Abusos sexuales sobre personas incapacitadas para oponerse a su agresor y sobre incapaces para consentir / Sexual abuse of persons incapable of opposing their aggressor and incapable of consenting

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Taxonomía de los homicidios de mujeres en las relaciones de pareja / Taxonomy of homicides of women in intimate partner relationships

La prevención de la violencia contra la pareja supone un problema que ha suscitado gran interés a nivel internacional. El homicidio de pareja es el exponente más grave, aunque su prevalencia sea baja y su etiología compleja. Este trabajo revisa brevemente la descripción del problema desde la perspectiva de género y la existencia de asimetría, la perspectiva de la violencia y su descripción de factores de riesgo diferenciales y el modelo ecológico que relaciona variables personales, contextuales y comunitarias, presentando una propuesta más integradora. Se describen los estudios que analizan y comparan perfiles de homicidas, así como la situación en materia de evaluación del riesgo, todo ello con especial atención a las implicaciones para el contexto español. Por último, por su relevancia se discute la existencia de tipologías de homicidas y perfiles más próximos a patrones o dinámicas suicidas (en los homicidios diádicos y los familicidios). La información disponible pone de manifiesto la necesidad de ampliar el estudio de los homicidas de pareja y la dificultad de anticipar muchos de estos casos

Intimate partner violence prevention is a challenge that has received wide international interest. Homicide is the most serious result of this type of violence, although its prevalence is low and its etiology is complex. This paper briefly reviews the description of the problem from a gender perspective and the existence of asymmetry, the perspective of violence and its description of differential risk factors, and the ecological model that connects personal, contextual, and societal variables, presenting a more integrative proposal. Studies analyzing and comparing homicide profiles are described, as well as the state of the art regarding risk assessment, with special attention to the implications for the Spanish context. Finally, due to its relevance, the existence of typologies of homicides as well as profiles closer to suicidal patterns are discussed (in dyadic homicides and familicides). The available information highlights the need to expand the study of intimate partner homicides and the difficulty of anticipating many of these cases

Comparación de los perfiles victimológicos en una muestra de mujeres agredidas sexualmente antes o después de los 20 años de edad / Comparison of two victimology profiles in a sample of sexually assaulted women before or after twenty years old

El presente trabajo analiza el grave problema de la violencia sexual ejercida sobre las mujeres en función del momento vital en que tuvo lugar dicha violencia, y de un amplio número de variables sociodemográficas que nos permiten ofrecer una descripción del perfil de las víctimas y de las condiciones que probabilizan dicha victimización. Se realizó un estudio observacional, de cohorte retrospectivo, con una muestra de mujeres que acudieron a la Asociación de Mujeres Víctimas de Agresiones Sexuales (AMUVI) y declararon haber sufrido violencia sexual. Se les aplicó una entrevista elaborada para el caso que recogía información de diferentes variables, existiendo diferencias significativas en función de la edad a la que fueron agredidas. Los resultados obtenidos en cuanto a la frecuencia de la violencia sexual, el nivel socioeconómico de la víctima, la relación víctima-agresor, la diferencia de edad entre ellos, el tiempo transcurrido desde la primera agresión, las estrategias utilizadas por el agresor, el apoyo familiar y las consecuencias físicas, sugieren la existencia de dos perfiles de víctimas. Este hallazgo permitirá mejorar la calidad de los programas de prevención a mujeres víctimas de violencia sexual (AU)

This paper discusses the serious problem of sexual violence on women depending on at what point in his life it took place and depending on a wide number of demographic variables that allow to provide a description of the profile of the victims and the conditions that make more likely that victimization. An observational retrospective cohort was conducted. For this purpose, we elaborated an interview where we asked about different variables that were answered by sample of women attending the Association of Women Victims of Sexual Assault to declare that they had suffered sexual violence. They did an interview with some variables: frequency of sexual violence suffered, socioeconomic status of the victim, relationship with the perpetrator, age difference between the victim and the aggressor, time since sexual violence happened, strategies used by the perpetrator or family support received. The conclusions suggest the existence of two profiles, and these profiles can be used to improved the quality of the prevention programs for women victims of sexual violence (AU)

The Clinical and Radiological Examination of Acute Intimate Partner Violence Injuries: A Retrospective Analysis of an Italian Cohort of Women.

BACKGROUND: Intimate partner violence (IPV) is the most frequent type of violence against women. We compared clinical and radiological IPV characteristics to stranger assault (SA). METHODS: We retrospectively identified 123 women with IPV from court reports and matched them to 124 SA. Clinical and radiological characteristics were evaluated by testing their sensitivity, specificity, positive and negative predictive value for IPV, and the strength of their association with IPV. RESULTS: IPV women referred with more delay to the emergency department (ED), had more ED accesses, and showed more mismatch between reports to the triage and disclosures to the ED physician. They also displayed more head, neck, and face injuries, and new-plus-old fractures. CONCLUSION: The identification of specific features may help ED physicians to suspect IPV.

Factors associated with college women's labeling of sexual victimization.

Despite high rates of sexual assault among college women, most victims do not label the experience as sexual assault or rape. Prior research examining labeling of sexual victimization has focused on women's characterization of rape experiences as either not victimization or victimization. This study extends prior research by exploring factors associated with labeling various forms of sexual victimization as "not victimization," a "serious miscommunication," or a "sexual assault, date rape, rape, or crime." A sample of 1,060 college women reported on their experiences of sexual victimization since the age of 14 years. Women who reported experiences of prior sexual victimization (n = 371) indicated their level of acquaintance with the assailant, assault disclosure, substance use at time of assault, attributions of self- and perpetrator-blame for the assault, and labeling of the experience. Most women who reported experiences of sexual victimization did not self-identify as victims, and 38% labeled sexual victimization as a serious miscommunication. Greater acquaintance with the perpetrator, higher behavioral self-blame, and victim substance use at the time of the assault were associated with labeling sexual assault experiences as a serious miscommunication. Implications are discussed.

Cumulative abuse: do things add up? An evaluation of the conceptualization, operationalization, and methodological approaches in the study of the phenomenon of cumulative abuse.

For women, any one type of abuse rarely occurs in isolation of other types, and a single abusive experience is often the exception rather than the norm. The importance of this concept of the cumulative nature of abuse and its negative impact on health has been well recognized within the empirical literature, however there has been little consensus on what to call this phenomenon or how to study it. For the most part researchers have operated on the premise that it is the sheer number of different types of cumulating abuse experiences that is primarily responsible for worse health outcomes among women. And although this simplistic 'more is worse' approach to conceptualizing and operationalizing cumulative abuse has proven to be a powerful predictor of poorer health, it contradicts growing empirical evidence that suggests not all victimizations are created equal and that some victimizations may have a more deleterious effect on health than others. Embedded in abuse histories are individual and abuse characteristics as well as other life adversities that need to be considered in order to fully understand the spectrum and magnitude of cumulative abuse and its impact on women's health. Furthermore, given the long-term and persistent effects of abuse on health it becomes imperative to not only evaluate recent abusive experiences, but rather all abuse experiences occurring across the lifespan. This review highlights and evaluates the conceptual, operational, and methodological challenges posed by our current methods of studying and understanding the phenomenon of cumulative abuse and suggests that this phenomenon and its relationship to health is much more complex than research is currently portraying. This paper calls for the urgent need for interdisciplinary collaboration in order to more effectively and innovatively study the phenomenon of cumulative abuse.

Person-oriented methods in partner violence research: distinct biopsychosocial profiles among battered women.

Violence researchers have called for the use of person-oriented methods to understand differences that have been found in biopsychosocial consequences among those who experience intimate partner violence (IPV). To address this issue, we apply a person-oriented statistical method, latent profile analysis (LPA), to test for meaningful subgroups of a sample of 448 battered women based on participants' appraisals of their vulnerability relative to their violent partner, depressive symptoms, physical injuries, overall physical health functioning, and their positive and negative social relationships with friends and family. The LPA established five significantly distinct subgroups. Using MANOVA, we examined these subgroups and their respective IPV exposure, both concomitant and separate incidents within the past year. Those with the most intensive violence exposure show the greatest level of challenge and impairment. However, the groups with comparable levels of IPV exposure manifest distinctly different configurations of biopsychosocial profiles, indicating a need for adaptive interventions commensurate with these profiles. We discuss the implications these findings have for developing adaptive interventions for battered women, as well as the potential utility of person-oriented tools for violence researchers.

Exploring a taxonomy for aggression against women: can it aid conceptual clarity?

The assessment of aggression against women is demanding primarily because assessment strategies do not share a common language to describe reliably the wide range of forms of aggression women experience. The lack of a common language impairs efforts to describe these experiences, understand causes and consequences of aggression against women, and develop effective intervention and prevention efforts. This review accomplishes two goals. First, it applies a theoretically and empirically based taxonomy to behaviors assessed by existing measurement instruments. Second, it evaluates whether the taxonomy provides a common language for the field. Strengths of the taxonomy include its ability to describe and categorize all forms of aggression found in existing quantitative measures. The taxonomy also classifies numerous examples of aggression discussed in the literature but notably absent from quantitative measures. Although we use existing quantitative measures as a starting place to evaluate the taxonomy, its use is not limited to quantitative methods. Implications for theory, research, and practice are discussed.

Adapting and testing the Appraisal of Violent Situation scales.

The purpose of this study was to test the psychometric properties of a vertical version of horizontally oriented three Appraisal of Violent Situation scales that elicit women's subjective appraisals of severity, dangerousness, and controllability of violence. Construct validity of the vertical scale eliciting 64 abused women's perceptions of severity of violence experienced was supported by a low to modest correlation between that scale and the Severity of Violence Against Women Scale. Concurrent validity between the horizontal and vertical versions of the scales was demonstrated with a subsample of 26 abused women completing both. Results provide preliminary support for the revised scales.

Chronic pain in women survivors of intimate partner violence.

UNLABELLED: In this descriptive study of chronic pain in a community sample of 292 women who had separated from their abusive partners on average 20 months previously, more than one-third experienced high disability pain as measured by Von Korff's Chronic Pain Grade. Beyond the usual pain locations associated with abuse, 43.2% reported swollen/painful joints. More interference in daily life was attributed to joint pain than to back, head, stomach, pelvic or bowel pain. Women with high disability pain were more likely to have experienced child abuse, adult sexual assault, more severe spousal abuse, lifetime abuse-related injuries, symptoms of depression and post-traumatic stress disorder, lifetime suicide attempts, difficulty sleeping, and unemployment. High disability pain also was associated with visits to a family doctor and psychiatrist and use of medication in more than prescribed dosages. Less than 25% of women with high disability pain were taking opioids, or prescription nonsteroidal anti-inflammatory medications. Interestingly, high disability pain was not related to smoking, use of street drugs, potential for alcohol dependence, age, income, or education. The findings add to knowledge of severity and patterns of chronic pain in abused women and support the need for further multivariate analysis of the relationships among abuse experiences, mental health, and chronic pain severity to better inform decisions regarding diagnosis and treatment. PERSPECTIVE: Understanding patterns of chronic pain in abuse survivors and their associations with abuse history, mental health symptoms, health service use, and medication is important for clinical assessment and intervention. Chronic pain persisted long after leaving abusive partners and extended beyond usual locations (back, headache, pelvic, gastrointestinal) to include swollen/painful joints.

Maternal blame: battered women and abused children.

Participants (N = 126) read one of four scenarios depicting an incident of child physical abuse inflicted by the father. Scenarios varied history of wife abuse (present vs. absent) and severity of child abuse (battering vs. death). Overall, the father was held highly responsible. Greater maternal culpability was assigned when a history of wife abuse was present. The degree to which the mother should have been able to predict the incident of child abuse and maternal responsibility were mitigated when the abuse resulted in the death of her child. Perceptions of maternal psychological stability were jeopardized as a function of the presence of wife abuse. Implications are discussed.

Violence against women in Pakistan: a framework for analysis.

Understanding violence against women is as complex as its process. As a perusal of literature shows that most of the explanations were contextually and culturally based, this review attempts to analyze the issue of violence against women using theories applicable within the Pakistani context. Literature examining the issue of violence against women and its various theories was reviewed. A framework using the determinants of violence against women as proposed, include intrinsic and extrinsic factors within the people, the socio-economic-political and cultural system of Pakistan and the influences of surrounding countries. The Pakistani scenario has been described and the theoretical bases were presented. Each determinant has been discussed with supporting literature. Further studies are needed to strengthen the framework; however, it provided a modest view of violence against women in Pakistan. The framework would help the policy and decision makers to understand the dynamics of violence against women and may move them to action to bring about improvements in women's' lives.

Correspondence analysis: a method for classifying similar patterns of violence against women.

Violence against women has received relatively little debate in society. It includes physical, psychological, and sexual abuse that jeopardizes the victim's health. Multivariate correspondence analysis and cluster analysis were applied to crimes reported to the Integrated Women's Aid Center in Rio de Janeiro, Brazil, to investigate associations between injury and define criteria for classifying the aggressions. Three groups of abuse were identified, differing according to the nature (physical, psychological, or sexual) and severity of the crimes. Less serious crimes consisted of threats and moderate physical injuries. The intermediate severity group included serious physical assault and threats. More serious crimes included death threats, rape, and sexual assault. The method thus allowed classification of the crimes in three groups according to severity.

Correspondence analysis: a method for classifying similar patterns of violence against women / Análise de correspondência: um método para classificação de mulheres com perfil semelhante de vitimização

Violence against woman has received relatively little debate in society. It includes physical, psychological, and sexual abuse that jeopardizes the victim's health. Multivariate correspondence analysis and cluster analysis were applied to crimes reported to the Integrated Women's Aid Center in Rio de Janeiro, Brazil, to investigate associations between injury and define criteria for classifying the aggressions. Three groups of abuse were identified, differing according to the nature (physical, psychological, or sexual) and severity of the crimes. Less serious crimes consisted of threats and moderate physical injuries. The intermediate severity group included serious physical assault and threats. More serious crimes included death threats, rape, and sexual assault. The method thus allowed classification of the crimes in three groups according to severity.

A violência contra a mulher é uma questão ainda pouco debatida na sociedade, abrangendo um conjunto de agressões físicas, psicológicas e sexuais que contribuem para a depreciação da saúde da vítima. Aplicou-se a técnica de análise de correspondência multivariada, seguida da técnica de análise de cluster aos crimes registrados no Centro Integrado de Atendimento à Mulher, Rio de Janeiro, Brasil, com o objetivo de investigar o padrão de associação entre os agravos e estabelecer critérios para a classificação das agressões. Identificaram-se três grupos que se distinguem pela natureza do crime (físico, psicológico e sexual) e pelos níveis de gravidade. O menos grave é formado pelos crimes de lesão corporal leve e ameaça. O de gravidade intermediária reúne crimes de lesão corporal grave e ameaça. No de maior gravidade estão os crimes de ameaça de morte, estupro e abuso sexual. O método permitiu a classificação dos crimes em três grupos, que podem ser ordenados de acordo com o grau de severidade que guardam entre si.

Heterogeneity among violence-exposed women: applying person-oriented research methods.

Variability of experience and outcomes among violence-exposed people pose considerable challenges toward developing effective prevention and treatment protocols. To address these needs, the authors present an approach to research and a class of methodologies referred to as person oriented. Person-oriented tools support assessment of meaningful patterns among people that distinguish one group from another, subgroups for whom different interventions are indicated. The authors review the conceptual base of person-oriented methods, outline their distinction from more familiar variable-oriented methods, present descriptions of selected methods as well as empirical applications of person-oriented methods germane to violence exposure, and conclude with discussion of implications for future research and translation between research and practice. The authors focus on violence against women as a population, drawing on stress and coping theory as a theoretical framework. However, person-oriented methods hold utility for investigating diversity among violence-exposed people's experiences and needs across populations and theoretical foundations.

Patterns of injuries: accident or abuse.

This study uses two types of independent variables, age and the location of the physical wound, to develop a model of injury patterning that identifies violent behavior without direct observation of the assault. In this research, domestic violence injuries are compared to accidental injuries. The results indicate that there are specific and predictable injury patterns that separate abuse from other kinds of wounds. A logistic regression model was developed to identify the regions of the body most susceptible to injury from domestic assault. Using the age of the victim and the injury regions, probabilities were calculated to determine which wounds were caused by abuse.

Experiences of intimate partner violence and related injuries among women in Yokohama, Japan.

We estimated rates of intimate partner violence and related injuries in a sample of 1371 women aged 18 to 49 years in Yokohama, Japan. By the age of 30 years, 14.3% of women who had ever had a partner had experienced violence from that partner, and 3.3% had suffered injuries related to such violence. By the time women had reached the age of 49 years, these percentages were 19% and 4%, respectively. In addition to the need for increased prevention efforts, our findings indicate the need for an expanded legal definition of intimate partner violence in Japan given that the current definition excludes premarital violence.

A specification of the types of intimate partner violence experienced by women in the general population.

This study analyzes data from a national, general population sample of respondents (National Violence Against Women Survey) to estimate the prevalence of the different forms of intimate partner violence (IPV) that women experience in the United States. The study's purpose, to differentiate types of IPV, follows the Johnson and Ferraro tradition that distinguishes occasional and random acts of abuse from chronic and controlling forms of violence. When examining the specific types of IPV that the survey respondents disclosed, the author finds that the distribution closely resembles Gordon's epidemiological findings. This study analyzed the variance in the number of types of IPV as a function of the childhood abuse the women experienced and their partner's controlling and threatening behaviors. It concludes with a discussion of the multiple responses to IPV that are necessary in contemporary U.S. society.

Reproductive health and domestic violence: are the poorest women uniquely disadvantaged?

We use Demographic and Health Survey data from Cambodia, the Dominican Republic, and Haiti to compare women in different poverty and violence categories in terms of their experience of selected reproductive health outcomes. "Poor" women are those who belong to the bottom quintile of households arrayed according to a widely accepted asset-based wealth index. The results suggest that women who are both poor and have experienced violence are not unique in their reproductive health disadvantage. In particular, for all three reproductive health outcomes we consider the negative association with having experienced violence cuts across all women, poor and wealthy.

[Gender violence prevalence in female users of health services in Mexico]. / Prevalencia de diferentes tipos de violencia en usuarias del sector salud en México.

OBJECTIVE: To identify the prevalence of violence against females among those who are health service beneficiaries in Mexico. MATERIAL AND METHODS: The National Survey on Violence against Women (ENVIM, per its Spanish abbreviation) was applied in 2003 to female users of public primary and secondary health care services. The sampling framework was based on a stratified, probabilistic sample in two stages. First the health care units were selected with probability proportional to the number of physicians' offices in the unit, from a list of possible care units. Second, women 15 years and older who sought care at the health care unit were selected for participation in the study through systematic sampling. Univariate analysis and then bivariate analysis were carried out on the data collected with a questionnaire. RESULTS: The sample included 26 042 women between 15 and 92 years of age, with a mean age of 35.8 years. Physical violence during childhood was reported by 42% of the women. Only 7.8% answered yes to a general question about whether they experienced domestic partner violence, but 21.5% reported experiencing violence of any type during the last 12 months as measured by a scale including specific acts of psychological, economic, physical and sexual violence. The most frequently reported type of violence was psychological (19.6%). Of the women who had been pregnant, 14.1% reported having experienced violence during pregnancy, and 4.4% reported being hit in the abdomen. The prevalence of sexual violence was 17.3% and close to half reported being victims of this type of violence before age 15. Higher prevalence of violence was found among women with lower levels of formal education, living in a rented home, in areas with higher overcrowding indices, and users of Ministry of Health care services. CONCLUSIONS: Identifying and measuring violence is complex, given the diverse types of violence and how they are perceived and therefore reported by women themselves. This is an important public health problem, in view of the high frequency observed in this study and the immediate implications. These findings indicate the urgent need for interventions to prevent and treat violence.