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Substance abuse and intimate partner violence: treatment considerations
Keith C Klostermann
Substance Abuse Treatment, Prevention, and Policy , 2006, DOI: 10.1186/1747-597x-1-24
Abstract: While historically considered a private family matter, intimate partner violence (IPV) has more recently been conceptualized as a widespread public health concern, requiring the attention of both the treatment community and criminal justice system. In fact, representative surveys of couples, which include less severe instances of aggression, such as single occurrences of pushing or slapping one's partner, suggest rates of 15% to 20% annually for any husband-to-wife violence [1,2]. Yet, these estimates are dwarfed in comparison to those observed among married or cohabiting substance-abusing patients entering substance abuse treatment. More specifically, studies conducted over the last decade have consistently revealed that roughly 60% of substance-abusing men with intimate partners report at least one instance of IPV during the year prior to program entry. Given the increased use of family-involved assessments and interventions in substance abuse treatment programs, providers are increasingly faced with the challenge of addressing this complex clinical issue.Unfortunately, effective treatment options for providers who must deal with this issue are limited. To date, the typical answer has been for providers to refer these cases to agencies specializing in batterers' treatment. However, there are three fundamental problems with this strategy. First, many batterers' treatment programs will only accept individuals who are specifically mandated by the legal community to participate in IPV treatment. Yet, most patients in substance abuse treatment settings are not required to attend a batterers' program; in fact, a large majority of substance-abusing patients are not identified as having engaged in IPV or are only so identified after lengthy or careful assessment while receiving treatment for substance abuse. Second, in those instances in which batterers' programs will accept referrals of nonmandated substance-abusing patients, the vast majority of these patients typically
A study of intimate partner violence among females attending a Teaching Hospital out-patient department
KALA Kuruppuarachchi,LT Wijeratne,GDSSK Weerasinghe,MUPK Peris
Sri Lanka Journal of Psychiatry , 2010,
Abstract: Background: Intimate partner violence (IPV) is considered a public health problem with physical and psychological consequences. Aims: To describe the prevalence of IPV among married females attending the out-patient department of North Colombo Teaching Hospital and their attitude towards abuse. Methods: A pre-tested self-administered questionnaire on physical, verbal, sexual and emotional abuse was given to the first 50 consenting married females attending the out-patient department on each day for five consecutive days. Confidentiality of responses was assured and adequate privacy was provided for the questionnaires to be completed. Results: Of the 242 participants 98(40.5%) reported some form of abuse by their male partner. Prevalence of abuse reported was physical abuse 19%, verbal abuse 23%, emotional abuse 23% and sexual abuse 7%. A quarter (26.9%) of those inflicted physical violence sought medical treatment for the injuries but only two of them divulged the reason for the injury to medical staff. More than three quarters (79%) of those abused were in the relationship for more than ten years. The majority of the females surveyed believed that violence by the male partner should be tolerated. Conclusions: IPV is a common problem that is poorly divulged to medical personnel. Attitudes regarding IPV have to be changed in order to reduce abuse significantly.
Reported intimate partner violence amongst women attending a public hospital in Botswana  [cached]
Lindiwe I. Zungu,Akeem O. Salawu,Gboyega A. Ogunbanjo
African Journal of Primary Health Care & Family Medicine , 2010, DOI: 10.4102/phcfm.v2i1.185
Abstract: Background: Intimate partner violence (IPV) is common worldwide and occurs across social, economic, religious and cultural groups. This makes it an important public health issue for health care providers. In South Africa, the problem of violence against women is complex and it has social and public health consequences. The paucity of data on IPV is related to underreporting and a lack of screening of this form of violence in health care settings. Objectives: The aim of this study was to determine the prevalence of IPV and explore the risk factors associated with this type of violence against women who visited a public hospital in Botswana. Method: A descriptive, cross-sectional survey was conducted among randomly sampled adult women aged 21 years and older, during their hospital visits in 2007. Data were obtained by means of structured interviews, after obtaining written and signed, informed consent from each participant. Results: A total of 320 women participated in this study. Almost half (49.7%) reported having had an experience of IPV in one form or another at some point in their lifetime, while 68 (21.2%) reported a recent incident of abuse by their partners in the past year. Experiences of IPV were predominantly reported by women aged 21 – 30 years (122; 38%). Most of the allegedly abused participants were single (173; 54%) and unemployed (140; 44%). Significant associations were found between alcohol use by participants’ male intimate partners (χ2 = 17.318; p = 0.001) and IPV, as well as cigarette smoking (χ2 = 17.318; p = 0.001) and IPV. Conclusion: The prevalence of alleged IPV in Botswana is relatively high (49.7%), especially among young adult women, but the prevalence of reported IPV is low (13.2%). It is essential that women are screened regularly in the country’s public and private health care settings for IPV. How to cite this article: Zungu LI, Salawu AO,Ogunbanjo GA. Reported intimate partner violence amongst women attending a public hospital in Botswana. Afr J Prm Health Care Fam Med. 2010; 2(1),Art. #185, 6 pages. DOI: 10.4102/phcfm.v2i1.185
Animal abuse and intimate partner violence: researching the link and its significance in Ireland - a veterinary perspective
B Gallagher, M Allen, B Jones
Irish Veterinary Journal , 2008, DOI: 10.1186/2046-0481-61-10-658
Abstract: A number of recent studies have highlighted the relationship between non-accidental injury (NAI) in animals (also known as 'battered pet syndrome') and domestic violence [20,3,6,15]. Further research identifies that intimate partner violence, abuse of children and abuse of companion pets tends to occur in the same families ([9,1,2]; Boat, 1995; [6,15,14]). Flynn [15] found that 46.5% of women using a refuge in South Carolina reported that their abuser had either harmed or threatened to harm their pets. Other studies have suggested a higher prevalence. Ascione [5] demonstrated that almost two-thirds of women who suffered domestic violence also witnessed abuse of, or threats to, their pets. A study in the United Kingdom identified similar statistics, with 66% of women in one survey reporting threats, and 38% reporting actual abuse of their pet [26]. This data indicates that animal abuse in the context of interpersonal violence is likely to be more prevalent and universal than was previously realised. While it is likely that similar patterns of multiple forms of abuse can be found in Ireland, no Irish study has examined this aspect of intimate partner violence.The purpose of this study, undertaken by veterinary practitioners and a social worker, was to examine the 'link' between domestic violence and animal abuse in Ireland, and to establish to what extent the abuse of pets is used to control women within an abusive relationship. In doing so, the aim is to raise awareness of the 'link' amongst the staff of women's refuges, social workers, childcare workers and veterinary practitioners.Official Irish statistics place reports of violence against women within European and US figures, with the only Irish national prevalence study to-date [19] showing that 18% of women had, at some time in their lives, been victims of emotional, sexual or physical violence, or subject to threats of violence, and had their property or pets damaged, by male intimate partners. European Union f
PRevalence of Abuse and Intimate Partner Violence Surgical Evaluation (P.R.A.I.S.E.): rationale and design of a multi-center cross-sectional study.
PRAISE Investigators
BMC Musculoskeletal Disorders , 2010, DOI: 10.1186/1471-2474-11-77
Abstract: We propose a cross-sectional multicenter study wherein 3,600 women will complete a self-reported written questionnaire across clinical sites in North America, Europe, and Australia. Recruitment of participants will take place at orthopaedic fracture clinics at each clinical site. The questionnaire will contain a validated set of questions used to screen for IPV, as well as questions that pertain to the participant's demographic, injury characteristics, and experiences with health care utilization. Female patients presenting to the orthopaedic fracture clinics will complete two validated self-reported written questionnaires (Woman Abuse Screening Tool (WAST) and the Partner Violence Screen (PVS)) to determine the prevalence of IPV in the past 12 months and in their lifetime. The two questionnaires were designed for rapid assessment of IPV status in emergency departments, family practice, and women's health clinics that we believe are similar to our intended setting of an orthopaedic clinic.If the prevalence of IPV among women attending orthopaedic clinics is greater than the current perceptions of orthopaedic surgeons, this study will serve to advocate for the continued education of medical professionals to better recognize probable IPV cases and offer existing services to enhance the care of these patients.Intimate partner violence (IPV) is described by the American Medical Association as "a pattern of coercive behaviors that may include repeated battering and injury, psychological abuse, sexual assault, progressive social isolation, deprivation, and intimidation" [1]. The long-term consequences of IPV include health risks, posttraumatic stress disorder, depression, and staggering economic costs for health care of victims [2].The cumulative lifetime prevalence of domestic violence for women admitted to the Emergency Department is approximately 54 percent [2]. However, IPV is underreported among women who seek medical attention [2-4]. The American College of Surgeons
Personal, Situational and Socio-Cultural Factors as Correlates of Intimate Partner Abuse in Nigeria  [PDF]
David Oladeji
Advances in Sexual Medicine (ASM) , 2013, DOI: 10.4236/asm.2013.34014
Abstract: This study established the relationships between personal, situational and socio-cultural factors and intimate partner abuse among couples in Nigeria. A multiple regression statistical procedure was employed in analyzing the data collected from 200 participants randomly selected from five ministries in Ibadan, Oyo state, Nigeria. Results obtained indicated that the three variables when combined effectively predicted intimate partner abuse (F-ratio of 5.756 significant at 0.05 alpha level). Taken separately, situational and socio-cultural factors contributed significantly to the prediction (t = 2.146, p < 0.05; t = 2.284, p < 0.05), while personal factor did not (t = 1.705, p > 0.05). On the basis of these findings it was suggested that counselling psychologists should design intervention strategies to promote life-skills training in schools and out-of-schools settings. These include age-appropriate content on sexuality, conflict resolution, building healthy relationships and personal safety. Also, it was suggested that couples should be informed on the long-term health and social consequences of physical and sexual abuse.
Correlation Between Intimate Partner Violence Victimization and Risk of Substance Abuse and Depression among African-American Women Seen in an Urban Emergency Department  [cached]
Hankin, Abigail,Smith, L. Shakiyla,Daugherty, Jill,Houry, Debra
Western Journal of Emergency Medicine : Integrating Emergency Care with Population Health , 2010,
Abstract: Objective: To assess rates of substance abuse (including tobacco, alcohol, and drug abuse) as well as rates of intimate partner violence (IPV) among African-American women seen in an urban Emergency Department (ED). Methods: Eligible participants included all African-American women between the ages of 21-55 years old who were seen in an urban ED for any complaint, and who were triaged to the waiting room. Eligible women who consented to participate were taken to complete a computer-based survey that focused on demographic information and general health questions as well as standardized instruments including the Index of Spouse Abuse (ISA), the Tolerance, Worried, Eye openers, Amnesia, K(C)ut down (TWEAK) screen for alcohol abuse, Drug Abuse Screening Test (DAST20), and Hooked on Nicotine Checklist (HONC). This analysis uses results from a larger study evaluating the effects of providing patients with targeted educational literature based on the results of their screening. Results: 610 women were surveyed. Among these, 85 women (13.9%) screened positive for IPV. Women who screened positive for IPV were significantly more likely to also screen positive for tobacco abuse (56% vs. 37.5%, p< 0.001), alcohol abuse (47.1% vs. 23.2%, p < 0.001), and drug abuse (44.7% vs. 9.5%, p<0.001). Women who screened positive for IPV were also more likely to screen positive for depression and to report social isolation. Conclusion: African-American women seen in the ED, who screen positive for IPV, are at significantly higher risk of drug, alcohol, tobacco abuse, depression and social isolation than women who do not screen positive for IPV. These findings have important implications for ED-based and community-based social services for women who are victims of intimate partner violence. [West J Emerg Med. 2010; 11(3): 253-257.]
Screening on Perpetration and Victimization of Intimate Partner Violence (IPV): Two Studies on the Validity of an IPV Screening Instrument in Patients in Substance Abuse Treatment  [PDF]
Fleur L. Kraanen, Ellen Vedel, Agnes Scholing, Paul M. G. Emmelkamp
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0063681
Abstract: Background About 50% of patients in substance abuse treatment with a partner perpetrated and/or experienced intimate partner violence in the past year. To date, there are no screeners to identify both perpetrators and victims of partner intimate violence in a substance abusing population. We developed a 4 item screening instrument for this purpose, the Jellinek Inventory for assessing Partner Violence (J-IPV). Important strengths of the J-IPV are that it takes only 2 minutes to administer and is easy to use and to score. Methods To investigate the validity of the J-IPV, two independent studies were conducted including 98 and 99 participants, respectively. Aim of the second study was to cross-validate findings from the first study. Psychometric properties of the J-IPV were determined by calculating sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ratio’s by comparing J-IPV outcomes to outcomes on the Revised Conflict Tactics Scales (‘gold standard’). Also, receiver operator characteristics (ROC)-curves were determined to weight sensitivity and specificity as a result of different J-IPV cutoffs, and the area under the curve (AUC) was calculated. Results Results of the first study demonstrated that the J-IPV possesses good psychometric properties to detect perpetrators and victims of any as well as severe intimate partner violence. Results from the second study replicated findings from the first study. Conclusions We recommend administering the J-IPV to patients entering substance abuse treatment. If perpetrators and victims of partner violence are identified, action can be taken to stop IPV perpetration and arrange help for victims, for example by offering perpetrators treatment or by providing safety planning or advocacy interventions to victims.
History of Childhood Abuse, Sensation Seeking, and Intimate Partner Violence under/Not under the Influence of a Substance: A Cross-Sectional Study in Russia  [PDF]
Weihai Zhan, Alla V. Shaboltas, Roman V. Skochilov, Tatiana V. Krasnoselskikh, Nadia Abdala
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0068027
Abstract: Objectives To examine correlates of perpetration and victimization of intimate partner violence (IPV) under and not under the influence of a substance, we conducted a study among women in Russia. Methods In 2011, a cross-sectional survey was conducted among patients receiving services at a clinic for sexually transmitted infections in St. Petersburg, Russia. Multinomial logistic regression was used for analysis. Results Of 299 women, 104 (34.8%) and 113 (37.8%) reported a history of IPV perpetration and victimization, respectively. Nearly half (47.1%) of perpetrators and 61.1% of victims reported that the latest IPV event (perpetration and victimization, respectively) was experienced under the influence of a substance. Factors independently associated with IPV victimization under the influence of a substance were alcohol misuse and a higher number of lifetime sex partners, whereas only experience of childhood abuse (emotional and physical abuse) was independently associated with IPV victimization that did not occur under the influence of a substance. Childhood physical abuse, lower age of first sex, sensation seeking, and alcohol misuse were independently associated with IPV perpetration under the influence of a substance, while only childhood abuse (emotional and physical abuse) was independently associated with IPV perpetration that did not occur under the influence of a substance. Conclusions IPV under and not under the influence of a substance had different correlates (e.g., alcohol misuse and sensation seeking). Despite the strong association between substance use and IPV, experience of childhood abuse is an important predictor of IPV perpetration and victimization in Russia, above and beyond substance use.
Intimate partner violence among pregnant women in Rwanda
Joseph Ntaganira, Adamson S Muula, Florence Masaisa, Fidens Dusabeyezu, Seter Siziya, Emmanuel Rudatsikira
BMC Women's Health , 2008, DOI: 10.1186/1472-6874-8-17
Abstract: A convenient sample of 600 pregnant women attending antenatal clinics were administered a questionnaire which included items on demographics, HIV status, IPV, and alcohol use by the male partner. Mean age and proportions of IPV in different groups were assessed. Odds of IPV were estimated using logistic regression analysis.Of the 600 respondents, 35.1% reported IPV in the last 12 months. HIV+ pregnant women had higher rates of all forms of IVP violence than HIV- pregnant women: pulling hair (44.3% vs. 20.3%), slapping (32.0% vs. 15.3%), kicking with fists (36.3% vs. 19.7%), throwing to the ground and kicking with feet (23.3% vs. 12.7%), and burning with hot liquid (4.1% vs. 3.5%). HIV positive participants were more than twice likely to report physical IPV than those who were HIV negative (OR = 2.38; 95% CI [1.59, 3.57]). Other factors positively associated with physical IPV included sexual abuse before the age of 14 years (OR = 2.69; 95% CI [1.69, 4.29]), having an alcohol drinking male partner (OR = 4.10; 95% CI [2.48, 6.77] for occasional drinkers and OR = 3.37; 95% CI [2.05, 5.54] for heavy drinkers), and having a male partner with other sexual partners (OR = 1.53; 95% CI [1.15, 2.20]. Education was negatively associated with lifetime IPV.We have reported on prevalence of IPV violence among pregnant women attending antenatal care in Rwanda, Central Africa. We advocate that screening for IPV be an integral part of HIV and AIDS care, as well as routine antenatal care. Services for battered women should also be made available.Intimate partner violence (IPV), defined as actual or threatened physical, sexual, psychological, and emotional abuse by current or former partners is a global public health concern affecting 25%–43% women in their lifetime [1-4]. The adverse health consequences of IPV have been documented in previous reports and include: mental disorders such as suicidal ideation, suicide and post-traumatic stress disorders; gynecological and obstetric disord
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