Intimate partner violence in military couples: A review of the literature

IntroductionIntimate partner violence (IPV) is a serious public health concern that has not received an immense amount of attention in the military community. It is well documented in military literature that rates of IPV across US military populations range from 13.5% to 58%, with considerably lower rates obtained among samples not selected on the basis of psychopathology (Marshall, Panuzio, & Taft, 2005). The main objectives are to address the this gap in literature concerning the definitions of violence used, prevalence of IPV in military intimate relationships, the nature and patterns of violence, risk factors, and theories that may help to provide a better understanding of the violence attached to this unique population.Methods and theoryCivilian and military communities are urged to work towards using common definitions and practices to facilitate comparison of rates among the populations. Furthermore, methodological tools should move towards using more multi-method and longitudinal designs, more theoretical model applications and more diverse sample selection as strategies to further our understanding of the structure and inner workings of IPV in military couples.Conclusion and recommendationsMore exhaustive research, especially in Canada, including consistent definitions and methodology needs to be conducted. Also, future research needs to address the gap in the literature regarding theory application, risk factors associated with this phenomenon, and prevention methods.     

The Contextual Role of Depression within Couples Experiencing Partner Violence

Despite previous research suggesting a link between intimate partner violence (IPV) and depression within romantic relationships, few studies have examined the role of depression in couples experiencing violence. Using dyadic data of 129 heterosexual couples seeking couples therapy for high conflict including physical IPV, depressive symptoms were evaluated as a moderator in the association between psychological and physical IPV. Results indicated that moderate and high reports of women's depressive symptoms provided a context, while men's psychological abuse toward them moved from low to high, for women to be more physically abusive toward their partners. Further, low reports of women's depressive symptoms provided a context, while men's psychological abuse toward them moved from low to high, for women to be less physically abusive toward their partners. Better understanding the role of depression and how it may offer a context for physical violence assists helping professionals in holistically addressing violence within romantic relationships.     

What Do Medical Providers Need to Successfully Intervene with Intimate Partner Violence?

ABSTRACT

Increasingly, medical providers (physicians and mid-level providers) rely on research evidence to inform their medical practice. In order for medical providers to accept their role in diagnosing and intervening with IPV, they need clinical tools and institutional support. This paper explores the tools (prevalence rates, screening questions, intervention strategies) and support (educational, institutional, professional, research) needed to assist medical providers in successfully intervening with IPV. It also looks at the importance of guidelines and expert consensus panel statements to help establish best clinical practices when direct research evidence is lacking or conflicting.     

Intertraumatic Dissociative Attachment

SUMMARY

This article focuses on the treatment of couples with a collective personal history of multiple traumatic experiences, and central related concepts. Referred to as the intertrauma couples therapy (InTCT) model, this article outlines an approach to treating trauma victim couples in which each partner has suffered one or more traumatic experiences (i.e., war, rape, criminal assault, incest, community violence, etc.). InTCT is a structured five-phase model of care, derived from a long trauma treatment tradition, and the author's clinical experience in the treatment of multitrauma persons for over 20 years.

This comprehensive, integrative approach to treatment is designed to resolve chronic interpersonal hostility, isolation in marriage, fears of intimacy and engulfment, and the persistent revivifications of partners' traumatic memories as a painful product of daily relational encounters. Unfortunately, these encounters represent trauma structures interacting with trauma structures, with no end or relief to the mutual pain-generating interactional patterns. The phases of the treatment takes the couple from disorganization and intense emotional reactivity to stabilization through integration to an end phase with a post-integration life skills building program for lasting results. Also presented are issues such as attachment, specific trauma responses to include interactive concepts of trauma bonding and systems theory in the context of trauma and dissociation. The article also presents a multitrauma couple case study, and discusses the critical role of therapist's functions.     

The State of Dyadic Methodology: An Analysis of the Literature on Interventions for Military Couples

ABSTRACT

Military members and their spouses experience unique stressors compared with civilian couples, making them distinctively vulnerable to a number of marital and mental health concerns. However, the amount and quality of intervention research to guide treatment for military couples are unknown. Therefore, a systematic literature search of interventions for military couples was completed resulting in 10 articles that met the study's inclusion and exclusion criteria. Further, a rubric to assess dyadic methodology was created and utilized to determine the dyadic quality of the methodology of the sampled articles. The results of the systematic literature review revealed that (a) there are few evidence-based interventions for military couples in which both members of the dyad are included and (b) the methodology by which treatments are evaluated largely do not employ systemic or dyadic measures. Recommendations for future research with military couples includes the need for couple-focused interventions using experimental methodology, systemic theories to guide intervention and research, and appropriate dyadic assessment and analysis tools to determine the effectiveness of couple's interventions for military, reserve, and veteran populations.     

Clinical Application of the Couple Adaptation to Traumatic Stress (CATS) Model: A Pragmatic Framework for Working With Traumatized Couples

ABSTRACT

The authors attempt to apply knowledge of traumatization to clinical practice with couple dyads. Elaborating on the Couple Adaptation to Traumatic Stress (CATS) Model (Nelson Goff & Smith, 2005), the authors have worked to bridge the gap between a general understanding of trauma's impact on the couple relationship and couples' treatment. This article facilitates the application of the CATS Model to clinical work with couples impacted by trauma. Incorporating Herman's (1997) traumatic process with the original CATS Model, the authors created a more specific, clinically useful framework for clinicians. The goal of the current article is to provide clinicians with a pragmatic illustration articulating a clinical framework for understanding and treating posttraumaumitc symptoms and processes within the couple relationship. The main implication is that clinicians will be able to conduct effectively guided systemic therapy with distressed couples necessary to generate progress in the treatment of symptomatology and couple functioning of trauma survivors and their partners.     

Operant reinforcement with structural family therapy in treating anorexia nervosa

Abstract

This paper integrates clinical data gathered through psychotherapy with dual-career couples and research findings from social psychology and sociology. The paper's main focus is the clinical understanding and therapeutic interventions most appropriate for these couples' marital and individual difficulties. The paper briefly describes characteristics of the dual-career lifestyle and personalities. The analysis provides case examples illustrating external and internal sources of stress generated by a lack of time or the need for an effective system for handling housework and childcare.     

Unrealistic beliefs of clinical couples: Their relationship to expectations,goals and satisfaction

Abstract

Forty-seven marital therapy couples completed inventories measuring unrealistic beliefs about self and unrealistic beliefs about marital relationships. In addition, they completed questionnaire measures of their expectations and goals for therapy and their levels of marital satisfaction. As hypothesized, the clients' unrealistic beliefs, particularly those regarding relationships, were negatively associated with their estimated chance for improvement in therapy, desire to improve rather than terminate the relationship, preference for marital versus individually oriented treatment, and overall marital satisfaction. These results are consistent with the theoretical rationale for cognitive therapy with clinical couples and suggest specific targets for intervention in this process. Directions for future research are discussed.     

Parental Intimate Partner Violence, Parenting Practices, and Adolescent Peer Bullying: A Prospective Study

Intimate partner violence (IPV) has been recognized as a major public health concern, with millions of children exposed to parental violence each year. Childhood exposure to parental violence has been linked to both maladaptive parenting practices and a host of adjustment difficulties in the exposed children. The Children in the Community Study followed a representative sample of youth, their parents, and their own offspring for over 25?years, in seven separate assessments. The current study examined the association between reports of IPV and parenting practices among original study members (Generation 2; N?=?396) and their adolescent offspring’s (Generation 3; N?=?129, M age?=?12.8 (2.4), range?=?10–18) reports of overt and relational bullying and victimization behaviors on average 6–7?years later. Results indicate that parental reports of any IPV predicted higher offspring overt peer victimization, while severe IPV predicted higher offspring relational peer bullying and overt peer victimization. For female offspring, any IPV predicted higher relational peer victimization and for male offspring, severe IPV predicted higher overt peer bullying. Parenting practices did not significantly mediate the association between IPV and peer bullying or victimization. Implications for prevention and directions for future research are discussed.     

An Updated Feminist View of Intimate Partner Violence

In this article, we explore intimate partner violence (IPV) from an intersectional, feminist perspective. We describe how an updated feminist view guides us to a perspective on IPV that is more strongly grounded in an antioppressive, nonviolent, socially just feminist stance than a second‐wave gender‐essential feminist stance that suggests that patriarchy is the cause of IPV. At the time we began to work together it seemed that a researcher had to be identified as a “family violence” researcher or a “feminist” researcher of violence against women, and that it wasn't possible to be a feminist researcher who looked beyond patriarchy as the cause of IPV. We advocate critically thinking about essentialist practices in clinical work so that we can maintain an antioppressive, socially just, nonviolent approach to working with clients who experience IPV.     

Bystanders’ reactions to intimate partner violence: an experimental approach

ABSTRACT

Intimate Partner Violence (IPV) is a widespread phenomenon. Despite the prevalence of IPV in Western societies, most cases remain unnoticed or at least unreported to authorities. Social psychologists have been investigating bystanders’ reactions to IPV, to understand which factors may influence the willingness to intervene in support of a female victim of violence. We review a research programme that directly investigated personal and situational factors that make potential bystanders believe a woman victim of IPV deserves and needs (their) help and support, and what, on the contrary, makes them deny any such willingness to help. We present evidence about the situational antecedents of bystander’s reaction, the underlying mechanisms of this intervention, and an extension of such evidence to non-prototypical cases, i.e., to an IPV episode occurring within a same-sex couple. We conclude by discussing future directions, and by highlighting the theoretical and practical contributions of this programme of research to the understanding of IPV for both researchers and practitioners.     

Deconstructing the “Covered Bridge” - Couples Therapy with Sexual Abuse Survivors and Their Partners

SUMMARY

In accepting the editor's invitation to submit an article for this volume, I have taken the subject matter, Building Bridges, quite literally: that is, to talk about bridges as a rather compelling metaphor for couple relationships. I have chosen to focus on the covered bridge, in particular, as it informs me most graphically of the structure and therapeutic challenge presented by couples in which one partner is a child sexual abuse survivor. In my clinical work with such couples, I invariably find myself in the role of surveyor/engi-neer/builder, deconstructing the “covered bridge” and engaged in building a stronger, more open and enduring structure. The steps toward rebuilding and transforming the “covered bridge” structure for these couples are outlined and illustrated.     

Assessment and Intervention with Black-White Multiracial Couples

SUMMARY

Effective therapy with Black-White multiracial couples begins with therapist work on self attitudes and with sensitive assessment of the ways racism and race may or may not be connected to a couple's problems. We suggest ways to begin to explore self attitudes and suggest basic assessment questions for work with Black-White couples. In addition, we point out important clinical issues that may come up for Black-White couples in the areas of social support/social network, parenting, and grief.     

Guest referees for 17(4)

Background and objectives: Although intimate partner violence (IPV) has demonstrated strong associations with anxiety and posttraumatic stress, these constructs have rarely been examined simultaneously in IPV research. Gaps in knowledge remain as to their differential associations to substance use problems among IPV-victimized women. Design: A sample of 143 community women self-reported on their current IPV victimization, mental health and substance use problems. Method: Hierarchical entry multiple regressions were used to test for the direct and indirect effects of psychological, physical, and sexual IPV to alcohol and drug problems through anxiety and posttraumatic stress. Results: Higher anxiety symptom severity and higher physical IPV severity were associated with greater alcohol and drug problems. Higher posttraumatic stress symptom severity was associated with greater alcohol and drug problems. Mediation analyses indicated (i) significant indirect pathways of IPV types to alcohol problems through posttraumatic stress symptom severity controlling for anxiety symptom severity and (ii) significant indirect pathways of IPV types to drug problems through anxiety symptom severity controlling for posttraumatic stress symptom severity. Conclusions: In examining the indirect pathways of psychological, physical, and sexual IPV to substance use problems this study highlights that anxiety and posttraumatic stress symptom severity have unique effects on alcohol and drug problems among IPV-victimized women.     

Consciousness and Criterion: On Block's Case for Unconscious Seeing

Block ( 2012 ) highlights two experimental studies of neglect patients which, he contends, provide ‘dramatic evidence’ for unconscious seeing. In Block's hands this is the highly non‐trivial thesis that seeing of the same fundamental kind as ordinary conscious seeing can occur outside of phenomenal consciousness. Block's case for it provides an excellent opportunity to consider a large body of research on clinical syndromes widely held to evidence unconscious perception. I begin by considering in detail the two studies of neglect to which Block appeals. I show why their interpretation as evidence of unconscious seeing faces a series of local difficulties. I then explain how, even bracketing these issues, a long‐standing but overlooked problem concerning our criterion for consciousness problematizes the appeal to both studies. I explain why this problem is especially pressing for Block given his view that phenomenal consciousness overflows access consciousness. I further show that it is epidemic—not only affecting all report‐based studies of unconscious seeing in neglect, but also analogous studies of the condition most often alleged to show unconscious seeing, namely blindsight.     

Differentiation and Intimate Partner Violence

ABSTRACT

This study explored the impact of differentiation of self on Intimate Partner Violence (IPV). We sought to determine if an individual's level of differentiation of self in a relationship adds to the variance accounted for in IPV perpetration by known risk factors, i.e., relational satisfaction, marital conflict, romantic jealousy, depression, and anxiety. Results indicated that differentiation of self in a relationship is a predictor for perpetration of physical intimate partner violence even after controlling for other known risk factors.     

Therapists' Perspectives on Working with Interracial Couples

SUMMARY

This paper is based on interviews with seven marriage and family therapists (AAMFT Clinical Members) on their experiences of providing therapy to interracial couples in the course of their private practices. The interviews were conducted by the author as part of a masters thesis project. Interracial couples may frequently present for therapy with a variety of generic couples' issues and concerns. However, therapists often find that underlying these more generic concerns are issues related to the ethnic, racial, and cultural differences that the partners bring to the relationship. This paper focuses on the historical context of intermarriage, specific concerns and issues that interracial couples experience in their relationships, and on the experiences of therapists providing therapeutic services to this diverse and challenging client population.     

Intimate partner violence in the military: Treatment considerations

While considerable research has examined the prevalence of IPV in civilian couples, much less information is available on married or cohabitating couples in which one or both parents are active duty soldiers or veterans of foreign wars. In this review, we explore various aspects of the partner violence phenomena among military personnel (i.e., active duty and veterans) and their implications for intervention. We highlight (a) the scope of the problem, (b) discuss domestic violence as defined by the Department of Defense (DoD), (c) list prevalence rates of IPV among military families, (d) identify correlates of IPV, and (e) discuss treatment options for providers working with these couples. We also discuss the barriers to intervention and their implications for victims, perpetrators, and providers. Conclusions and recommendations for future research directions are also briefly discussed.     

Intimate Partner Violence (IPV) and Neurological Outcomes: A Review for Practitioners

ABSTRACT

Thirty-eight million women will experience intimate partner violence (IPV) during the course of their lifetime. Many of these women will experience brain injuries as a result of IPV and may not seek medical attention. Several types of practitioners who work with IPV survivors consistently, e.g., first responders, advocates, and clinicians, may be unfamiliar with brain functioning, screening, assessment, and treatment. This article reviews the dual traumas of IPV and TBI, the impact on neurological processes and symptomatology, and short and long-term outcomes. Recommendations for screening, intervention, interprofessional collaboration, and research are outlined.     

Intercultural Therapy with Latino Immigrants and White Partners

SUMMARY

Interethnic and interracial marriages of Latinos and White Americans are on the rise and will continue to reshape the identities of individuals, couples, families, and communities. Clinicians working with these intercultural couples find no systematic training to address what is becoming a significant segment of our society. Couple therapists, however, cannot be culturally competent and effective based solely on knowledge of some dimensions of a couple's cultural backgrounds. Using clinical and theoretical ideas, the author defines clinical work with these couples as an explicit intercultural exchange. Our task as clinicians requires a rethinking of our conversations with these couples. It involves a caring therapeutic approach that is sustained on relational and systemic levels, and intercultural conversational skills inspired by clinical and other literatures that are explicitly dedicated to work with cultural difference and the “other.”