The Psychology of Health and Illness: The Mental Health and Physiological Effects of Intimate Partner Violence on Women

Violence against women is a global public health problem with about one in three women experiencing either physical and or sexual intimate partner violence during their lifetime. Globally as many as 38% of homicides committed against women are by a male intimate partner. Violence against women may have negative effects on their mental, physical, and reproductive health (WHO fact sheet, 2016). Untreated individuals who have experienced violence or life-threatening situations may develop posttraumatic stress disorder (PTSD). This disorder has the potential to be life-changing and cause negative psychological and medical issues (Rokach, Ahmed, & Patel, 2017). This potentially life-changing nature and consequence of violence affecting women world-wide deserves greater attention to ensure elimination of risk factors, financial support of investigational studies to promote detection of victims, and research to increase therapeutic efficacy of remediation. These efforts should be bolstered by all physicians, mental health experts, social service specialists, and public health advocates.     

Psychosocial Variables Associated With Verbal Abuse as a Form of Intimate Partner Violence Against Women in a Spanish Sample

This article aims to analyze psychosocial variables associated with verbal abuse in women who suffer intimate partner violence. The following factors, taken from the scientific literature, were examined: social and family isolation; low self-esteem; an excess of empathy for the abuser; submission; psychological dependence on the abuser; and, self-blame as internal attribution for the cause of abuse. Our results show that low self-esteem has a direct relationship with verbal abuse. Additionally, family (including in-laws) and social (from friends, workmates, and neighbors), isolation are significantly and positively related to verbal abuse. The results of our study raise questions about the adoption of gender roles and their consequences when stereotyped tendencies are acquired. Implications, as well as ideas future research, are discussed.     

Prevalence of Types of Perpetration: Gender and Patterns of Intimate Partner Violence Within a Prison Sample in Singapore

It has been reported in Western research on intimate partner violence (IPV) that there are similar rates between males and females (Filbert, 2010). The objective of this study was to compare male and female prisoners from Singapore on rates of IPV as well as the Johnson (2006) types of IPV. Women (n = 75) self-reported higher rates of physical IPV perpetration in the past year (64.0%) than (n = 75) did men (46.1%). Women reported similar rates of IPV for themselves and their partners in the past year (64.0%), while men reported slightly more physical IPV for themselves (46.1%) than they did for their female partners (41.3%). In line with Johnson (2006), rates of intimate terrorism were calculated between 5% and 7% for themselves and their partners, with little variation due to gender. Violent resistance (VR) was calculated at between 2.1% and 7%, with more female than male VR reported for women. Much higher rates of situational couple violence was calculated for both males and females, ranging from 53.3% to 66.7% in the past year, while mutual violent control was significantly lower, ranging from between 14.8% to 20.0%, with data being discussed in relation to patriarchal and family violence perspectives. We concluded that the rates of IPV between males and females were very similar as were the types of IPV. Further research with other cultures should be encouraged for comparison with Western samples.     

Using Relational-cultural Theory to Negotiate Relational Rebuilding in Survivors of Intimate Partner Violence

In this article, the authors describe the application of relational-cultural theory (RCT) for survivors of intimate partner violence (IPV). RCT’s philosophical foundation and core processes work effectively within the context of the counseling session. Through the RCT lens, the authors examine how the theory’s approaches can be utilized for relational rebuilding. Finally, RCT strategies are included for working with women who have experienced shame and relational disconnections as the result of IPV.     

The Caregivers' Attachment and Relationship Education Class: A New and Promising Group Therapy for Caregivers of Individuals with Parkinson's Disease

The authors examined whether a newly developed group therapy, based on principles of attachment theory and emotionally focused couples therapy, can potentially address the unique mental health and relationship difficulties in caregivers of individuals with Parkinson's disease. A comprehensive outreach effort, involving a review of 251 military veterans' medical records, yielded enrollment of seven spousal caregivers in the group therapy. At 1-month follow-up, caregivers who initially reported mild or greater levels of caregiver burden demonstrated statistically reliable declines in psychological distress, relationship distress, or both. Posttreatment surveys indicated positive perceptions in overall helpfulness of treatment goals, as well as positive changes in insight (e.g., greater understanding of the patient's attachment needs) and behaviors (e.g., greater social contact and self-care of the caregiver). Results are considered in the context of inadequate access to treatment for caregivers of spouses with Parkinson's disease or other major medical issues.     

Couples' Disease: The Experience of Living with a Partner with Chronic Depression

This study is concerned with the impact of chronic depression on partners. Thirteen male and female participants who lived with a partner with chronic depression were interviewed. Data were analyzed using thematic analysis. Findings highlighted a need for caregivers to be more centrally involved in their partner's care, given that they face stigma, shifts in role identity, and uncertainty, which all potentially threaten the level of support they can give their partner. In this sense, depression might be described as a “couples disease,” suggesting that couples therapy and group support for partners should be more widely available to help reduce the burden on partners and potentially prevent relationship breakdown.     

A case-controlled field study evaluating ICD-11 proposals for relational problems and intimate partner violence

Background/Objective: Intimate partner relationship problems and intimate partner abuse and neglect — referred to in this paper as “relational problems and maltreatment” — have substantial and well-documented impact on both physical and mental health. However, classification guidelines, such as those found in the International Classification of Diseases (ICD-10), are vague and unlikely to support consistent application. Revised guidelines proposed for ICD-11 are much more operationalized. We used standardized clinical vignette conditions with an international panel of clinicians to test if ICD-11 changes resulted in improved classification accuracy. Method: English-speaking mental health professionals (N = 738) from 65 nations applied ICD-10 or ICD-11 (proposed) guidelines with experimentally manipulated case presentations of presence or absence of (a) individual mental health diagnoses and (b) relational problems or maltreatment. Results: ICD-11, compared with ICD-10, guidelines resulted in significantly better classification accuracy, although only in the presence of co-morbid mental health problems. Clinician factors (e. g., gender, language, world region) largely did not impact classification performance. Conclusions: Despite being considerably more explicated, raters’ performance with ICD-11 guidelines reveals training issues that should be addressed prior to the release of ICD-11 in 2018 (e. g., overriding the guidelines with pre-existing archetypes for relationship problems and physical and psychological abuse).     

Validation of the Working Alliance Inventory–Observer Short Version with male intimate partner violence offenders

The working alliance is a key element to increase intimate partner violence (IPV) offenders’ motivation, adherence to treatment, and active participation in batterer intervention programs (BIPs). The objective of the present study is to assess the psychometric properties and factor structure of the Working Alliance Inventory–Observer Short Version (WAI-O-S) with a sample of IPV offenders. The sample was 140 men convicted for IPV and court-mandated to a community-based BIP. Inter-rater agreement and reliability were evaluated by computing the intraclass correlation coefficient. To test the latent structure a Bayesian confirmatory factor analysis approach was used. To test criterion-related validity, the WAI-O-S factorial scores were correlated to protherapeutic behavior, stage of change and motivation to change. The WAI-O-S showed an adequate reliability. Results from Bayesian confirmatory factor analyses showed two first-order factors (Bond and Agreement), and a second-order factor (General working alliance) explaining the relationship between the first-order factors. Results also support the validity of this instrument. The availability of reliable and valid observational measure of the working alliance provides a useful tool to overcome self-report measurement limitations such as social desirability, deception, and denial among IPV offenders.     

Perceived stigma of caregivers: Psychometric evaluation for Devaluation of Consumer Families Scale

Background/Objective: The Devaluation of Consumer Families Scale (DCFS) is commonly used to measure perceived stigma towards family members of people with mental illness. However, its factorial structure has never been confirmed using confirmatory factor analysis (CFA). This study aimed to test the psychometric properties of the DCFS Taiwan version (DCFS-TW). Method: Family caregivers (N=511) completed the DCFS-TW (97 completed the DCFS again after 2 to 4 weeks) and other instruments. CFA, test-retest reliability, internal consistency, concurrent validity, and known-group validity were analyzed. Results: The three-factor structure of the DCFS-TW performed better than the one-factor structure. Test-retest reliability (r = .66) and internal consistency were satisfactory (α = .85); concurrent validity (absolute r = .20 to .58) was acceptable; known-group validity was supported by the significantly different DCFS-TW scores in clinical characteristics (had been vs. had not been hospitalized; had been vs. had not been compulsorily admitted). Conclusions: The DCFS-TW has decent psychometric properties and is suitable for health professionals to measure perceived stigma towards family members of people with mental illness.     

The Mediation Effect of Posttraumatic Stress Disorder Symptoms on the Relationship of Intimate Partner Violence and IFN-γ Levels

Background: Women who experience intimate partner violence (IPV) report greater stress and negative health consequences than nonabused women. Although an association between psychological stress and altered immune function has been shown, IPV studies have not investigated this relationship. Objective: This study explored the association of IPV with mental health symptoms and an immune marker to determine if posttraumatic stress disorder (PTSD) symptoms mediate the effect of IPV on pro-inflammatory (IFN-γ) cytokine levels. Methods: A cross-sectional, comparative design was used to compare 62 women with IPV and 39 nonabused women. Results: Mean IFN-γ values were higher in abused women and in women with current PTSD symptoms. There were no significant relationships with potential confounding variables that could provide an alternative explanation for the increase in production of proinflammatory cytokines. Conclusions: PTSD symptoms mediate the association between IPV and IFN-γ levels and may partially explain the association of mental health symptoms with physical health sequelae in IPV.