Enhanced Versus Basic Referral for Intimate Partner Violence in an Urban Emergency Department Setting.

BACKGROUND: Victims of intimate partner violence (IPV) frequently do not disclose abuse to medical providers. Therefore, research has examined the most effective screening and referral methods to help identify victims of abuse and connect them to needed resources. OBJECTIVES: To determine the efficacy of referrals intended to connect IPV victims with behavioral health resources, while taking into consideration demographic and mental health variables. METHODS: We examined a convenience sample of medically stable individuals in an emergency department setting. Participants were given the Mini-International Neuropsychiatric Interview and Partner Violence Screen measures to assess mental health and IPV victimization. Individuals that screened positive were randomized to a basic or enhanced referral and given a follow-up interview to determine referral success. Referrals were considered successful if an individual scheduled an appointment with provided behavioral health resources within the follow-up interval. RESULTS: Two-hundred and one individuals were enrolled. Forty-one (20.4%) participants screened positive for IPV victimization. Male and female participants in the enhanced referral group were more likely to have a successful referral than those in the basic referral group, with a large effect size such that 72.7% of participants in the enhanced referral and 15.7% of participants in the basic referral group contacted referral resources. Both referral type and marital status significantly predicted referral success. CONCLUSION: Comorbidity with mental health concerns measured as high within those that screened positive for IPV victimization. The enhanced referral showed to be an effective way to encourage participants to contact behavioral health resources.

Physical Intimate Partner Violence Concordance Rates in Couples: Does CTS2 Item Order Matter?

Intimate partner violence (IPV) concordance rates between partners are low across national, community, and clinical samples. Discordance between partners' IPV reports is problematic given that self-report questionnaires, such as the CTS2, are commonly used to assess IPV. Moreover, most research is based solely on the report of one partner. Some have attributed this discordance to how CTS2 items are presented. The CTS2 presents items inquiring on the frequencies of perpetration by oneself and then one's partner in pairs. The present study examined whether IPV concordance rates improve if couples are administered a version of the CTS2 where all items assessing their partner's behaviors are presented first, followed by items assessing the respondents' behaviors. Additionally, the present study examined whether correlations between self-reported and partner-reported perpetration and victimization differ depending on the order in which CTS2 items are presented. Two samples of heterosexual couples were recruited from a large metropolitan area in the United States. The first sample was administered the CTS2 in its usual format. The second sample was administered a version of the CTS2 that presented items on one's partners' behavior first, followed by self-reported behavior. Results revealed that concordance rates among violent couples were higher in the group administered the CTS2 in its altered format, particularly agreement on male IPV perpetration. However, when agreement on minor and severe IPV was examined separately, concordance rates between groups were relatively similar for severe IPV. These findings suggest that altering the item presentation of the CTS2 may improve the interrater reliability of the Physical Assault Scale of the CTS2. Additional results are discussed.

Risk Factors of Female-Perpetrated Intimate Partner Violence among Hispanic Young Adults: Attachment Style, Emotional Dysregulation, and Negative Childhood Experiences.

This paper examined whether risk factors commonly associated with intimate partner violence (IPV) are associated with female-perpetrated physical IPV and female physical IPV victimization among young Hispanic women. It also examined how emotion dysregulation, impulsivity, and attachment style exacerbated these relationships. Furthermore, it investigates how these associations differ by the type of self-reported physical violence against their romantic partner. Based on the participants' self-reported physical violence, they were classified into one of four groups: nonviolent, victim-only, perpetrator-only, and bidirectionally violent. Bidirectional violence was by far the most common form of violence reported. Utilizing self-report data from 360 young Hispanic women, we used binary logistic regression to examine potential predictors of physical IPV perpetration and victimization for each group. Results demonstrated that women in the bidirectionally violent group reported the highest levels of perpetration and victimization. Parental violence victimization, witnessing interparental violence, insecure attachment styles, and emotional dysregulation predicted physical IPV perpetration and victimization. These findings emphasize the need for effective interventions that include both members of the dyad and acknowledge the impact of women's attachment style, emotion dysregulation, and adverse childhood experiences on female-perpetrated IPV and female IPV victimization.

Attachment, Emotion Dysregulation, and Physical IPV in Predominantly Hispanic, Young Adult Couples.

Insecure attachment has been found to be a risk factor for perpetrating physical intimate partner violence (IPV). However, this association is likely exacerbated by additional factors, such as conflicting insecure attachment in one's partner and difficulties with overall emotion regulation and impulse control. The present study aimed to examine the associations between insecure attachment and physical IPV perpetration in male and female partners, as well as to examine whether these associations are exacerbated by involvement with a partner with opposing attachment needs and overall emotion dysregulation and impulsivity. Additionally, this study examined whether partners' emotion dysregulation interacted to predict IPV. Two hundred eight heterosexual couples primarily recruited from a Hispanic-serving university completed questionnaires on attachment, emotion dysregulation, and one's own and one's partner's perpetration. Results revealed that attachment anxiety, impulsivity, and an interaction effect between attachment avoidance and partner's attachment anxiety were associated with self-reported, but not partner-reported, male perpetration. For females, attachment anxiety was associated with female IPV (self-reported and partner-reported), and impulsivity was associated with self-reported female IPV. Overall, results underscore how relationships between known risk factors and IPV perpetration may differ depending on if IPV perpetration is measured using self-reported or partner-reported data. Additional results and implications are discussed.

Stability of the Severity of Intimate Partner Violence.

Prior research with a sample of male probationers indicates severity levels of one arresting intimate partner violence (IPV) offense are predictive of future frequency of such offenses and treatment completion. This study is an extended analysis looking at severity ratings across two IPV offenses to measure violence stability. The stability of IPV severity levels was analyzed in a sample of offenders in Lake County, Illinois. Offender subtypes of generally violent (GV) men and family only (FO) violent men were incorporated into stability analyses using generalized linear mixed modeling (GLMM) to determine whether certain types of offenders vary in violence levels over time. The purpose was to determine the predictive utility of using a single offense to determine the domestic violence trajectory for male probationers. Reoffense records of 80 men were collected from a larger sample of 352 males, ages 17 to 72 placed on probation in Lake County, Illinois, between 2006 and 2008. Severity of offenses was coded dichotomously based on a behaviorally derived measure. Results demonstrate 64% of reoffenders remained stable in IPV severity. Overall, severity levels decreased across time. This is the first study to use a probationary sample of men to analyze violence stability trends over time. This study confirms the utility of measuring a single offense to predict future violence trajectories for IPV offenders.

Is All Dating Violence Equal? Gender and Severity Differences in Predictors of Perpetration.

The present study assesses the extent of perpetration of physical violence in predominately Hispanic high school students in the Rio Grande Valley, Texas. The relationship between adverse childhood experiences, exposure to interparental violence, attachment, emotion regulation, and impulsivity on two distinct, mutually exclusive, categories of severity of physical teen dating violence (TDV) perpetration is further explored. Participants completed self-report measures as part of a larger, anonymous web-based questionnaire. Two categories (i.e., minor/moderate and severe) were created to discern the contextual variables associated with different levels of severity of physical violence perpetration by males and females. Eight-hundred and twenty-nine 14- to 18-year-old adolescents from four different high schools participated in the study, of whom 407 reported having been in a dating relationship in the last 12 months. The results demonstrate that when only the most severe item of TDV is taken into consideration, the rates of violence perpetration by males and females are almost equal and remarkably lower than those reported in the literature. However, when the assessment includes minor/moderate levels of violence, such as pushing, the rates of violence perpetration by females are twice those of males and are consistent with those reported in the literature. Furthermore, different variables are associated with different levels of severity of violence perpetration. The results support approaches that emphasize the need to take the context of the violence into consideration, since all levels are not equal. The need to take the severity of violence into account in studies assessing dating violence is highlighted.

The Impact of Perpetrator Characteristics on the Completion of a Partner Abuse Intervention Program.

This study examined how type of perpetrator (family only [FO] vs. generally violent [GV]), readiness to change, and stake in conformity function separately and together in predicting completion of a partner abuse intervention program (PAIP). Data were collected from 192 male perpetrators of intimate partner violence (IPV) who were court mandated to attend a PAIP. Participants were categorized as FO violent or GV based on a combination of their self-report and official records of violence. Stake in conformity has been defined as the degree to which an individual is invested in the values and institutions of a society. A composite stake in conformity score was computed for each participant based on his education level, and marital and employment status. Each participant was also assigned a stage of change score based on his responses on a validated measure of stage of change for domestic violence perpetrators. Analyses indicated that stage of change was not related to program completion or attendance. Type of perpetrator and stake in conformity composite score were significantly related to program completion. Perpetrators with higher stake in conformity scores and individuals categorized as FO attended more PAIP sessions and were more likely to complete the program. When both predictors were examined together, only stake in conformity composite score uniquely predicted program attendance and completion. These findings provide additional evidence that subtype of IPV perpetrator has implications for treatment responsiveness and provide preliminary evidence for the value of improved measurement of investment in societal institutions.

Treatment impact on recidivism of family only vs. generally violent partner violence perpetrators.

BACKGROUND/OBJECTIVE: The outcome of a treatment program for a large sample of male perpetrators on probation for intimate partner violence (IPV) was evaluated with particular reference to the differential impact on family only (FO) versus generally violent (GV) perpetrators. METHOD: Official rates of recidivism for three years post termination of treatment and probation were examined for 456 perpetrators after they were classified as FO and GV. RESULTS: Both treatment completion and type of perpetrator were predictive of IPV recidivism and time to recidivism. However, analyses conducted separately for the two groups indicated that participation in the intervention predicted both recidivism and time to recidivism for the GV but not FO perpetrators who participated in treatment. Specifically, GV men were responsive to treatment whereas FO men were not. Results were somewhat different depending on who was included in the no treatment comparison group. CONCLUSIONS: Implications of these findings for one size fits all interventions in IPV are discussed with specific reference to the need to develop different interventions for GV and FO perpetrators.

ANTECEDENTES/OBJETIVO: El resultado de un programa de intervención para una muestra de agresores masculinos en libertad condicional por violencia contra su pareja intima (VPI) fue evaluado con particular referencia al impacto diferencial en agresores de familia solamente (AF) y agresores generalmente violentos (GV). MÈTODO: Las tasas oficiales de reincidencia durante tres años después de la terminación del tratamiento y de la libertad condicional fueron examinadas en 456 agresores después de ser clasificados como AF y GV. RESULTADOS: Tanto completar la intervencion como el tipo de agresor fueron predictores de la reincidencia de la VPI y del tiempo para reincidir. Sin embargo, el análisis de los dos grupos por separado mostró que la intervención predijo tanto la reincidencia como el tiempo para reincidir en los agresores GV pero no para los agresores AF que participaron en el tratamiento. Específicamente, los hombres GV fueron receptivos al tratamiento mientras que los hombres AF no lo fueron. Los resultados fueron algo diferentes dependiendo de quién fue incluido en el grupo de contraste. CONCLUSIONES: Se discuten las implicaciones de estos resultados para intervenciones de una misma talla en VPI con especial atención a la necesidad de desarrollar diferentes intervenciones para los agresores GV y los AF.

Exposure to violence, typology, and recidivism in a probation sample of domestic violence perpetrators.

The present study investigated the predictive utility of self-reported domestic violence perpetrators' exposure to violence in their family of origin and patterns related to this exposure through the use of longitudinal analyses on a sample of 228 men on probation in Lake County, Illinois. Differences in typology, recidivism, recidivism frequency, and violent behavior survival patterns in men with a history of domestic violence perpetration and with varying levels of family of origin violence exposure were examined. Findings suggest that those who witnessed interparental violence (either alone, or in combination with experiencing violence) were most likely to be classified as Generally Violent offenders (e.g., perpetrators who direct violence toward their family and others), compared to those who did not report experiencing or witnessing violence. In addition, results also indicate that men who experienced both witnessing interparental violence and receiving physical abuse in childhood were more likely to recidivate more frequently compared to those who did not report experiencing or witnessing violence. No significant findings for typology and recidivism were noted. Clinical and policy/practice implications are discussed.

Subtypes of batterers in treatment: empirical support for a distinction between type I, type II and type III.

This study explores the existence of different types of batterers in a sample of 266 men who had been court referred for intimate partner violence. The data collected in the assessment that have been used to perform a hierarchical and a two-step cluster analysis fall into three areas: aggression towards the partner, general aggression and presence of psychopathology and personality traits, more specifically, alcohol use, borderline and antisocial personality traits, psychopathy traits, state anger and trait anger, anger expression and control, anger, hostility, and, finally, impulsivity. The results show a typology consisting of 3 types of batterers on the basis of violence level and psychopathology: low (65%), moderate (27.8%) and high (7.1%). This study provides empirical support for the development of batterer typologies. These typologies will help achieve early detection of different types of batterers, allowing us to tailor interventions on the basis of the needs of each of the types.