Domestic Violence Screening in Medical and Mental Health Care Settings

ABSTRACT

Health care providers and patients agree that domestic violence presents a serious health issue that falls within the purview of medical care. The patient-physician encounter has the potential to assist domestic violence victims in considering their options of living without violence and playing a critical role in preventing future violence. Despite this possibility, many persons evaluated in the health care system do not experience the benefits of such interactions. This article reviews current research that evaluates physician, patient, and systems barriers to providing care to patients experiencing domestic violence as well as gaps in the current research and suggestions for how these barriers might be overcome. Educational initiatives, implementation of protocols, and increasing environmental cues that prompt patients and physicians to discuss domestic violence may all increase the likelihood of screening and the success of interventions.     

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.     

Can We Prevent the Hitting? Recommendations for Preventing Intimate Partner Violence Between Young Adults

ABSTRACT

All empirically-evaluated partner violence prevention programs were reviewed. Most changed knowledge and attitudes regarding dating and sexual aggression, but few demonstrated behavioral change. Peer violence and substance use programs directed toward at-risk individuals demonstrate much larger effects than those directed at all individuals. Research is needed to (a) identify risk-factors for violence persistence, (b) examine the cost-benefit of universal and targeted programs, and (c) explore the ability of programs, such as parenting, stress management, and substance abuse programs, to reduce partner aggression. We recommend that institutions implement hierarchical systems of prevention, with brief interventions for all; more extensive program for moderate levels of aggression; and intensive psychosocial and legal interventions for serious offenders.     

Violent Experiences Questionnaire Predictors of Low Base-Rate Aggressive Acts

This study found elevations in low base-rate aggressive acts among college students (n = 171) who reported (via the Violent Experiences Questionnaire–Revised) exposure to extreme forms of maltreatment (i.e., parental physical abuse, domestic violence, sibling abuse, peer bullying, relational aggression) or corporal punishment during their upbringing. Low base-rate aggressive acts were identified through a separate customized questionnaire. Parental physical abuse was associated with an increased risk (three- to nine-fold) of past physical fighting, violence-related trouble, inflicting violent injury, and making a threat to kill someone. Corporal punishment was associated with elevated risk (two- to four-fold) of physical fighting or inflicting violent injury to another. Past threat(s) to kill were linked to histories of corporal punishment, sibling abuse, or domestic violence. These results illustrate that the adverse effects of childhood maltreatment extend broadly to both clinical and nonclinical samples.     

Patterns of Adolescent Aggression and Victimization: Sex Differences and Correlates

This study identified heterogeneous patterns of peer and dating aggression and victimization among boys and girls and examined their relation to risk and protective correlates. Girls (n = 1648) and boys (n = 1420) in grades 8–10 completed surveys assessing 14 indicators of violence involvement. Latent class analyses indicated a four-class solution, though a test of measurement invariance indicated the nature of the classes differed by sex. Among boys and girls, three classes emerged: Uninvolved (45% of girls, 61% of boys), Peer Aggressor-Victims (23% of girls, 21% of boys), and Cross-Context Aggressor-Victims (CCAV) (12% of girls, 5% of boys). Those in the Peer Aggressor-Victims class were likely to report involvement in peer aggression only; however, girls in this class were likely to be involved only in moderate violence, whereas boys were likely to be involved in moderate and severe violence. Those in the CCAV class were likely to report involvement in all forms of violence except sexual and controlling aggression, which was likely only among boys. Among girls, but not boys, a Verbal Dating Aggressor-Victims class (21% of girls) emerged that was characterized by involvement in occasional verbal dating aggression only. Among boys, but not girls, a Cross-Context Physical Victims class (13% of boys) emerged that was characterized by being only a victim of moderate physical peer and dating violence. Unique and shared risk and protective factors distinguished class membership for girls and boys. Findings suggest the pathways leading to violence may differ by sex and result in different patterns of violence involvement.     

Future Directions in Intimate Partner Violence Prevention Research

ABSTRACT

During the past 20 years, research on dynamics of intimate partner violence, risk factors, and treatment of intimate partner violence has flourished. However, research on the prevention of intimate partner violence is in its infancy. The current volume was developed in order to examine the state of the art in preventing intimate partner violence. To that end, this article offers a synthesis of recommendations for future research made by the authors in this volume and participants in the symposium on the prevention of intimate partner violence sponsored by the Department of Defense. A goal in compiling these recommendations is to foster more and better research into preventing intimate partner violence.     

The Relationship Between Understanding of Self and Others in Children's Friendships

This study examined the relationship between Australian children's acceptance of self and their stage of friendship expectations. Subjects, 116 boys and 92 girls (8 to 13 years old), completed the Piers-Harris Children's Self-Concept Scale and a Picture Sequence Task. The results showed that children who were at the evaluation, admiration, and common activities stages of friendship expectations reported comparatively lower self-acceptance feelings for the global self and for a number of minor self-concept areas than did those who were at higher developmental levels.     

Trends in Online Academic Publishing

Modern information technology allows academics many new ways to enhance their research activities. This article suggests that one of the most important changes in recent years has been the overwhelming proliferation of academic research. It proposes that many new developments in online publishing have been, and will continue to be, in response to this proliferation of research. It also offers some general principles based on six years' working for a series of innovative online journals, including examples of where new technologies have been used successfully to enrich a journal's content without adding substantively to the workloads of authors and editors.     

Domestic Abuse Across the Lifespan

ABSTRACT

Domestic abuse has reached epidemic proportions in the United States. Occupational therapists working in many different settings will encounter children, adults, elders and individuals with disabilities who have experienced intimate violence and abuse. This article presents common definitions and illustrative examples of each type of violence. Issues related to the difficulty inherent in identifying victims of abuse are discussed with an elaboration of indicators that are likely to be seen by an occupational therapist in the clinical setting. Risk factors for becoming a victim or an abuser for each population group and the effects of violence on victims are presented. A brief discussion of the legal and ethical implications of identifying and treating abuse victims concludes the article.     

Sex,Drugs, Violence,and HIV Status Among Male-to-Female Transgender Persons in Houston,Texas

SUMMARY

To inform the Community Planning Group (Houston, Texas) in setting HIV-prevention priorities, risk behavior surveys were completed by 67 male-to-female (MtF) transgender persons. By self-identification, 58% were preoperative and 48% were self-described heterosexual women. We found this small sample of male-to-female transgender individuals to have high rates of HIV infection, and high prevalence of risky behaviors, intimate partner violence, and suicidal ideation. Twenty-seven percent were infected with HIV. Barriers were seldom used during oral sex and used less than half the time for anal sex with either primary or casual partners. Nearly one-third of the sample reported use of methamphetamines, amyl nitrite or LSD and 40% reported crack or cocaine use. Intimate partner violence and forced sex were reported by 50% and 25%, respectively. Suicidal ideation was reported by 16% in the last 30 days; lifetime suicidal ideation was 60%.