Consequences of domestic violence on women's mental health in Bosnia and Herzegovina.
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AIM: To assess psychological consequences of domestic violence, and determine the frequency and forms of domestic violence against women in Bosnia and Herzegovina. METHODS: The study was carried out in the Tuzla Canton region in the period from 2000 to 2002, and included 283 women aged 43+/-9.6 years. Out of 283 women, 104 received psychiatric treatment at the Department for Psychiatry of the University Clinical Center Tuzla, 50 women were refugees; and 129 were domicile inhabitants of the Tuzla Canton. Domestic Violence Inventory, Cornell Index, Symptom Checklist-90-Revised, PTSD Checklist Version for Civilians, and Beck Depression Inventory were used for data collection. Basic sociodemographic data and information from the medical documentation of the Department for Psychiatry of the University Clinical Center Tuzla was also collected. RESULTS: Out of 283 women, 215 (75.9%) were physically, psychologically, and sexually abused by their husbands. Among the abused, 107 (50.7%) experienced a combination of various forms of domestic violence. The frequency of domestic violence was high among psychiatric patients (78.3%). Victims of domestic violence had a significantly higher rate of general neuroticism, depression, somatization, sensitivity, obsessive-compulsive symptoms, anxiety, and paranoid tendency than women who were not abused. The prevalence of posttraumatic stress disorder (PTSD) symptoms according to the type of trauma was higher in women with the history of childhood abuse (8/11) and domestic violence (53/67) than in women who experienced war trauma (26/57) and the loss of loved ones (24/83). The majority of 104 psychiatric patients suffered from PTSD in comorbidity with depression (n=45), followed by depression (n=17), dissociative disorder (n=13), psychotic disorder (n=7), and borderline personality disorder with depression (n=7). The intensity of psychological symptoms, depression, and Global Severity Index for Psychological Symptoms (GSI) were in significant positive correlation with the frequency of psychological (r=0.45, P<0.001), physical (r=0.43, P<0.001), and sexual abuse (r=0.37, P<0.001). CONCLUSION: Domestic violence in various forms had long-term consequences on mental health of women. This should be taken into account when treating women with war-related trauma. (+info)
Measuring the impact of intimate partner violence on the health of women in Victoria, Australia.
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OBJECTIVE: Using burden of disease methodology, estimate the health risks of intimate partner violence (IPV) among women in Victoria, Australia. METHODS: We calculated population attributable fractions (from survey data on the prevalence of IPV and the relative risks of associated health problems in Australia) and determined health outcomes by applying them to disability-adjusted life year estimates for the relevant disease and injury categories for Victoria, Australia for 2001. FINDINGS: For women of all ages IPV accounted for 2.9% (95% uncertainty interval 2.4-3.4%) of the total disease and injury burden. Among women 18-44 years of age, IPV was associated with 7.9% (95% uncertainty interval 6.4-9.5%) of the overall disease burden and was a larger risk to health than risk factors traditionally included in burden of disease studies, such as raised blood pressure, tobacco use and increased body weight. Poor mental health contributed 73% and substance abuse 22% to the disease burden attributed to IPV. CONCLUSION: Our findings suggest that IPV constitutes a significant risk to women's health. Mental health policy-makers and health workers treating common mental health problems need to be aware that IPV is an important risk factor. Future research should concentrate on evaluating effective interventions to prevent women being exposed to violence, and identifying the most appropriate mental health care for victims to reduce short- and long-term disability. (+info)
Assessing the physical violence component of the Revised Conflict Tactics Scales when used in heterosexual couples: An item response theory analysis.
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Although there are psychometric evaluations of the Revised Conflict Tactics Scales (CTS2) when applied to heterosexual relationships, none has used item response theory (IRT). To address this gap, the present paper assesses the instrument's physical violence subscale. The CTS2 was applied to 764 women who also responded for their partners. Single dimensionality assumption was corroborated. A 2-parameter logistic IRT model was used for estimating location and discriminating power of each item. Differential item functioning and item information pattern along the violence continuum were assessed. Gender differences were detected in 3 out of 12 items. Item coverage of the latent trait spectrum indicated little information at the lower ends, while plenty in the middle and upper ranges. Still, depending on gender, some item overlaps and regions with gaps could be detected. Despite some unresolved problems, the analysis shows that the items form a theoretically coherent information set across the continuum. Provided the user is aware of possible drawbacks, using the physical violence subscale of the CTS2 in heterosexual couples is still a sensible option. (+info)
Experiences of intimate partner violence and related injuries among women in Yokohama, Japan.
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We estimated rates of intimate partner violence and related injuries in a sample of 1371 women aged 18 to 49 years in Yokohama, Japan. By the age of 30 years, 14.3% of women who had ever had a partner had experienced violence from that partner, and 3.3% had suffered injuries related to such violence. By the time women had reached the age of 49 years, these percentages were 19% and 4%, respectively. In addition to the need for increased prevention efforts, our findings indicate the need for an expanded legal definition of intimate partner violence in Japan given that the current definition excludes premarital violence. (+info)
Domestic violence and symptoms of gynecologic morbidity among women in North India.
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CONTEXT: Although there is increasing recognition of the global scope of domestic violence and the potential reproductive health consequences of violence, little is known about the relationship between physical and sexual domestic violence and gynecologic morbidity in developing country settings. METHODS: A sample of 3,642 couples from northern India was created by matching husbands and wives who responded to the men's and women's surveys of the 1995-1996 PERFORM System of Indicators Survey. The association between men's reports of physical and sexual violence they had perpetrated against their wives and wives' reports of gynecologic symptoms was analyzed in bivariate and multivariate analyses. RESULTS: Overall, 37% of men said they had committed one or more acts of physical or sexual violence against their wives in the past 12 months, with 12% reporting physical violence only, 17% sexual violence only and 9% both physical and sexual violence. Thirty-four percent of women reported at least one symptom of gynecologic morbidity. Compared with women whose husbands reported no violence, those who had experienced both physical and sexual violence and those who had experienced sexual violence only had elevated odds of reporting gynecologic symptoms (odds ratios, 1.7 and 1.4, respectively). CONCLUSIONS: Plausible mechanisms through which domestic violence may influence gynecologic morbidity include physical trauma, psychological stress or transmission of STIs. Reproductive health care that incorporates domestic violence support services is needed to meet the special needs of abused women. (+info)
Physical health consequences of intimate partner violence in Spanish women.
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BACKGROUND: Intimate partner violence (IPV) against women can result in serious health problems. The objectives of this study are to analyse the association between the different types of IPV and women's physical health, and to examine whether this association varies depending on the intensity, duration and timing of the violence. METHODS: A sample of 1402 randomly selected women attending 23 family practices in Spain responded to an anonymous self-reported questionnaire. Measures considered were exposure to physical, sexual and psychological IPV; intensity, duration and timing of such violence; chronic physical disease; number of lifetime surgical operations and number of days spent in bed in the last three months. Descriptive, bivariate and multivariate analyses were conducted. RESULTS: Lifetime IPV prevalence was 32%. Higher prevalence of chronic disease was observed in abused women than in never abused women, as well as greater number of days spent in bed. Women who reported having experienced the three types of IPV were more likely to suffer a chronic disease (OR = 2.03; 95% CI = 1.18-3.51) and to spend more days in bed (t = 2.35; P = 0.019) than those never abused. Women abused in the past but not in the present presented a higher probability of having a chronic disease than never abused women, and women who had been abused both in the past and in the present had a higher probability of spending more days in bed. CONCLUSION: IPV can negatively affect physical health of the victims. It is therefore necessary to detect cases of IPV at a primary health care level. (+info)
Factors influencing identification of and response to intimate partner violence: a survey of physicians and nurses.
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BACKGROUND: Intimate partner violence against women (IPV) has been identified as a serious public health problem. Although the health care system is an important site for identification and intervention, there have been challenges in determining how health care professionals can best address this issue in practice. We surveyed nurses and physicians in 2004 regarding their attitudes and behaviours with respect to IPV, including whether they routinely inquire about IPV, as well as potentially relevant barriers, facilitators, experiential, and practice-related factors. METHODS: A modified Dillman Tailored Design approach was used to survey 1000 nurses and 1000 physicians by mail in Ontario, Canada. Respondents were randomly selected from professional directories and represented practice areas pre-identified from the literature as those most likely to care for women at the point of initial IPV disclosure: family practice, obstetrics and gynecology, emergency care, maternal/newborn care, and public health. The survey instrument had a case-based scenario followed by 43 questions asking about behaviours and resources specific to woman abuse. RESULTS: In total, 931 questionnaires were returned; 597 by nurses (59.7% response rate) and 328 by physicians (32.8% response rate). Overall, 32% of nurses and 42% of physicians reported routinely initiating the topic of IPV in practice. Principal components analysis identified eight constructs related to whether routine inquiry was conducted: preparedness, self-confidence, professional supports, abuse inquiry, practitioner consequences of asking, comfort following disclosure, practitioner lack of control, and practice pressures. Each construct was analyzed according to a number of related issues, including clinician training and experience with woman abuse, area of practice, and type of health care provider. Preparedness emerged as a key construct related to whether respondents routinely initiated the topic of IPV. CONCLUSION: The present study provides new insight into the factors that facilitate and impede clinicians' decisions to address the issue of IPV with their female patients. Inadequate preparation, both educational and experiential, emerged as a key barrier to routine inquiry, as did the importance of the "real world" pressures associated with the daily context of primary care practice. (+info)
Intimate partner violence incidence and continuation in a primary care screening program.
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There are few longitudinal estimates of intimate partner violence (IPV) incidence and continuation. This report provides estimates of IPV incidence and continuation in women receiving health care in clinics participating in an IPV assessment and services intervention study. The Women's Experience with Battering Scale was used in combination with questions addressing physical and sexual assault to annually screen women for IPV. Between April 2002 and August 2005, 657 women in rural South Carolina consented and were screened at least twice. Among those with a current partner (n = 530), the majority (86.2%) had never experienced IPV. Among prevalent victims, IPV continued over time for 37%. IPV continuation rates were higher among older women and those who considered abuse as a problem in their relationship. Of those women who were IPV negative at time 1, IPV incidence at time 2 was 4.2%. A higher score on the Women's Experience with Battering Scale at time 1, a marker of psychological abuse, was a strong predictor of physical IPV incidence (p(trend) = 0.0001). These data suggest that the incidence of IPV over a short follow-up period is relatively low and that the majority of IPV desists over this short follow-up period. (+info)