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2.
Eur. j. psychol. appl. legal context (Internet) ; 12(2): 53-60, jul.-dic. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-190649

RESUMO

Intimate partner sexual violence has countless consequences for women suffering it. This research analyse the effect of the type of sexual coercion tactic and partner dependence on both the attribution of responsibility and the probability of leaving a relationship. In Study 1, six scenarios for different sexual tactics were presented (coaxing, coercion, and aggression) to 5 experts in order to select those with better evidence of content validity regarding the construct evaluated. In Study 2, the three selected scenarios were presented to 304 Spanish participants from the general population, analysing the effect of the type of tactic and dependence on attributed responsibility and the probability of leaving a relationship. Results showed that in the sexual aggression scenario, participants assigned the highest responsibility to the aggressorand showed the strongest likelihood of leaving the relationship. Further, results revealed that in the coaxing scenario, dependence had an indirect effect on the probability of leaving the relationship through a lower responsibility attributed to the aggressor. As a conclusion, this study emphasises the importance of the sexual tactic used by aggressors in individuals' perception about sexual coercion, contributing to increasing the visibility of this unacceptable action, especially in its more subtle and normalised form


La violencia sexual en las relaciones de pareja tiene innumerables consecuencias para las mujeres que la sufren. Esta investigación analiza el efecto del tipo de táctica de coerción sexual y la dependencia de la pareja en la atribución de responsabilidad y la probabilidad de dejar la relación. En el Estudio 1 se presentaron seis escenarios sobre diferentes tácticas sexuales(persuasión, coerción y agresión) a 5 expertos con la finalidad de seleccionar a aquellos que mostraran una mayor validez de contenido con respecto al constructo evaluado. En el Estudio 2, 304 participantes leyeron los tres escenarios seleccionados y se analizó el efecto del tipo de táctica y la dependencia en la responsabilidad atribuida y en la probabilidad de dejar la relación. Los resultados mostraron que los participantes responsabilizaban más al agresor y dejarían con más probabilidad la relación en la condición de agresión sexual que en la condición de coerción sexual o persuasión sexual. Además, los resultados revelan que en el escenario más sutil (persuasión) la dependencia tiene un efecto indirecto sobre probabilidad de dejar la relación a través de una menor responsabilidad atribuida al agresor. Como conclusión, esta investigación enfatiza la importancia que tiene la táctica sexual utilizada por el agresor en la percepción de la coerción sexual, contribuyendo a aumentar la visibilidad de este acto inaceptable, especialmente en su forma más sutil y normalizada


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Delitos Sexuais/psicologia , Violência por Parceiro Íntimo/psicologia , Dependência Psicológica , Manobra Psicológica , Fatores de Risco
3.
JAMA Netw Open ; 3(12): e2028499, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33351083

RESUMO

Importance: Engaging adolescent boys and young men in preventing violence against women is a potentially impactful public health strategy. Objective: To evaluate the effectiveness of a community-based, gender-transformative program (ie, Manhood 2.0) on perpetration of gender-based violence by adolescent boys and young men. Design, Setting, and Participants: In this unblinded cluster randomized clinical trial, neighborhoods were designated as the unit of clustering (1:1 allocation). Three-month (ie, time point 2 [T2]) and 9-month (ie, time point 3 [T3]) follow-ups were conducted. The trial took place in 20 Pittsburgh, Pennsylvania, neighborhoods and 1 centrally located site with concentrated disadvantage. Pittsburgh-based adolescent boys and young men (ages 13 to 19 years) were recruited between July 27, 2015, and June 5, 2017, through youth-serving organizations and community-based alternatives to residential placement for juvenile justice-involved youth. Intention-to-treat analysis was conducted from June 2018 to November 2019. Interventions: Manhood 2.0, an international program adapted for adolescent boys and young men in US urban communities, encourages these individuals to challenge gender norms that foster violence against women and unhealthy sexual relationships. Individuals in the control population received job-readiness training. Each program was 18 hours. Main Outcomes and Measures: The primary outcome was change in participant-level perpetration of sexual violence (SV) or adolescent relationship abuse (ARA) at T3. Results: Among 866 participants, 465 individuals (54%) enrolled in 11 intervention clusters and 401 individuals (46%) enrolled in 10 control clusters. In the intervention group, 325 participants (70%) were analyzed at T2 and 334 participants (72%) were analyzed at T3; in the control group, 262 participants (65%) were analyzed at T2 and 301 participants (75%) were analyzed at T3. Mean (SD) age was 15.5 (1.6) years; 609 participants (70%) self-identified as non-Hispanic Black, and 178 (20%) self-identified as Hispanic, multiracial, or other race/ethnicity other than White. Among individuals in the intervention group, 296 participants (64%) reported any SV or ARA perpetration at baseline, and 173 participants (52%) reported any SV or ARA perpetration at T3. Among individuals in the control group, 213 participants (53%) reported any SV or ARA perpetration at baseline, and 124 participants (41%) reported any SV or ARA perpetration at T3). The difference in reduction between groups was not significant. There was no evidence of an intervention effect for the primary outcome (adjusted odds ratio [OR], 1.32; 95% CI, 0.86-2.01; P = .20). Conclusions and Relevance: The findings from this evaluation of a community-based gender-transformative program for adolescent boys and young men did not show a significant intervention effect in reducing SV or ARA perpetration between Manhood 2.0 and a job-readiness control program. Combining gender-transformative approaches with job-readiness programs may be relevant for violence prevention in low-resource urban settings. Attention to improving implementation and strategies to sustain such community-based efforts are needed. Trial Registration: ClinicalTrials.gov Identifier: NCT02427061.


Assuntos
Violência por Parceiro Íntimo , Saúde Pública/métodos , Tratamento Domiciliar/métodos , Delitos Sexuais , Adolescente , Eficiência Organizacional , Feminino , Humanos , Relações Interpessoais , Violência por Parceiro Íntimo/prevenção & controle , Violência por Parceiro Íntimo/psicologia , Masculino , Determinação de Necessidades de Cuidados de Saúde , Desenvolvimento de Programas , Delitos Sexuais/prevenção & controle , Delitos Sexuais/psicologia , Comportamento Sexual/psicologia , População Urbana , Adulto Jovem
4.
Rev Saude Publica ; 54: 97, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33146302

RESUMO

OBJECTIVE: To identify the prevalence of violence during pregnancy and the association with the socioeconomic, behavioral and clinical characteristics of pregnant women. METHODS: Cross-sectional study in a low-risk maternity hospital in the municipality of Cariacica, Espírito Santo. A total of 330 puerperal women were interviewed from August to October 2017. Information on socioeconomic, behavioral, reproductive and clinical characteristics, as well as life experiences, was collected through a questionnaire. To identify the types of violence, the proper World Health Organization instrument was used. Gross bivariate and multivariate analysis was performed and adjusted for Poisson regression with robust variance. RESULTS: Prevalence was 16.1% (95%CI 2.5-20.4) for psychological violence, 7.6% (95%CI 5.1-11.0) for physical violence and 2.7% (95%CI 1.4-5.2) for sexual violence. Psychological violence remained associated with age, family income, beginning of sexual life, disease in pregnancy, desire to interrupt pregnancy and number of partners. Physical violence was associated with schooling, beginning of sexual life and disease in pregnancy. Sexual violence remained associated with marital status and desire to interrupt pregnancy (p < 0.05). CONCLUSIONS: Psychological violence by an intimate partner was the most prevalent among pregnant women. Women that were younger, had lower income and less schooling, who started their sexual life before the age of 14 and who wished to interrupt pregnancy, experienced violence more frequently during pregnancy.


Assuntos
Violência por Parceiro Íntimo/estatística & dados numéricos , Saúde Mental/estatística & dados numéricos , Abuso Físico/estatística & dados numéricos , Delitos Sexuais/estatística & dados numéricos , Parceiros Sexuais/psicologia , Maus-Tratos Conjugais/estatística & dados numéricos , Adulto , Brasil/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Violência por Parceiro Íntimo/psicologia , Abuso Físico/psicologia , Gravidez , Prevalência , Fatores de Risco , Delitos Sexuais/psicologia , Fatores Socioeconômicos , Maus-Tratos Conjugais/psicologia
5.
J Womens Health (Larchmt) ; 29(10): 1239-1242, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33006492

RESUMO

Intimate partner violence (IPV)-defined as physical, psychological, sexual, and/or economic violence typically experienced by women at home and perpetrated by their partners or expartners-is a pervasive form of violence that destroys women's feelings of love, trust, and self-esteem, with important negative consequences on physical and psychological health. Many reports from several countries have underlined a remarkable increase in the cases of IPV during the COVID-19 emergency. In this opinion article, we discussed the hypothesis that such an increase may be related to the restrictive measures enacted to contain the pandemic, including women's forced cohabitation with the abusive partner, as well as the exacerbation of partners' pre-existing psychological disorders during the lockdown. In addition, we retrospectively analyzed some data derived from our practice in a public Italian referral center for sexual and domestic violence (Service for Sexual and Domestic Violence [SVSeD]). These data interestingly revealed an opposite trend, that is, a decrease in the number of women who sought assistance since the beginning of the COVID-19 outbreak. Such a reduction should be interpreted as a negative consequence of the pandemic-related restrictive measures. Although necessary, these measures reduced women's possibilities of seeking help from antiviolence centers and/or emergency services. Owing to the COVID-19 outbreak, there is an urgent need for developing and implementing alternative treatment options for IPV victims (such as online and phone counseling and telemedicine), as well as training programs for health care professionals, especially those employed in emergency departments, to facilitate early detection of IPV.


Assuntos
Infecções por Coronavirus/prevenção & controle , Violência por Parceiro Íntimo/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena/psicologia , Parceiros Sexuais/psicologia , Maus-Tratos Conjugais/estatística & dados numéricos , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Feminino , Humanos , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/tendências , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Estudos Retrospectivos , Autoimagem , Delitos Sexuais/psicologia , Delitos Sexuais/tendências , Maus-Tratos Conjugais/psicologia , Maus-Tratos Conjugais/tendências
6.
PLoS One ; 15(10): e0239708, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33002042

RESUMO

INTRODUCTION: Intimate partner violence against women is one of the most common forms of violence. Different research fields are trying to understand the cycle of violence, such as the psychological field, to understand how these women's relational patterns and intrapsychic conflict function in the cycle of violence. OBJECTIVE: To investigate the operationalized psychodynamic diagnosis of women victims of domestic violence, exploring the severity and experience of violence, structural functions, dysfunctional interpersonal patterns, and intrapsychic conflicts. METHOD: We conducted a cross-sectional quantitative study using the OPD-2 Clinical Interviews, which were recorded and transcribed. The sample was composed by 56 women victims of domestic violence, mean age 30.07 (SD = ±9.65). Reliability was satisfactory for judges interviews(k>0,6). RESULTS: According to the OPD-2 evaluation, we found that the severity of the violence was associated with the intensity of women's subjective suffering. In the relational pattern, they stay in the relationship, leaving themselves vulnerable; perceive the partner as controlling, aggressive, offensive, and fear abandonment. As a defensive mechanism to relational discomfort and suffering victims anticipate the aggressor's desire, resulting in submissive behavior. The main psychic conflict was the "need for care versus self-sufficiency" (78.6%). And medium was the predominant structure level, in which they presented insecure internal objects, presenting difficulties in emotional regulation and perceiving reality in a distorted way. Hence, they do not recognize their limitations and needs. We found that 78.6% of the cases had some psychiatric disorder: MDD, PTSD. CONCLUSION: This study provides empirical evidence on clinical observations on the psychological functioning of this population and the issues that make up the maintenance of domestic violence against women. The understanding of internalized patterns, structural functions, and motivational tensions are fundamental for the prevention of re-victimization and improving coping mechanisms, as well as promoting greater adherence to treatment.


Assuntos
Violência por Parceiro Íntimo/psicologia , Adolescente , Adulto , Fatores Etários , Idoso , Vítimas de Crime/psicologia , Estudos Transversais , Feminino , Humanos , Relações Interpessoais , Entrevista Psicológica , Violência por Parceiro Íntimo/estatística & dados numéricos , Pessoa de Meia-Idade , Psicanálise , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologia , Estresse Psicológico/psicologia , Adulto Jovem
7.
Artigo em Inglês | MEDLINE | ID: mdl-32872328

RESUMO

In psychological consultations with women who survive Intimate Partner Violence, it is essential to work on elaboration of the trauma as a complex trauma within the context of a relationship. We consider dreams to be a symbolic-representative process, which requires the right psychic, relational and contextual conditions to occur, and that is hindered when trauma is present. The objective of the present study is to investigate the meanings that psychologists working at anti-violence centers attribute to the clinical intervention with women victims of IPV, with a focus on the area of sleep and dreaming in a traumatic experience, and in the clinical work on the trauma. Twelve female psychologists were interviewed using the Interpretative Phenomenological Analysis methodology. From the analysis of the interviews, three main themes emerged: (1) Day and night, neither awake nor asleep, (2) Anti Violence Centers: setting as a container of emotion? and (3) dreaming undreamt dreams. The study highlights the importance of dreams as an indicator not only of psychic and mental functioning but also of the psychological relationship within a specific context.


Assuntos
Aconselhamento , Violência por Parceiro Íntimo/psicologia , Psicoterapia Psicodinâmica , Adulto , Feminino , Humanos , Violência por Parceiro Íntimo/etnologia , Itália , Violência
8.
Artigo em Inglês | MEDLINE | ID: mdl-32872679

RESUMO

Public helping reactions are essential to reduce a victim's secondary victimization in intimate partner violence against women (IPVAW) cases. Because gender-related characteristics have been linked widely to IPVAW prevalence, the study aimed to examine individual attitudes and perceptions toward different forms of violence against women, as well as gender-related macrosocial ideological and structural factors, in explaining helping reactions to IPVAW across 28 European countries. We performed multilevel logistic regression analysis, taking measures from the Eurobarometer 2016 (N = 7115) and the European Institute for Gender Equality datasets. Our study revealed a greater individual perceived IPVAW prevalence, positive perception about the appropriateness of a legal response to psychological and sexual violence against women partners, and less VAW-supportive attitudes predicted helping reactions (i.e., formal, informal), but not negative reactions to IPVAW. Moreover, individuals from European countries with a greater perceived IPVAW prevalence and gender equality preferred formal reactions to IPVAW. Otherwise, in the European countries with lesser perceived IPVAW prevalence and negative perceptions about the appropriate legal response to psychological and sexual violence, people were more likely to provide informal reactions to IPVAW. Our results showed the role of gender-related characteristics influenced real reactions toward known victim of IPVAW.


Assuntos
Comportamento de Ajuda , Violência por Parceiro Íntimo , Apoio Social , Atitude Frente a Saúde , Europa (Continente)/epidemiologia , Feminino , Humanos , Relações Interpessoais , Violência por Parceiro Íntimo/legislação & jurisprudência , Violência por Parceiro Íntimo/prevenção & controle , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/estatística & dados numéricos , Masculino , Fatores de Risco , Fatores Sexuais , Parceiros Sexuais/psicologia , Fatores Socioeconômicos
9.
Interv. psicosoc. (Internet) ; 29(3): 165-174, sept. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-194493

RESUMO

Studies of intimate partner violence (IPV) have generally focused on only one partner. Although this has allowed advances in scientific knowledge on the causes of IPV, currently recent literature is demanding the need to study both members of the couple. Methodologically, the study of dyads requires the use of appropriate statistical techniques to avoid possible systematic biases (for example, type I error due to dependence of observations). We used the Actor-Partner Interdependence Model to study aggression and victimization in 361 heterosexual couples of young adults. The results indicated, on the one hand, that self-reported mutual aggression was found in more than 50% of the couples. On the other hand, we found that participants' victimization was largely predicted by their own aggressive behavior towards the other member of the couple. While this result suggests the existence of a victim-offender overlap, it may also hide an upwards victimization scores bias: when participants are aggressive toward their partners, they may bias their victimization scores upwards to justify their levels of aggression ("I was aggressive because I felt victimized")


Los estudios sobre la violencia de pareja (en inglés IPV) generalmente han centrado sus análisis sólo en uno de los miembros. Aunque esto ha permitido avanzar en el conocimiento de las causas de la IPV, la literatura reciente ha señalado la necesidad de estudiar a los dos miembros de la pareja. Metodológicamente el estudio de las parejas requiere el uso de técnicas estadísticas apropiadas para evitar posibles sesgos sistemáticos (por ejemplo, error tipo I debido a la dependencia de las observaciones). En este estudio utilizamos el modelo de interdependencia actor-pareja para el estudio de la agresión y la victimización en 361 parejas jóvenes heterosexuales de jóvenes adultos. Los resultados indicaban, por una parte, que había agresión mutua autoinformada en más de la mitad de las parejas. Por otro lado, encontramos que el principal predictor de la victimización de los participantes fue su propio comportamiento agresivo hacia el otro miembro de la pareja. Este resultado sugiere que la víctima y el agresor son la misma persona. Sin embargo, también puede ocultar un posible sesgo al alza de las puntuaciones de victimización: cuando los participantes son agresivos con sus parejas, pueden sesgar al alza sus puntuaciones de victimización para justificar sus niveles de agresión ("Fui agresivo porque me sentí victimizado")


Assuntos
Humanos , Maus-Tratos Conjugais/psicologia , Violência por Parceiro Íntimo/psicologia , Vítimas de Crime/psicologia , Desejabilidade Social , Autorrelato , Heterossexualidade/psicologia , Análise de Variância
10.
Interv. psicosoc. (Internet) ; 29(3): 175-190, sept. 2020. graf, tab, ilus
Artigo em Inglês | IBECS | ID: ibc-194494

RESUMO

Previous research suggests that the inclusion of motivational strategies in interventions for intimate partner violence (IPV) offenders could increase their effectiveness. This review evaluated the effectiveness of interventions for IPV offenders that includes motivational strategies to reduce physical and psychological IPV, treatment dropout, official recidivism to IPV offending, and to increase intervention attendance dose. The present systematic review and meta-analysis were conducted using PRISMA guidelines. The following databases were searched from 1983 to 2018 for randomized controlled trials (RCTs) of interventions for IPV offenders that incorporated motivational strategies for adult participants that included men and included IPV behaviors as outcomes: Cochrane Collaboration, MEDLINE, EMBASE, PsycINFO and CINAHL. A total 1,134 studies were identified, 12 RCTs were included in the narrative review and 7 in the meta-analysis. Results indicated that IPV interventions that incorporated motivational strategies were significantly more effective in increasing the intervention dose and reducing dropout than interventions without motivational strategies. IPV offenders receiving interventions with motivational strategies were 1.73 times less likely to intervention dropout compared to those in interventions without such strategies. For physical and psychological IPV and official recidivism (e.g., rearrests, police record), evidence favored interventions with motivational strategies, although not significantly. These findings have important practical implications, especially considering the high dropout rates in IPV offender programs and the link between dropout and higher rates of recidivism


La investigación previa sugiere que la inclusión de estrategias motivacionales en las intervenciones con agresores de pareja podría incrementar la efectividad de estas intervenciones. Esta revisión evaluó la eficacia de las intervenciones en agresores de pareja, que incluye las estrategias motivacionales para reducir la violencia física y psicológica contra la pareja, el abandono de la intervención y la reincidencia oficial, así como para aumentar la dosis de asistencia a las intervenciones. Tanto la revisión sistemática como el meta-análisis se llevaron a cabo siguiendo las recomendaciones PRISMA. Se examinaron las siguientes bases de datos desde 1983 hasta 2018, con objeto de localizar ensayos controlados aleatorizados (ECA) de intervenciones para agresores de pareja que incluyeran estrategias motivacionales, en las que los participantes fueran hombres mayores de edad y que incluyeran como variables de resultado conductas de violencia contra la pareja: Cochrane Collaboration, MEDLINE, EMBASE, PsycINFO y CINAHL. Se identificaron 1,134 estudios, incluyéndose 12 ECAs en la revisión narrativa y 7 en el meta-análisis. Los resultados indicaron que las intervenciones para agresores de pareja que incorporan estrategias motivacionales eran significativamente más efectivas en incrementar la dosis de intervención y reducir el abandono de la intervención que las que no incluían estrategias motivacionales. Los agresores que participaron en intervenciones con estrategias motivacionales tenían 1.73 veces menor probabilidad de abandonar el tratamiento, en comparación con aquellos que participaron en intervenciones sin tales estrategias. En cuanto a la violencia física y psicológica contra la pareja y la reincidencia oficial (e.g., arrestos reiterados, denuncias policiales), la evidencia, aunque no es significativa, favorece las intervenciones con estrategias motivacionales. Estos resultados tienen importantes implicaciones prácticas, especialmente si se tiene en cuenta las altas tasas de abandono de la intervención que se producen en los programas de intervención con agresores de pareja y la relación existente entre abandono de la intervención y mayores tasas de reincidencia


Assuntos
Humanos , Maus-Tratos Conjugais/psicologia , Relações Interpessoais , Motivação/fisiologia , Violência por Parceiro Íntimo/psicologia , 25783 , Assunção de Riscos
11.
An. psicol ; 36(2): 200-209, mayo 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-192056

RESUMO

En los últimos años ha aumentado el interés por el estudio de la ciberviolencia en la pareja, sin embargo es necesario examinar la metodología de investigación que sustenta las evidencias obtenidas hasta el momento. Este artículo presenta una revisión sistemática de la literatura científica que analiza 30 instrumentos de medida de ciberviolencia en la pareja de adolescentes y jóvenes adultos utilizados a lo largo de estos años. Los principales resultados muestran una elevada pluralidad metodológica, conceptual y terminológica, observándose un reducido número de instrumentos con suficientes garantías psicométricas. Predominan los trabajos de procedencia estadounidense y, entre los instrumentos aplicados en muestras españolas, destaca una infrarrepresentación de indicadores de ciberviolencia de tipo sexual, lo que limita la comprensión de esta problemática. Esta investigación aporta información sobre el estado actual en el estudio de la ciberviolencia en la pareja y pone de relieve deficiencias metodológicas en la construcción del conocimiento en este campo de estudio. Este trabajo permite una mejor comprensión de la disparidad de resultados señalada por investigaciones previas, especialmente referidas a prevalencia, frecuencia y diferencias de género en este tipo de comportamientos violentos, además de sentar las bases para abordar el fenómeno desde el rigor científico


The interest for the study of the cyber dating abuse has increased in the last years; however, it is necessary to examine the research methodology that supports the evidence obtained so far. This paper presents a systematic review of the scientific literature that analyzes 30 measuring instruments of cyber dating abuse in adolescent and young adults used along these years. The main results show a methodological, conceptual and terminological plurality, observing a small number of instruments with sufficient psychometric guarantees. The instruments come mostly from the United States, and of the instruments applied to Spanish samples, few include indicators of sexual cyber dating abuse, which limits the understanding of this problem. This research provides information on the current status of the study of cyber dating abuse and highlights methodological shortcomings in the construction of knowledge in this field of study. This study allows a better understanding of the disparity of results indicated by previous research, especially referring to prevalence, frequency and gender differences in this type of violent behavior, as well as laying the foundations for addressing the phenomenon from scientific rigor


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Violência por Parceiro Íntimo/psicologia , Relações Interpessoais , Psicometria/métodos , Rede Social , Violência por Parceiro Íntimo/estatística & dados numéricos , Vítimas de Crime/estatística & dados numéricos , Psicometria/estatística & dados numéricos , Vítimas de Crime/psicologia , Internet
12.
PLoS Med ; 17(8): e1003131, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32810147

RESUMO

BACKGROUND: Intimate partner violence (IPV) is linked to substance use by male perpetrators and is associated with an increased risk of depression for women who experience violence. Unite for a Better Life (UBL) is a gender-transformative intervention delivered to men, women, and couples in Ethiopia; previous evidence demonstrated the intervention significantly reduced experience of and perpetration of IPV when delivered to men and led to more equitable household task-sharing when delivered to men and couples. The aim of this analysis is to assess engagement in the UBL intervention and to examine the relationship between random assignment to the intervention and men's past-year substance use and women's reported depressive symptoms as measured at the individual level. METHODS AND FINDINGS: A sample of 64 villages in Gurague zone, Ethiopia, was randomly allocated to 4 arms (men's UBL, women's UBL, couples' UBL, or control). In each village, 106 households were randomly sampled, and households in the intervention arms were invited to participate in UBL, consisting of 14 sessions delivered by trained facilitators. Households in the control arm were offered a short educational session on IPV. Descriptive data on participant engagement in the intervention are reported, and outcomes assessed in an intention-to-treat (ITT) analysis include male use of substances (alcohol and khat) and women's depressive symptoms as measured by the Patient Health Questionnaire (PHQ-9). Results from both adjusted and unadjusted specifications are reported, the latter adjusting for baseline covariates including age, education level, marriage length, polygamy, socioeconomic status, months between intervention and endline, and the baseline level of the outcome variable. The baseline sample includes 6,770 respondents surveyed in 2014-2015, and follow-up data were available from 88% of baseline respondents surveyed in 2017-2018; the majority of respondents report no education, and 61% are Muslim. Respondents reported high attendance rates and engagement in the intervention. In addition, there was evidence of a significant reduction in frequent past-year alcohol intoxication self-reported by men (adjusted odds ratio [AOR] = 0.56, 95% CI 0.36-0.85, p = 0.007), and a significant increase in the probability of frequent khat use self-reported by men (AOR = 3.09, 95% CI 1.37-6.96, p = 0.007), both observed in the couples' UBL arm at 24 months' follow-up relative to the control arm. There was a significant increase in symptoms of moderate depression among women in the women's UBL arm only (AOR = 1.65, 95% CI 1.13-2.41, p = 0.010), again relative to the control arm. There was no evidence of shifts in symptoms of mild or severe depression. The primary limitation of this study is the reliance on self-reported data around sensitive behaviors. CONCLUSIONS: The findings suggest that the UBL intervention was associated with a reduction in men's use of alcohol when delivered to couples, but there was no evidence of a decrease in reported symptoms of depression among women in any experimental arm, and some evidence of an increase in symptoms of moderate depression in the women's UBL arm. Further research should explore how to optimize IPV prevention interventions to target related risks of mental health and substance use. TRIAL REGISTRATION: Clinicaltrials.gov NCT02311699; Socialscienceregistry.org AEARCTR-0000211.


Assuntos
Depressão/psicologia , Depressão/terapia , Violência por Parceiro Íntimo/prevenção & controle , Violência por Parceiro Íntimo/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto , Análise por Conglomerados , Depressão/epidemiologia , Etiópia/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Autorrelato , Parceiros Sexuais/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Inquéritos e Questionários , Adulto Jovem
13.
PLoS Med ; 17(8): e1003274, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32810146

RESUMO

BACKGROUND: Intimate partner violence (IPV) is associated with increased HIV risk and other adverse health and psychosocial outcomes. We assessed the impact of Unite for a Better Life (UBL), a gender-transformative, participatory intervention delivered to men, women, and couples in Ethiopia in the context of the coffee ceremony, a traditional community-based discussion forum. METHODS AND FINDINGS: Villages (n = 64) in 4 Ethiopian districts were randomly allocated to control, men's UBL, women's UBL, or couples' UBL, and approximately 106 households per village were randomly selected for inclusion in the trial. The intervention included 14 sessions delivered twice weekly by trained facilitators; control arm households were offered a short IPV educational session. Primary outcomes were women's experience of past-year physical or sexual IPV 24 months postintervention. Secondary outcomes included male perpetration of past-year physical or sexual IPV, comprehensive HIV knowledge, and condom use at last intercourse. Additional prespecified outcomes included experience and perpetration of past-year physical and/or sexual IPV and emotional IPV, HIV/AIDs knowledge and behaviors, decision-making, and gender norms. An intention-to-treat (ITT) analysis was conducted, evaluating 6,770 households surveyed at baseline in 2014-2015 (1,680 households, 16 clusters in control; 1,692 households, 16 clusters in couples' UBL; 1,707 households, 16 clusters in women's UBL; 1,691 households, 16 clusters in men's UBL). Follow-up data were available from 88% of baseline respondents and 87% of baseline spouses surveyed in 2017-2018. Results from both unadjusted and adjusted specifications are reported, the latter adjusting for age, education level, marriage length, polygamy, socioeconomic status, and months between intervention and endline. For primary outcomes, there was no effect of any UBL intervention compared to control on women's past-year experience of physical (couples' UBL arm adjusted odds ratio [AOR] = 1.00, 95% confidence interval [CI]: 0.77-1.30, p = 0.973; women's UBL arm AOR = 1.11, 95% CI 0.87-1.42, p = 0.414; men's UBL arm AOR = 1.02, 95% CI: 0.81-1.28, p = 0.865) or sexual IPV (couples' UBL arm AOR = 0.86, 95% CI: 0.62-1.20, p = 0.378; women's UBL arm AOR = 1.15, 95% CI: 0.89-1.50; p = 0.291; men's UBL arm AOR = 0.80, 95% CI: 0.63-1.01, p = 0.062). For the secondary outcomes, only the men's UBL intervention significantly reduced male perpetration of past-year sexual IPV (AOR: 0.73; 95% CI: 0.56-0.94, p = 0.014), and no intervention reduced perpetration of past-year physical IPV. Among women, the couples' UBL intervention significantly improved comprehensive HIV knowledge, and both couples' and women's UBL significantly increased reported condom use at last intercourse. Among additional outcomes of interest, the men's UBL intervention was associated with a significant reduction in women's experience of past-year physical and/or sexual IPV (AOR = 0.81, 95% CI: 0.66-0.99, p = 0.036) and men's perpetration of physical and/or sexual IPV (AOR = 0.78; 95% CI: 0.62-0.98, p = 0.037). UBL delivered to men and couples was associated with a significant reduction in HIV risk behaviors and more equitable intrahousehold decision-making and household task-sharing. The primary limitation is reliance on self-reported data. CONCLUSIONS: A gender-transformative intervention delivered to men was effective in reducing self-reported perpetration of sexual IPV but did not reduce IPV when delivered to couples or women. We found evidence of decreased sexual IPV with men's UBL across men's and women's reports and of increased HIV knowledge and condom use at last intercourse among women. The men's UBL intervention could help accelerate progress towards gender equality and combating HIV/AIDS. TRIAL REGISTRATION: The trial was prospectively registered at clinicaltrials.gov (NCT02311699) and in the American Economic Association registry (AEARCTR-0000211).


Assuntos
Características Culturais , Infecções por HIV/etnologia , Infecções por HIV/terapia , Violência por Parceiro Íntimo/etnologia , População Rural , Parceiros Sexuais , Adolescente , Adulto , Análise por Conglomerados , Serviços de Saúde Comunitária/métodos , Etiópia/etnologia , Feminino , Infecções por HIV/psicologia , Humanos , Violência por Parceiro Íntimo/psicologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Parceiros Sexuais/psicologia , Resultado do Tratamento , Adulto Jovem
15.
Epidemiol Psychiatr Sci ; 29: e159, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32792037

RESUMO

AIMS: This study assessed the relationships between different perpetrator-victim roles in intimate partner violence (IPV), emotion regulation (ER) and mental health problems among men who have sex with men (MSM) in China. METHODS: From April to June 2019, 1233 participants were approached via gay-friendly non-governmental organisations in 15 cities across mainland China. RESULTS: Of the total, 578 eligible participants completed an anonymous online survey. All participants provided informed consent and information about their violent perpetrator-victim role and mental health status. The results revealed a high prevalence of IPV in this study sample, with 32.7% of participants reporting IPV victimisation and 32.5% of participants reporting IPV perpetration during their lifetime. A total of 81 (14.0%) participants were suicidal, 309 (53.5%) participants reported poor general mental health and 208 (36.0%) had significant depressive symptoms. Adjusted logistic regression models revealed that both physical victimisation (adjusted odds ratio [ORa] = 3.22, 95% confidence interval [CI] = 1.11-9.32) and sexual victimisation (ORa = 2.90, 95% CI = 1.39-6.05) had positive associations with suicidality, and unidirectional and bidirectional psychological perpetration were associated with poor general mental health and significant depressive symptoms. Although high cognitive reappraisal showed a negative association with poor general mental health (ORa = 0.89,95% CI = 0.86-0.92), the correlation with victims of IPV was weaker than it was with non-victims. CONCLUSIONS: This study revealed that different perpetrator-victim roles in different IPV situations should be considered comprehensively in research, prevention and intervention. ER is not enough to buffer the effects of IPV on the mental health of MSM victims.


Assuntos
Vítimas de Crime/psicologia , Regulação Emocional , Homossexualidade Masculina/psicologia , Saúde Mental/estatística & dados numéricos , Adulto , China/epidemiologia , Vítimas de Crime/estatística & dados numéricos , Estudos Transversais , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/estatística & dados numéricos , Masculino , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
16.
PLoS One ; 15(8): e0236880, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32764776

RESUMO

Sexual minority (SM) youth are at high risk for intimate partner violence (IPV) and suicidal ideation/attempts compared to their heterosexual peers. We examined whether SM identity enhanced the relationship between experiences of IPV and suicidal ideation/attempts. Weighted logistic regression models were run using the 2017 Youth Risk Behavior Survey. All main effects were significant; each SM identity and both physical and sexual IPV were significantly associated with suicidal ideation and suicide attempts. The interaction between bisexual identity and physical IPV was significant for suicidal ideation; as physical IPV experiences increased, the difference between bisexual identity and heterosexual youth was non-significant. Findings suggest exploring trauma and suicidal ideation by aggregate groups and increasing support for SM youth in schools and communities.


Assuntos
Violência por Parceiro Íntimo/estatística & dados numéricos , Minorias Sexuais e de Gênero/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Ideação Suicida , Tentativa de Suicídio/estatística & dados numéricos , Adolescente , Criança , Feminino , Humanos , Violência por Parceiro Íntimo/psicologia , Modelos Logísticos , Masculino , Fatores de Risco , Tentativa de Suicídio/psicologia
17.
Int J Law Psychiatry ; 71: 101606, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32768122

RESUMO

Intimate Partner Violence (IPV) is a global pandemic and many have been victims of it long before Covid-19. International organizations have documented an increase in IPV reports during the current pandemic, raising awareness of the potential causes for such an increase. Reflecting on risk factors associated with IPV, and the underlying need of the perpetrators to exert control over the victims, it becomes increasingly important to understand how the current policies of social distancing, self-isolation, and lockdown can precipitate episodes of IPV. Furthermore, access to specialized services and health care can be compromised, and health care professionals face new challenges and demands imposed by the pandemic while managing IPV cases. This article begins by examining the main risk factors more commonly associated with IPV in the literature. It proceeds by reflecting on how these risk factors may be exacerbated during the Covid-19 pandemic, which can explain the increased number of reports. Finally, it emphasizes the new challenges faced by health care professionals, while assisting IPV victims during the pandemic and provides possible recommendations on actions to implement during and beyond the Covid-19 pandemic to prevent such cases.


Assuntos
Infecções por Coronavirus/epidemiologia , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Betacoronavirus , Feminino , Humanos , Masculino , Pandemias , Fatores de Risco
18.
PLoS One ; 15(7): e0235761, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32628738

RESUMO

The Women's Experience with Battering (WEB) scale is a self-report instrument that uses a 10-item Likert-type scale to measure IPV victims' cognitive and affective experience of battering. This study aimed to validate the Chinese version of the WEB scale using gender-neutral questions, Experience of Battering Scale (Chinese) (EBS-C), to assess the psychological vulnerability of victims of intimate partner violence (IPV). The study adopted a range of methods, including translation and back translation, expert reviews, cognitive debriefing, and test-retest reliability assessment. The EBS-C was validated in a purposive convenience sample of 718 Chinese-speaking participants (male = 362; female = 356) aged 18-24 (mean age = 21.4) in Hong Kong. The results of CFA showed a good model fit: CFI = .97, TLI = .96, RMSEA = .05, SRMR = .03. The EBS-C was also found to be significantly associated with the Revised Conflict Tactics Scales (CTS2; r = .13-.17, p < .01), depression (BDI-II: r = .15, p < .01), anxiety (GAD-7: r = .17, p < .01), interpersonal support (ISEL-12: r = -.27, p < .01), relationship satisfaction (RAS: r = -.36, p < .01), and self-esteem (RSES: r = -.22, p < .01). The study demonstrated the EBS-C to be a reliable and valid measure for assessing the psychological vulnerability of IPV victims. It is thus useful for identifying the risks such individuals face by assessing their experience of fear, danger, and disempowerment in the intimate relationship relative to abusive incident-based measures alone. The EBS-C will also be useful for developing effective treatments to address the psychological vulnerability resulting from IPV and will facilitate cross-cultural comparative research aimed at enriching our knowledge of IPV victimization.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Mulheres Maltratadas/psicologia , Vítimas de Crime/psicologia , Violência por Parceiro Íntimo/psicologia , Autorrelato , Parceiros Sexuais/psicologia , Maus-Tratos Conjugais/psicologia , Adolescente , Adulto , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Mulheres Maltratadas/estatística & dados numéricos , Feminino , Nível de Saúde , Humanos , Violência por Parceiro Íntimo/estatística & dados numéricos , Masculino , Maus-Tratos Conjugais/estatística & dados numéricos , Adulto Jovem
19.
Cochrane Database Syst Rev ; 7: CD013017, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32608505

RESUMO

BACKGROUND: Intimate partner violence (IPV) against women is prevalent and strongly associated with mental health problems. Women experiencing IPV attend health services frequently for mental health problems. The World Health Organization recommends that women who have experienced IPV and have a mental health diagnosis should receive evidence-based mental health treatments. However, it is not known if psychological therapies work for women in the context of IPV and whether they cause harm. OBJECTIVES: To assess the effectiveness of psychological therapies for women who experience IPV on the primary outcomes of depression, self-efficacy and an indicator of harm (dropouts) at six- to 12-months' follow-up, and on secondary outcomes of other mental health symptoms, anxiety, quality of life, re-exposure to IPV, safety planning and behaviours, use of healthcare and IPV services, and social support. SEARCH METHODS: We searched the Cochrane Common Mental Disorders Controlled Trials Register (CCMDCTR), CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, and three other databases, to the end of October 2019. We also searched international trials registries to identify unpublished or ongoing trials and handsearched selected journals, reference lists of included trials and grey literature. SELECTION CRITERIA: We included randomised controlled trials (RCTs), quasi-RCTs, cluster-RCTs and cross-over trials of psychological therapies with women aged 16 years and older who self-reported recent or lifetime experience of IPV. We included trials if women also experienced co-existing mental health diagnoses or substance abuse issues, or both. Psychological therapies included a wide range of interventions that targeted cognition, motivation and behaviour compared with usual care, no treatment, delayed or minimal interventions. We classified psychological therapies according to Cochrane Common Mental Disorders's psychological therapies list. DATA COLLECTION AND ANALYSIS: Two review authors extracted data and undertook 'Risk of Bias' assessment. Treatment effects were compared between experimental and comparator interventions at short-term (up to six months post-baseline), medium-term (six to under 12 months, primary outcome time point), and long-term follow-up (12 months and above). We used standardised mean difference (SMD) for continuous and odds ratio (OR) for dichotomous outcomes, and used random-effects meta-analysis, due to high heterogeneity across trials. MAIN RESULTS: We included 33 psychological trials involving 5517 women randomly assigned to experimental (2798 women, 51%) and comparator interventions (2719 women, 49%). Psychological therapies included 11 integrative therapies, nine humanistic therapies, six cognitive behavioural therapy, four third-wave cognitive behavioural therapies and three other psychologically-orientated interventions. There were no trials classified as psychodynamic therapies. Most trials were from high-income countries (19 in USA, three in Iran, two each in Australia and Greece, and one trial each in China, India, Kenya, Nigeria, Pakistan, Spain and UK), among women recruited from healthcare, community, shelter or refuge settings, or a combination of any or all of these. Psychological therapies were mostly delivered face-to-face (28 trials), but varied by length of treatment (two to 50 sessions) and staff delivering therapies (social workers, nurses, psychologists, community health workers, family doctors, researchers). The average sample size was 82 women (14 to 479), aged 37 years on average, and 66% were unemployed. Half of the women were married or living with a partner and just over half of the participants had experienced IPV in the last 12 months (17 trials), 6% in the past two years (two trials) and 42% during their lifetime (14 trials). Whilst 20 trials (61%) described reliable low-risk random-sampling strategies, only 12 trials (36%) described reliable procedures to conceal the allocation of participant status. While 19 trials measured women's depression, only four trials measured depression as a continuous outcome at medium-term follow-up. These showed a probable beneficial effect of psychological therapies in reducing depression (SMD -0.24, 95% CI -0.47 to -0.01; four trials, 600 women; moderate-certainty evidence). However, for self-efficacy, there may be no evidence of a difference between groups (SMD -0.12, 95% CI -0.33 to 0.09; one trial with medium-term follow-up data, 346 women; low-certainty evidence). Further, there may be no difference between the number of women who dropped out from the experimental or comparator intervention groups, an indicator of no harm (OR 1.04, 95% CI 0.75 to 1.44; five trials with medium-term follow-up data, 840 women; low-certainty evidence). Although no trials reported adverse events from psychological therapies or participation in the trial, only one trial measured harm outcomes using a validated scale. For secondary outcomes, trials measured anxiety only at short-term follow-up, showing that psychological therapies may reduce anxiety symptoms (SMD -0.96, 95% CI -1.29 to -0.63; four trials, 158 women; low-certainty evidence). However, within medium-term follow-up, low-certainty evidence revealed that there may be no evidence between groups for the outcomes safety planning (SMD 0.04, 95% CI -0.18 to 0.25; one trial, 337 women), post-traumatic stress disorder (SMD -0.24, 95% CI -0.54 to 0.06; four trials, 484 women) or re-exposure to any form of IPV (SMD 0.03, 95% CI -0.14 to 0.2; two trials, 547 women). AUTHORS' CONCLUSIONS: There is evidence that for women who experience IPV, psychological therapies probably reduce depression and may reduce anxiety. However, we are uncertain whether psychological therapies improve other outcomes (self-efficacy, post-traumatic stress disorder, re-exposure to IPV, safety planning) and there are limited data on harm. Thus, while psychological therapies probably improve emotional health, it is unclear if women's ongoing needs for safety, support and holistic healing from complex trauma are addressed by this approach. There is a need for more interventions focused on trauma approaches and more rigorous trials (with consistent outcomes at similar follow-up time points), as we were unable to synthesise much of the research.


Assuntos
Ansiedade/terapia , Depressão/terapia , Violência por Parceiro Íntimo/psicologia , Psicoterapia/métodos , Transtornos de Estresse Pós-Traumáticos/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/diagnóstico , Depressão/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade , Pacientes Desistentes do Tratamento , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Segurança , Autoeficácia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto Jovem
20.
BMC Public Health ; 20(1): 937, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32611321

RESUMO

BACKGROUND: The study aimed to investigate the associations between physical partner violence victimization (IPV) and/or sexual violence victimization and various health risk behaviours and mental health in university students in 25 countries. METHODS: Using a cross-sectional study design, 18,335 university students with a median age of 20 years from 25 countries in Africa, the Americas and Asia, replied to self-reported measures of interpersonal violence, health compromising behaviours, mental health measures and protective factors. RESULTS: In adjusted logistic regression analysis, physical IPV and/or sexual violence victimization was associated, among men and/or among women, with sexual risk behaviours (multiple sexual partners, alcohol use in the context of sex, diagnosed with HIV and pregnancy), violence related behaviour (in a physical fight and carrying a weapon), poor mental health (depression, loneliness, post-traumatic stress disorder, sleeping problem and short sleep), addictive behaviour (binge drinking, tobacco and drug use), and other health risk behaviour (skipping breakfast and frequent salt intake). CONCLUSIONS: We found evidence that physical IPV and/or sexual violence victimization among female and/or male university students was associated with 4 of 5 sexual risk behaviours, 2 violence related behaviours, 5 of 5 poor mental health indicators, 3 of 3 addictive behaviours and 2 of 7 other health risk behaviours.


Assuntos
Vítimas de Crime/psicologia , Comportamentos de Risco à Saúde , Violência por Parceiro Íntimo/psicologia , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Delitos Sexuais/psicologia , Estudantes/psicologia , Adulto , África/epidemiologia , Ásia/epidemiologia , Vítimas de Crime/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Violência por Parceiro Íntimo/estatística & dados numéricos , Masculino , Gravidez , Fatores de Risco , Autorrelato , Delitos Sexuais/estatística & dados numéricos , América do Sul/epidemiologia , Estudantes/estatística & dados numéricos , Universidades , Índias Ocidentais/epidemiologia , Adulto Jovem
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