Cross-cultural differences in intimate partner violence and depression: a systematic review

Intimate partner violence (IPV) is a serious issue that affects women from many different cultures and contexts around the world and has serious mental health consequences such as depression. This review has systematically identified studies that have made cross-cultural comparisons of the relationship between IPV and depression. Parallel literature searches of PsychInfo, Academic Search Complete, and the Web of Knowledge were conducted for the period between January 1993 and August 2013 and reference lists of articles were scanned. Studies written in English that included a measure of depression and IPV and compared these constructs across women of different cultural groups were included. Eleven studies with a total of 33,716 participants met all the inclusion criteria. While all studies found a relationship between IPV and depression, six found that there were significant differences in IPV and depression between cultures and five indicated that there was no significant difference in this relationship between cultures. The reviewed literature suggests that where there are cross-cultural differences in the relationship between IPV and depression, factors such as help-seeking behavior, individual coping strategies, racism, identity as a wife, and cultural values are likely to play a mediating role. Future research should examine the unique contribution of these factors in alleviating depression associated with IPV within cultural groups

Ongoing challenges responding to behavioural and psychological symptoms of dementia

BACKGROUND: Mid- to late-stage dementia is often characterized by behavioural and psychological symptoms, including, but not limited to physical and verbal aggression. INTRODUCTION: Although there is a considerable research about the prevalence, aetiology, and management of behavioural and psychological symptoms of dementia, there is limited research about the experience of caring for people with such symptoms in long-term aged care facilities. AIM: The aims of the study were to describe: (i) nurses' experiences of caring for people with behavioural and psychological symptoms of dementia in long-term aged care facilities, and (ii) strategies nurses used to deal with these symptoms. METHODS: A qualitative exploratory and descriptive design, involving focus group interviews with 30 nurses from three long-term aged care units in Australia. The transcripts were analysed using inductive content analysis. RESULTS: The findings revealed five interrelated themes: (i) working under difficult conditions, (ii) behavioural and psychological symptoms of dementia: an everyday encounter, (iii) making sense of behavioural and psychological symptoms of dementia, (iv) attempting to manage behavioural and psychological symptoms of dementia, and (v) feeling undervalued. CONCLUSION: This study highlighted the difficult conditions under which nurses worked and the complexity of caring for individuals who have behavioural and psychological symptoms of dementia. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Organizational efforts to enhance the quality of care for individuals with behavioural and psychological symptoms of dementia in long-term aged care facilities should extend beyond staff education to heed nurses' concerns about organizational barriers to interpersonal care.

Protocol for a randomised controlled trial of a web-based healthy relationship tool and safety decision aid for women experiencing domestic violence (I-DECIDE)

BACKGROUND: Domestic violence is a serious problem affecting the health and wellbeing of women globally. Interventions in health care settings have primarily focused on screening and referral, however, women often may not disclose abuse to health practitioners. The internet offers a confidential space in which women can assess the health of their relationships and make a plan for safety and wellbeing for themselves and their children. This randomised controlled trial is testing the effectiveness of a web-based healthy relationship tool and safety decision aid (I-DECIDE). Based broadly on the IRIS trial in the United States, it has been adapted for the Australian context where it is conducted entirely online and uses the Psychosocial Readiness Model as the basis for the intervention. METHODS/DESIGN: In this two arm, pragmatic randomised controlled trial, women who have experienced abuse or fear of a partner in the previous 6 months will be computer randomised to receive either the I-DECIDE website or a comparator website (basic relationship and safety advice). The intervention includes self-directed reflection exercises on their relationship, danger level, priority setting, and results in an individualised, tailored action plan. Primary self-reported outcomes are: self-efficacy (General Self-Efficacy Scale) immediately after completion, 6 and 12 months post-baseline; and depressive symptoms (Centre for Epidemiologic Studies Depression Scale, Revised, 6 and 12 months post-baseline). Secondary outcomes include mean number of helpful actions for safety and wellbeing, mean level of fear of partner and cost-effectiveness. DISCUSSION: This fully-automated trial will evaluate a web-based self-information, self-reflection and self-management tool for domestic violence. We hypothesise that the improvement in self-efficacy and mental health will be mediated by increased perceived support and awareness encouraging positive change. If shown to be effective, I-DECIDE could be easily incorporated into the community sector and health care settings, providing an alternative to formal services for women not ready or able to acknowledge abuse and access specialised services. TRIAL REGISTRATION: Trial registered on 15(th) December 2014 with the Australian New Zealand Clinical Trials Registry ACTRN12614001306606.

Relationships between sport participation, problem alcohol use, and violence: A longitudinal study of young adults in Australia

There is a growing body of evidence suggesting a link between sport participation and violent behavior outside of the sporting context. However, there have been few studies that have investigated the basis of this relationship. The current study examined longitudinal relationships between sport participation, problem alcohol use, and various violent behaviors, and whether sport participation moderates relationships between problem alcohol use and violence. The sample comprised 2,262 young adults (55% female, age range at Time 1 = 17-24 years) from Victoria, Australia, surveyed in 2010 and 2012. When controlling for common risk factors, substance use, and past violence, sport participation was not associated with any violent behaviors 2 years later. However, sport participation moderated the relationship between problem alcohol use and fighting, whereby problem alcohol use was associated with engaging in fights 2 years later for sport participants, but not for nonparticipants. These findings suggest that it is not sport participation per se that influences later violence but the drinking norms or culture embedded within certain sporting contexts. Prevention approaches that address the drinking culture and social approval of excessive alcohol consumption within sporting contexts may reduce the incidence of violent behavior in the community.

Longitudinal predictors of domestic violence perpetration and victimization: a systematic review

Domestic violence (DV) is a serious and complex social issue which is associated with significant costs to both those individuals who are directly affected and the wider community. Preventative approaches with vulnerable population groups represent an important component of any integrated response to DV and should be informed by an understanding of those factors that influence violence developmentally. This paper reports the findings of a systematic review of longitudinal studies that have prospectively investigated childhood and/or adolescent predictors of DV perpetration and/or victimization among adult men and women in intimate relationships. We identified 25 original studies that met the inclusion criteria, all of which investigated predictors of domestic physical abuse. Few studies prospectively examined psychological, sexual and verbal abuse. Child and adolescent abuse, family of origin risks, child and adolescent behavioral problems, adolescent peer risks, and sociodemographic risks were all identified as significant predictors of DV perpetration and victimization. It is concluded that early childhood and adolescent factors are consistent predictors in the development of DV perpetration and victimization and that prevention and early intervention approaches targeting these factors are likely to prove the most effective.

The health and economic benefits of reducing intimate partner violence: an Australian example.

BACKGROUND: Intimate partner violence (IPV) has important impacts on the health of women in society. Our aim was to estimate the health and economic benefits of reducing the prevalence of IPV in the 2008 Australian female adult population. METHODS: Simulation models were developed to show the effect of a 5 percentage point absolute feasible reduction target in the prevalence of IPV from current Australian levels (27%). IPV is not measured in national surveys. Levels of psychological distress were used as a proxy for exposure to IPV since psychological conditions represent three-quarters of the disease burden from IPV. Lifetime cohort health benefits for females were estimated as fewer incident cases of violence-related disease and injury; deaths; and Disability Adjusted Life Years (DALYs). Opportunity cost savings were estimated for the health sector, paid and unpaid production and leisure from reduced incidence of IPV-related disease and deaths. Workforce production gains were estimated by comparing surveyed participation and absenteeism rates of females with moderate psychological distress (lifetime IPV exposure) against high or very high distress (current IPV exposure), and valued using the friction cost approach (FCA). The impact of improved health status on unpaid household production and leisure time were modelled from time use survey data. Potential costs associated with interventions to reduce IPV were not considered. Multivariable uncertainty analyses and univariable sensitivity analyses were undertaken. RESULTS: A 5 percentage point absolute reduction in the lifetime prevalence of IPV in the 2008 Australian female population was estimated to produce 6000 fewer incident cases of disease/injury, 74 fewer deaths, 5000 fewer DALYs lost and provide gains of 926,000 working days, 371,000 days of home-based production and 428,000 leisure days. Overall, AUD371 million in opportunity cost savings could be achievable. The greatest economic savings would be home-based production (AUD147 million), followed by leisure time (AUD98 million), workforce production (AUD94 million) and reduced health sector costs (AUD38 million). CONCLUSIONS: This study contributes new knowledge about the economic impact of IPV in females. The findings provide evidence of large potential opportunity cost savings from reducing the prevalence of IPV and reinforce the need to reduce IPV in Australia, and elsewhere.

Prosecutors’ perceptions of how to improve the quality of evidence in domestic violence cases

Limited evidence in domestic violence prosecutions is a persistent problem. Focus groups with 13 prosecutors from across Australia and New Zealand were used to explore how to improve the quality of evidence collected and presented in these cases. A thematic analysis identified three main strategies: improving the quality of investigations by initial police responders, supporting the complainant and tailoring the trial process to the domestic violence context. The most discussed strategy within these categories has previously received little attention– police video recording the complainant's initial account and using that video as the basis for the complainant's courtroom testimony.

The relationship between exposure to violence and anger in Thai adolescents

Youth violence is a serious public health problem in Thailand, and yet is poorly understood and is thought to vary considerably between metropolitan and rural areas. This article reports the findings of a cross-sectional study involving 1,170 technical college students who completed self-report questionnaires assessing the frequency of violent acts, antisocial behavior, and angry emotion. There were no differences in self-reported violent activities between metropolitan and rural participants, but those attending colleges in the metropolitan areas reported more acts involving weapons. Scores on the measure of anger expression predicted physical and verbal assault, specifically punching and name calling, suggesting that the implementation of interventions which help students to improve control over anger may be a useful violence prevention approach.

Applying a we al-li educaring framework to address histories of violence with Aboriginal women

An Aboriginal woman living in a remote area is 45 times more likely to experience domestic violence than their white peers. (Gordon et al, 2002) The nature of that violence is multi-layered, complex and incorporates a history of intergenerational loss, grief, trauma and the impact of colonisation, as discussed by Atkinson, C (2008). It involves women, children, families, communities. It is a story about people, many of whom find themselves in trouble with the legal system. Of the 25 male parents who killed their children in a domestic violence context five identified as Aboriginal (20%) (NSW Domestic Violence Death Review Team Annual Report, 2015, p.17). The percentage of women in Victorian prisons who have been victims of sexual, physical or emotional abuse has been reported to be 87% (Johnson, 2004). This figure is supported by the latest Ombudsman’s report on Victorian Prisons (2015).None of the 17 females who killed their children identified as Aboriginal or Torres Strait Islander (NSW Domestic Violence Death Review Team Annual Report 2015, p.18). The most common charge/offence for both Aboriginal men and women is an act intended to cause injury (see Figure 2).The stories of women in this program and anecdotal evidence from people working in the field reveals that most of this violence is lateral, ie within families and communities which is not an uncommon occurrence where there is a history of colonisation.

Brief report: associations between self-reported paternal relationships, anger, alcohol, and intimate partner violence in a prison sample

This study investigates the association between family relationships, anger, alcohol use, and self-reported intimate partner violence (IPV). Participants were 55 male prisoners who completed a survey about their family relationships, anger, alcohol use, and aggression. Exposure to parental IPV predicted rates of self-reported perpetration of IPV, suggesting the importance of understanding more about the developmental pathways to IPV if effective prevention, intervention, and assessment strategies are to be developed for use with this high-risk population.

Understanding dynamic risk factors for violence

Recent years have seen a consensus emerge regarding the dynamic risk factors that are associated with future violence. These risk factors are now routinely assessed in structured violence risk assessment instruments. They provide a focus for treatment in structured group programmes. However, relatively little attention has been paid to risk-related theoretical issues, whether these dynamic risk factors are causally related or simply correlates of violent offending, or the extent to which they change as a consequence of treatment. More challenging is the lack of evidence to suggest that changes in these dynamic risk factors actually result in reductions in violent offending. In this paper we consider the meaning of the term dynamic risk, arguing that only those factors that, when changed, reduce the likelihood of violent recidivism, can be considered to be truly dynamic. We conclude that few of the violence risk factors commonly regarded as dynamic fulfil this requirement. There is a need to think more critically about assessment findings and treatment recommendations relating to dynamic risk, and conduct research that establishes, rather than assumes, that certain dynamic risk factors are directly related to violence. Some suggestions for advancing knowledge and practice are provided.