Perceptions of firearms in a cohort of women exposed to intimate partner violence (IPV) in Central Pennsylvania.

BACKGROUND: Almost one-half of U.S. women will experience intimate partner violence (IPV), defined as physical, sexual, or psychological harm by a current or former partner. IPV is associated with an increased risk of homicide, with firearms as the most commonly used weapon. We designed this study to better understand the correlation of interpersonal trauma exposures and demographic factors on firearm perceptions among a cohort of IPV-exposed women. METHODS: Two hundred sixty-seven women in central Pennsylvania with exposure to IPV were surveyed about perceptions of gun access, safety, and gun presence in the home. Trauma variables included IPV type, IPV recency, unwanted sexual exposure, and adverse childhood experiences (ACEs). Multivariable analyses examined three questions examining firearm perceptions controlling for trauma exposures and demographics. RESULTS: Ease of firearm acquisition: Women who were older (mean 44.92 years +/- SD 12.05), compared to women who were younger (40.91 +/- SD 11.81 years) were more likely to describe it as easy or very easy to acquire a gun (aOR 1.05, 95%CI 1.004, 1.10). Perceived safety in the proximity of a gun: Women with the highest ACE score were less likely to feel safe with a gun nearby (aOR 0.31, 95%CI 0.14, 0.67). Odds of guns in the home: Women who were divorced or separated (aOR 0.22, 95%CI 0.09, 0.54), women were widowed or single (aOR0.23, 95%CI 0.08, 0.67), and women who were partnered (aOR 0.45 95%CI 0.20, 0.97) had lower odds of having a gun in the home, compared to married women. There was no significant effect of the trauma variables on the odds of having a gun at home. CONCLUSIONS: Women with more severe childhood trauma felt less safe around firearms, but trauma exposures did not predict the perception of gun prevalence in the local community or gun ownership. Instead, demographic factors of marriage predicted presence of a gun in the home.

Violence against women in Primary Health Care: Potentialities and limitations to identification.

OBJECTIVE: To determine the potential and limitations of Primary Health Care professionals to identify situations of violence against women. LOCATION: A municipality of Rio Grande do Sul, Brazil. DESIGN: Descriptive and exploratory study with a qualitative approach. PARTICIPANTS: Twenty-one health professionals of three Family Health Strategy units, as well as one Basic Health Unit. The inclusion criterion consisted of being a health worker in these services. The exclusion criterion was to be absent from work by any kind type license during the period of data production. METHOD: The technique used to produce data was individual, semi-structured, interviews in order to collect sociodemographic data and the monitoring by professionals related to the potentials and limitations to identify violence situations. The data collection was suspended based on the saturation criterion. The data were systematized and analyzed by the content analysis technique, according to the analytical categories of health care network and gender. RESULTS: The potential to identify themes were: professional experience, receptive atmosphere, bonding, and listening to the reports of women, children and/or neighbors and observing their behavior; to identify the lesions; prenatal consultations; and home visits. As to the limitations: silence, denial/non-recognition of violence, lack of complaints by women; fear and guilt; flaws and unpreparedness of the health team; and fear due to the presence of aggressor. CONCLUSIONS: It is urgent to recognize the potential of Primary Care and to promote the qualification of professionals in order to identify the situation among visible and invisible complaints, leading to the confrontation of violence.

Priorities and strategies for improving Roma women's access to primary health care services in cases on intimate partner violence: a concept mapping study.

BACKGROUND: With an explicit focus on Roma women in Spain (Kale/Spanish Gypsies), this study aims to integrate key informants' opinions about the main actions needed to improve primary health care services' and professionals' responses to Roma women in an Intimate Partner Violence (IPV) situation. METHODS: Concept mapping study. A total of 50 (brainstorming phase), 36 (sorting and rating phase) and 16 (interpretation phase) participants from Roma civil society groups, primary health care professionals and other related stakeholders (social services, academic experts and other IPV NGOs representatives) from different cities in Spain were involved in the different study phases. RESULTS: Among the 55 action proposals generated, ten priority actions were identified through consensus as most important for improving primary health care's response to Romani women in an IPV situation, and these included primary, secondary and tertiary prevention activities. CONCLUSION: Results indicated that efforts to address this challenge should take an integrated approach that reinforces the primary health care response to IPV in general, while also promoting more specific actions to address barriers to access that affect all Roma women and those who experience IPV in particular.

Violence against women and cervical cancer screening: a systematic review.

AIMS AND OBJECTIVES: To present a systematic review of papers published on the relationship between violence against women and cervical cancer screening. BACKGROUND: Violence against women is a serious public health problem. This phenomenon can have negative effects on victims' health and affect the frequency at which they receive cervical cancer screening. DESIGN: A systematic literature review. METHODS: This study was carried out in October 2015 with searches of the Lilacs, PubMed and Web of Science databases using the following keywords: violence, domestic violence, battered women, spouse abuse, Papanicolaou test, vaginal smears, early detection of cancer and cervix uteri. RESULTS: Eight papers published between 2002-2013 were included in this review, most of which were cross-sectional studies. Three studies found no association between victimisation and receiving Pap testing, and five studies reported an association. These contradictory results were due to higher or lower examination frequencies among the women who had experienced violence. CONCLUSION: The results of this study indicate that the association between violence against women and cervical cancer screening remains inconclusive, and they demonstrate the need for more detailed studies to help clarify this relationship. RELEVANCE TO CLINICAL PRACTICE: Professionals who aid women should be knowledgeable regarding the perception and detection of violence so that they can interrupt the cycle of aggression, which has harmful impacts on victims' health.

Prevalence of intimate partner violence in Spain: A national cross-sectional survey in primary care.

OBJECTIVES: (1) To analyze the prevalence of Intimate Partner Violence by types. (2) To examine the relationship between sociodemographic characteristics and Intimate Partner Violence. DESIGN: Cross-sectional study using a self-administered questionnaire. SETTING: Primary Healthcare centers in Spain. PARTICIPANTS: 10,322 women (18-70 years) attending Primary Healthcare centers. MAIN MEASUREMENTS: A compound index was calculated based on frequency, types, and duration of Intimate Partner Violence. Multivariable adjusted logistic regression models were used to identify the sociodemographic factors, which were independently associated with each Intimate Partner Violence category. RESULTS: The prevalence of Intimate Partner Violence was 24.8%. For the physical only category, no differences were observed regarding education or employment status, and women with the highest income have less risk. For the psychological only category, no differences were observed according to the income level. The risk increases as the education level decreases, and the greatest frequency of only psychological Intimate Partner Violence was observed in women who were unemployed or students. For both the physical and psychological category of Intimate Partner Violence, a clear risk increase is observed as income and education levels decrease. Retired women showed the highest frequency of this violence category. CONCLUSION: The results show that Intimate Partner Violence affects women of all social strata, but the frequency and Intimate Partner Violence category will vary according to the socio-economic.

Association of intimate partner violence and health-care provider-identified obesity.

The association of physical and nonphysical intimate partner violence (IPV) with obesity was examined. Women (N = 1,179) were surveyed regarding demographics, obesity, and IPV exposure using humiliate-afraid-rape-kick (HARK), an IPV screening tool. A three-level lifetime IPV exposure variable measured physical, nonphysical or no IPV. Health-care provider-identified obesity was defined if participants were told by a medical provider within the past 5 years that they were obese. Bivariate analyses examined obesity by IPV and demographics. Multivariable logistic regression assessed odds of obesity by IPV type, adjusting for age, race/ethnicity, education, and marital status. Among participants, 44% reported lifetime IPV (25% physical, 19% nonphysical), and 24% reported health-care provider-identified obesity. In unadjusted analyses, obesity was more prevalent among women exposed to physical IPV (30%) and nonphysical IPV (27%), compared to women without IPV (20%, p = .002). In multivariable models, women reporting physical IPV had 1.67 times greater odds of obesity (95% confidence interval [CI] 1.20, 2.33), and women reporting nonphysical IPV had 1.46 times greater odds of obesity (95% CI 1.01, 2.10), compared to women reporting no exposure. This study extends prior data by showing, not only an association between physical IPV and obesity, but also an association between obesity and nonphysical IPV.

Barriers and facilitators to effective coverage of Intimate Partner Violence services for immigrant women in Spain.

OBJECTIVE: To explore service providers' perceptions in order to identify barriers and facilitators to effective coverage of Intimate Partner Violence (IPV) services for immigrant women in Spain, according to the different categories proposed in Tanahashi's model of effective coverage. METHODS: A qualitative study based on 29 in-depth personal interviews and four group interviews with a total of 43 professionals working in public services (social and health-care services, women's refuges, the police force, the judiciary) and NGOs in Barcelona, Madrid, Valencia and Alicante (Spain) in 2011. FINDINGS: Current IPV services in Spain partially fail in their coverage of abused immigrant women due to barriers of (i) availability, such as the inexistence of culturally appropriate services; (ii) accessibility, as having a residence permit is a prerequisite for women's access to different services and rights; (iii) acceptability, such as women's lack of confidence in the effectiveness of services; and (iv) effectiveness, for example, lack of specific training among professionals on the issues of IPV and immigration. However, interviewees also identified facilitators, such as the enabling environment promoted by the Spanish Law on Gender-Based Violence (1/2004), and the impetus it has provided for the development of other specific legislative tools to address IPV in immigrant populations in Spain (availability, accessibility and effectiveness). CONCLUSION: Whilst not dismissing cultural barriers, aspects related to service structure are identified by providers as the main barriers and facilitators to immigrant women use of IPV services. Despite noteworthy achievements, improvements are still required in terms of mainstreaming assistance tailored to immigrant women's needs in IPV policies and services.

Intimate partner violence: relationships between alexithymia, depression, attachment styles, and coping strategies of battered women.

INTRODUCTION: One of the most common forms of violence against women is the intimate partner violence (IPV). This term includes physical, sexual, and emotional abuse and controlling behaviors by an intimate partner. AIM: This exploratory study investigates the relationship between alexithymia, adult attachment styles, depression, and coping strategies in a group of female victims of IPV and a control group. METHODS: Participants were 80 female victims of IPV with an age range from 18 years to 54 years (mean 31.62; standard deviation 9.81). The control group included 80 women with no history of IPV with an age range from 19 years to 37 years (mean 25.05; standard deviation 3.67). MAIN OUTCOME MEASURES: We administered the following self-report questionnaires: (i) 20-Item Toronto Alexithymia Scale (TAS-20); (ii) Coping Orientation Problems Experienced; (iii) Beck Depression Inventory (BDI)-II; and (iv) Attachment Style Questionnaire (ASQ). RESULTS: Compared with control group, the IPV group showed higher mean scores on TAS-20 (52.9 vs. 41.1, P < 0.001) and BDI-II (19.50 vs. 9.95, P < 0.001). In both groups, we found significant correlations between BDI-II and TAS-20 total scores (P < 0.001) and between BDI-II and the following dimensions of ASQ: confidence (P < 0.001), discomfort with closeness (P = 0.002), relationships as secondary (P < 0.001), need for approval (P < 0.001), and preoccupation with relationships (P < 0.001). Differently from the control group, in the IPV group, social support correlated significantly and positively (P < 0.001) with the dimension preoccupation with relationships on ASQ, but not with the secure attachment style. CONCLUSIONS: In comparison to the control group, alexithymia, depressive symptoms, and an insecure attachment style were negatively correlated with the ability to cope with stress for women in the IPV group.

Exploring the Relationships Between Rehabilitation and Survivors of Intimate Partner Violence: A Scoping Review.

Intimate partner violence (IPV) is a public health crisis affecting one in three women and one in ten men in their lifetimes. Rehabilitation professionals are highly likely to encounter survivors of IPV in their practice; yet, there exists no formal review assessing the relationship between IPV and rehabilitation. Our objective was to understand the types and contexts of rehabilitation care currently available for survivors of IPV, opportunities identified in the literature for rehabilitation care, and IPV awareness and education among rehabilitation providers. A search strategy related to IPV and four rehabilitation professionals of interest (occupational therapy, physiotherapy, speech-language pathology/therapy, and physiatry) was developed across 10 databases and complemented by a gray literature search. Two reviewers independently assessed articles for inclusion. In all, 44 articles met inclusion criteria, ranging from primary research articles (48%) to clinical newsletters. Included articles predominantly focused on opportunities for rehabilitation care (68%) and occupational therapists as a profession (68%). A minority of studies examined specific interventions for IPV survivors (18%) or assessed for knowledge and attitudes about IPV (16%) among rehabilitation professionals. To our knowledge, this is the first scoping review exploring the rehabilitation literature for IPV survivors. These findings show an awareness of IPV among rehabilitation professionals, the importance of identifying IPV in clients, and the ways in which rehabilitation professionals are uniquely situated to support survivors of IPV. There remains an opportunity to explore interventions designed specifically for IPV survivors.

Arrest Web Entanglement: Female Domestic Violence Survivors' Experiences with Police Intervention and Coercively Controlling Male Partners.

Although U.S.-based mandatory and preferred arrest laws and policies were created to promote domestic violence survivors' safety, at times they have contributed to the wrongful arrest of women defending themselves against their abusive partners. While these laws and policies are the subject of broad critique, less considered are domestic violence survivors' descriptions of the events that unfold after police officers respond to a domestic violence incident and before they make an arrest. This is an important area of inquiry as these events may highlight how the circumstances leading to wrongful arrest decisions are more complex than the laws and policies alone. Data from the present study came from the author's larger in-depth qualitative investigation of 33 cisgender women's descriptions of their legal and child protection systems involvement. The women were recruited from an antiviolence intervention agency receiving referrals from communities with mandatory and preferred laws and policies. The women had agency contact due to their use of force or alleged use of force. The respondents were diverse across race, age, class, ability, U.S. citizenship status, and sexual identity. The author analyzed the 33 women's 51 interview transcripts and extensive fieldnotes using rigorous iterative analysis and constructivist grounded theory. The analysis revealed that seven of the 33 women, all of whom identified domestic and sexual violence survivorship histories, described a patterned series of events that unfolded after the police arrived at the domestic violence incident and before the police made an arrest. In this study, the author details three of the seven women's stories to demonstrate how a series of events, including police prearrest questioning and their coercively controlling male partners' tactics, facilitated the women's entanglement in what the author refers to as an "arrest web." Their incremental disentanglement from the arrest's impact is also explored. Broad system-focused implications are discussed.

How to Evaluate Reports of Intimate Partner Violence? Examining Interpartner Agreement in a Forensic Sample of Different-Sex Couples Where Men are Accused of Intimate Partner Violence.

Research about interpartner agreement on intimate partner violence (IPV) is mainly based on community and clinical samples, with forensic or court-related samples being overlooked. This study assesses interpartner agreement on IPV reports based on the Revised Conflict Tactic Scales, aiming to explore if the proxy method would be reliable in a court-related setting. The study sample comprised 62 different-sex couples identified in the Portuguese judicial system due to an IPV-related crime perpetrated by men. Agreement was assessed based on different indexes: percent agreement and Gwet's AC1 for occurrence, and Tau-b and intraclass correlations for frequency. Men's and women's perpetration were considered. Results showed that interpartner agreement on IPV occurrence (ranging from poor-to-very good) tended to be higher and more consistent among indexes than agreement on IPV frequency (ranging from non-existent to strong). This study highlights the need to collect both partners' reports in court-related settings.

The Effect of Mindfulness-Based Empowerment Program on Self-Compassion, Self-Esteem and Ways of Coping With Stress of Women Experienced Violence: A Randomised Controlled Study.

The aim of this experimental research is to assess the impact of a mindfulness-based empowerment program applied to women who have experienced violence on their levels of self-compassion, self-esteem and coping with stress. The study was a randomised controlled trial with a control group. Participants were randomly assigned to the experimental group (EG, n1 = 27) and the control group (CG, n2 = 26) from women who had experienced violence. Descriptive statistical methods and t-tests for dependent and independent groups were employed in data analysis. After the mindfulness-based empowerment program, the intervention group exhibited a statistically significant high effect size in post-intervention measurements compared to the control group for the Self-Compassion Scale, Coopersmith Self-Esteem Inventory and Coping Styles Scale total and subscale mean scores (p < 0.001). The mindfulness-based empowerment program has been found to enhance self-compassion, self-esteem and coping levels in women who have experienced violence. Therefore, it is recommended to promote the widespread adoption of mindfulness-based interventions for individuals who have undergone trauma, such as violence, to facilitate their re-empowerment and functional recovery. Trial Registration: ClinicalTrials.gov identifier: NCT05310656.

Psychosocial dimensions of being a child in women's shelters: A phenomenological study on the experiences of battered women - A case study from Türkiye's Northern Region.

BACKGROUND: Violence against women has numerous devastating effects. Exposure to violence not only impacts women but also affects their children both physically and psychosocially. AIMS: The study aimed to evaluate the psychosocial problems of children living with their mothers in women's shelters from the mothers' perspective with a phenomenological approach. METHODS: Utilizing the phenomenological research method, semi-structured in-depth interviews were conducted with 14 individuals in a women's shelter in a province in northern Türkiye. The criterion sampling method, a purposive sampling technique, was employed to select participants. Interviews continued until data saturation was achieved. All interviews were audio recorded and then transcribed, and thematic analysis was applied to analyze the data. The study adhered to the COREQ checklist for reporting. RESULTS: The data analysis revealed four main categories (effects of violence on the mother, actions taken to protect children from violence, effects of violence and staying in a shelter on the child, and psychosocial needs for the protection of the child's mental health in the shelter) and 10 sub-themes (psychological effects, physical effects, social effects, domestic actions, organizational actions, psychological effects, physical effects, social effects, support system, and coping). CONCLUSION: The study concluded that violence significantly impacted the mental, physical, and social well-being of both women and children, posing challenges to their ability to cope with the aftermath. Women exerted considerable effort in protecting their children from violence, and they needed psychosocial support to ensure the well-being of their children's mental health during their stay in shelters.

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

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

Global Prevalence and Mental Health Outcomes of Intimate Partner Violence Among Women: A Systematic Review and Meta-Analysis.

The aim of this systematic review was to assess the magnitude of the association between types of intimate partner violence (IPV) and mental health outcomes and shed light on the large variation in IPV prevalence rates between low- to middle-income countries and high-income countries. The study is a systematic review and meta-analysis. The following databases were searched for this study: Cochrane, MEDLINE, EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and the Applied Social Sciences Index and Abstracts. The inclusion criteria for this study are as follows: quantitative studies published from 2012 to 2020 on IPV exposure in women aged 16+, using validated measures. Random effects meta-analyses and subgroup analysis exploring heterogeneity across population groups in different economic contexts are used in this study. In all, 201 studies were included with 250,599 women, primarily from high-income countries. Higher prevalence rates were reported for women's lifetime IPV than past year IPV. Lifetime psychological violence was the most prevalent form of IPV. Women in the community reported the highest prevalence for physical, psychological, and sexual violence in the past year compared to clinical groups. Perinatal women were most likely to have experienced lifetime physical IPV. Prevalence rates differed significantly (p = .037 to <.001) for "any IPV" and all subtypes by income country level. Meta-analysis suggested increased odds for all mental health outcomes associated with IPV including depression (odds ratio [OR] = 2.04-3.14), posttraumatic stress disorder (PTSD) (OR = 2.15-2.66), and suicidality (OR = 2.17-5.52). Clinical and community populations were exposed to high prevalence of IPV and increased likelihood of depression, PTSD, and suicidality. Future research should seek to understand women's perspectives on service/support responses to IPV to address their mental health needs. Work with IPV survivors should be carried out to develop bespoke services to reduce IPV in groups most at risk such as pregnant and/or help-seeking women.

Explaining Suicide Among Indian Women: Applying the Cultural Theory of Suicide to Indian Survivors of Gender-Based Violence Reporting Suicidal Ideation.

Indian women account for 36.6% of suicide-related deaths worldwide and gender-based violence (GBV) is a key social determinant. The cultural theory of suicide (CTS), which synthesizes risk factors and explanations of suicide among racial/ethnic minorities, posits four tenets: idioms of distress, cultural sanctions, and social discord. Our study applied the CTS to Indian women from slums reporting GBV to explore (1) culturally relevant risk pathways towards suicidal ideation using qualitative analyses, and test (2) the association between idioms of distress and suicidal ideation. 112 women from urban slums were recruited and 99 completed surveys. A subset were administered qualitative interviews. Aim 1 explored the CTS framework among participants describing suicidal ideation in qualitative interviews [n = 18]; Aim 2 explored if idioms of distress severity was associated with suicidal ideation through an ANCOVA [N = 99]. Idioms of distress such as 'tension' indicated suicidal ideation. Communities did not sanction suicidal ideation, leading to secrecy regarding disclosure. Women in 'love marriages' (versus arranged marriages) reported minority stress. Social discord heightened suicidal thoughts. Results of the ANCOVA confirmed that women reporting suicidal ideation had higher idioms of distress severity (M = 28.56, SD = 6.37), compared to women who did not (M = 21.77, SD = 6.07), F(1, 96) = 28.58, p < .001 (ηp2 = .23). Our study empirically validates the CTS among Indian GBV survivors. Culturally responsive suicide prevention can include assessing idioms of distress, improving family support, and educating to reduce stigma and enhance help-seeking.

Mental Health, Race, and Social Support among Women Survivors of Intimate Partner Violence.

Women with mental health (MH) symptoms are more vulnerable to the adverse effects of intimate partner violence (IPV). Social support (SS) helps those women cope with adversities and regain their overall well-being. Examining specific sources and functions of SS will help expand knowledge about resources for and barriers to MH services for women IPV survivors. However, few studies examined functional and relational SS among women IPV survivors residing in shelters. This cross-sectional study examined how 31 racially diverse women IPV survivors with different MH symptoms perceive relational SS from various sources as they stay in a shelter that provides functional SS. Cluster analyses were performed to classify participants into two groups: more MH or fewer MH symptoms. Results showed that the women with more MH symptoms reported higher tangible support than those with fewer MH symptoms. Results from ANCOVA showed a significant cross-over interaction between MH and race for overall SS, indicating that women of color with more MH symptoms were less likely to perceive overall SS than Caucasians when controlling for functional SS. MANCOVA analyzed the specific sources of overall SS, such as family, friends, and others. There was a significant cross-over interaction of MH and race on SS from others when controlling for functional SS. These findings suggest that women IPV survivors of color who experience more MH symptoms perceive support from others as less supportive and trustworthy. Social service providers must provide culturally sensitive and strengths-based SS programs to help women of color who have experienced social isolation, stigma, and shame associated with IPV and mental illnesses (MIs). They also must engage in community outreach programs by educating community members about the needs and rights of women IPV survivors with MIs and collaborating to build communities that promote safety, trust, diversity, equity, and inclusion.

Interparental Coercive Control and Child and Family Outcomes: A Systematic Review.

Coercive control (CC) is a core facet of intimate partner violence (IPV) and involves asserting power, dominance, and control over another person. Although the adverse impacts of childhood exposure to interparental IPV have been well documented, the outcomes of childhood exposure to interparental CC have not been systematically examined. This study aimed to address this gap by reviewing available empirical evidence on interparental CC and child and family outcomes. Articles were identified by searching electronic databases using keywords relating to CC, children and parents, and child wellbeing outcomes. The final review included 51 studies that reported on adverse outcomes pertaining to parenting and family relationships (k = 29), child internalizing and externalizing problems (k = 7), social-emotional development (k = 5), and physical/health development (k = 17). Specifically, studies reported that CC was associated with increased parental psychopathology, poorer family functioning, harsher parenting and higher levels of child abuse, strained parent-child relationships, children used as tools and co-victims of CC, increased risk of child internalizing and externalizing problems, limited socializing opportunities, increased bullying, poorer perinatal outcomes, limited access to healthcare, and increased risk of child mortality. Evidence identified CC as a unique contributor to adverse child wellbeing outcomes, independent of exposure to IPV more broadly. Results indicated that the impacts of childhood exposure to CC are complex, far reaching, and, in some cases, devastating. The limitations of the findings, as well as implications for practice, policy, and research are discussed.

Domestic Violence Against Women in Nepal: A Systematic Review of Risk Factors.

A systematic review was conducted to examine the factors that put women at risk of domestic violence in Nepal. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), PubMed, Cochrane, MEDLINE, CINAHL, and PsycINFO were searched supplemented by searching of the reference list manually. Of the 143 studies identified 24 were included in the final review. Search strategy was developed, and studies were included if they considered female participants (age 15-49 years) in heterosexual relationship, with exposure of different factors and whose outcomes were the magnitude of any form of violence (physical, sexual, and emotional/psychological). The Mixed Methods Appraisal Tool was used to assess the quality of the studies included. The findings are categorized based on the four levels of the ecological framework. At the individual level, the alcohol consumption level of husband, education level of both women and men, women's age at the time of marriage and childhood exposure to violence were found to be highly prevalent risk factors. At the relationship level, most prevalent risk factors were controlling husband and decision-making capacity of women. At the community level, belonging to underprivileged community or low caste system and living in Terai region were the risk factors. At the societal level, patriarchal belief and norms supporting violence were the risk factors. The complex nature of violence against women in Nepal requires culturally sensitive interventions along with organized efforts from the local and intra government to improve the status of Nepalese women at all levels of the ecological framework.

[Family violence]. / Violence familiale.

INTRODUCTION: Family violence is a serious public health problem, the scale of which is seriously increasing in Morocco. Although it has existed for a long time, we ignore the real characteristics of this plague in our country; our work consisted in an epidemiological approach of family violence in Marrakech during 2006. METHOD: After elaborating a questionnaire, which allows the study of the demographic and social profile of the families, the study of violence exercised in the family and the evaluation of the depression in the women, we led an inquiry amongst 265 women. RESULTS: Analysis of the results obtained has allowed us to underline the following characteristics: 16.6% of the women in our sample had been physically beaten; the young age is a risk factor; the age range most affected by violence is in women between the ages of 30 and 40 and which represent 39% of the battered women; domestic violence touches all the social, economic and cultural classes: in our study, 63% of the women having undergone violence were housewives, 25% were managers and 3% senior executives; family problems were the most important cause of violence in our study, representing 32.32%. Requests for money was the cause in 11.3% of the cases, and imposed sexual relations were found in 6.8% of the cases; alcoholism is an aggravating factor of family violence; 27.3% of the spouses who assaulted their wives were drunk; 52% of the assaulted women were victims of violence in childhood and 36% had been witness to their father's violence; in 63.6% of the cases of violence, the children were witnesses, and in 25% of the cases the children were victims of violence at the same time as their mothers; 50% of the women victims of violence did not react, while 38.6% left home, and 9.1 filed for divorce. Thirty-two percent of the assaulted woman had been traumatised by the aggression; the association of depression and violence was very high, 343% of the battered women in our study suffered from severe depression. CONCLUSION: This work underlines the necessity of an urgent intervention in order to limit the extension of this plague and its consequences.