canada with dire consequences for survivors. Peer support groups may address and reduce negative impacts of domestic violence and coercive control on women's stress, coping, safety, and alliances with social support network members, the focus of this study. METHODS: A one-group, pre-test/post-test quasi-experimental study was undertaken to evaluate the effectiveness of Growth Circle, a 14-week peer support program offered at an agency serving women affected by domestic violence in a major western Canadian city. Through convenience sampling, women 18 years and older who experienced domestic violence were recruited and provided data on stress, coping, safety-related empowerment, and social support/alliances. Thirty-five participants provided all pre-test and post-test data, with a subsample of 14 providing repeated hair samples. Hair was employed to determine stress hormone (cortisol) levels. RESULTS: A significant reduction in self-reported levels of perceived stress and stress hormone levels following completion of the Growth Circle program was revealed. Participants also reported a significant increase in safety-related empowerment, and supportive alliances with group members. CONCLUSIONS: The Growth Circle peer support program was demonstrated to be effective. Further implementation and research into the Growth Circle program across Canada is recommended.