Value of Modeling Violent Relationships.

Intimate partner violence (IPV) is a scar on human society. Growing evidence demonstrates that relationships involving IPV and women's decisionmaking about violence represent complex phenomena, best studied as complex adaptive systems. Unfortunately, that complexity limits our ability to fully understand it. This paper presents findings from a series of agent-based models (ABMs) that were created from studies involving multiple time series of couples' daily reports of violence, perceptions and behaviors. To identify potential influencing variables, we modeled the impact that random stress and intentional behavior of the women could have on men's violence and stalking. ABM models of IPV noted the lack of violence at baseline without influence, and found that three variable parameters (Distance-Distance+, HerViolence-HerViolence+, Distance-Distance-) accounted for most patterns of violence development. Random stress and arguments had little effect and the nature of the alcoholviolence relationship remained unclear, however, her violence could increase his violence and stalking. One important difference between ABMs was the importance of the persistence of her concern about the effects of violence on children. Although only modeled in the second ABM, it proved critical to results. When modeling women's decision-making, her abstinence from arguments, alcohol use and violence had no effect on whether to seek help, take legal action or leave; random stress and her daily violence did not affect seeking counseling. However, daily arguments, forgiveness and heavy alcohol use did impact actiontaking, increasing counseling, legal action and leaving generally. The addition of catastrophe equations could alter these outcomes, resulting in more counseling but less legal action. In addition, children are very important when considering decision-making; concern for children affects violence while number of children affects decision-making. In conclusion, ABM can yield important insights into IPV and have clinical implications. It can provide greater understanding of the phenomenon and allow us to test the nature of correlations. (i.e., between alcohol use and violence). ABM can clarify the inherent complexity within violent couples and facilitate sense-making. Finally, it can allow clinicians to test interventions in vitro without risk to vulnerable women.

Same-Day Correlates and Prior-Day Predictors of Couples' Violent Behaviors Based upon Partners' Daily Reports.

Although previous research identified predictors of violent events within violent heterosexual couples, findings were limited to the woman's reports, to her perceptions; his assessments were not obtained. This exploratory study was conducted to gain understanding of proximal predictors of violence assessed in "real-time" from the perspective of both partners. Fifteen adult heterosexual couples in which the woman reported experiencing partner violence in the prior 30 days were enrolled in a primary care clinic. Each partner provided separate daily telephone reports for eight weeks via an automated Interactive Voice Response (IVR), concerning the previous day's violence, alcohol use, stressors, emotional reactions and concerns for children. Same-day correlates were determined by Pearson correlations while prior-day predictors were identified via vector autoregression. Same-day correlations show that men's violence was associated with almost every other variable while women's violence correlated with men's violence, men's drug use, women's alcohol use, anger, closeness, hassles, and all men's negative feelings. Using prior-day predictors, men's violence was related to feelings (primarily hers), but women's violence was more dependent upon feelings of both of them as well as women's prior-day violence and alcohol use. Men's violence was dependent upon their partners' prior-day feelings and the men's lack of concern about effects of violence on children. Women's violence was also dependent upon women's prior-day feelings, as well as women's violence, alcohol use, marital closeness, and men's concern for children. Although the co-occurrence of men's and women's violence has been seen before, in this study only women's violence was linked to alcohol use.

Violence towards women and their decisions to take action: A complex systems approach.

Intimate partner violence (IPV) is a blight on society. Our traditional understanding suggests that interventions should be straightforward, leading to predictable positive results. However, these assumptions do not reflect the reality of IPV, which continues to frustrate physicians. While IPV research has thoroughly described the developmental risks and impacts of IPV, the violent incident itself remains largely unstudied and poorly understood. Although this lack of research may partially explain physician frustration and the limitations of our interventions, the greater problem may be our reliance upon the wrong paradigm in guiding our understanding. Complexity science says that systems are globally understandable, but not completely knowable. Our hypothesis is that IPV needs to be viewed as a complex adaptive system if we are to understand the phenomenon, identify expectations and appropriately intervene. When viewed through the lens of complexity science, IPV becomes less knowable and predictable, suggesting that interventionists should expect variable response. Research has indeed demonstrated that partner violence is a complex phenomenon with multiple, interdependent factors and a nonlinear trajectory. This nonlinearity/unpredictability can impact outcomes in IPV, often more so than the frequency or severity of the violence. Similarly, women's decision-making concerning the violence is also a nonlinear process dependent upon multiple factors and catastrophic influences. Once recognized, complexity science offers a novel approach to explain IPV's obfuscation and resistance to predictable change. Using the tempered expectations of a systems lens, the violent interdependencies can be clarified, the obscure causes of events can be visualized, and the temporal irregularities can be mapped. Not only can the disruptive tipping points, system feedforward propagations, powerful attractors and discontinuities compromise reasoned intervention, but these same factors, if understood, can be harnessed to foster and magnify circumstances that enable positive change.

Complex Relationship Between Daily Partner Violence and Alcohol Use Among Violent Heterosexual Men.

Although alcohol use and partner violence are consistently associated, the nature of the alcohol-violence relationship is still unclear. The purpose of this pilot study was to use longitudinal daily assessments of male partners' alcohol use and violent events to identify the nature of the alcohol-violence relationship, employing both linear and nonlinear analyses. The participants were 20 adult heterosexual couples of whom the woman reported experiencing partner violence in the prior 30 days. Each partner provided a separate daily telephone report for 8 weeks via an automated interactive voice response (IVR), concerning the previous day's violence, alcohol use, stressors, emotional reactions, and concerns for children. Individual IVR databases were merged to form a combined couple's IVR time series. Time series were analyzed using graphic, linear, and nonlinear methods. Graphic analysis using state space grids found no consistent pattern across couples. Similarly, linear analysis using same-day cross-correlation and prior-day beta statistics found no significant group-level alcohol-violence relationship. Using cross-approximate entropy statistics and differential structural equation modeling, no nonlinear relationships between alcohol use and violence were noted either. Whether applying linear or nonlinear analytic methods, there is no group-level relationship between alcohol use by male perpetrators and their violent acts. The implications are significant. First, the alcohol-violence relationship may differ among subgroups. Second, couples need to be assessed thoroughly to determine their unique relationship with alcohol use, so that couple-specific interventions can be designed. Third, if perpetrators believe that their violence is facilitated by their alcohol use, then alcohol reduction should be encouraged despite any evidence suggesting a different alcohol-violence relationship. Finally, the accepted alcohol-causes-violence belief held by many providers needs to be reconsidered. Because the nature of the alcohol-violence relationship varies considerably across couples, clinicians should seek to understand their unique relationship applying across-the-board management approaches.

Is Perceived Need for Action Among Women in Violent Relationships Nonlinear and, If So, Why?

Despite the prevalence and impact of partner violence, we understand little about women's action taking except that it seems an unpredictable, nonlinear process. This article determines the degree of nonlinearity in perceived need for help, legal action, or leaving among women in violent relationships. The participants included 143 women who experienced violence in the previous month, enrolled from six primary care clinics. Baseline surveys assessed background characteristics and factors which may affect perceived need for action. Multiple times series assessments of violence and need for action were collected daily for 8 weeks via telephone Interactive Voice Response. Measures of nonlinearity of violence, perceived need for help, legal action, and leaving were computed. Repeated measures ANOVA assessed differences across measures of nonlinearity. To identify factors contributing to nonlinearity, staged multiple regression assessed the relationship between nonlinearity measures and outcomes. Ninety-three women completed sufficient time series for nonlinearity assessment. Measures of nonlinearity were lower for need for legal action compared with needs for help and leaving. Regression analysis suggested that isolation, social networks, and lack of awareness contribute to nonlinearity. Women's perceived need for legal action and its level of nonlinearity were lowest compared with those of help seeking and leaving. Although its relative linearity suggests that the need for legal action may be the most predictable, its lower mean rating suggests that legal action is a low priority. Although need for help and leaving are of higher priorities, their nonlinearity suggests that intervention will not yield predictable results.

He Said, She Said: Comparing Men's and Women's Descriptions of Men's Partner Violence.

More than one in three women and one in four men in the United States report victimization by intimate partner violence. Women and men often disagree about the frequency or severity of violent acts, and researchers have proposed various reasons for discordant reports. Using daily surveys and qualitative interviews, we compared men's and women's reports about men's partner aggression and examined language they used to describe their experiences. Fifteen heterosexual couples in violent relationships completed an 8-week study that involved daily telephone surveys about violent behaviors and household environment; baseline and end-of-study surveys addressing predictors and outcomes of violence; and qualitative end-of-study interviews to provide perspective about their relationships. Most participants were Latinos with low income. Relationship length was 5.5 years, median. In daily surveys, both partners reported similar frequencies of men's physical violence (4% of days), but men reported more physical violence by women than women did (8% vs. 3% of days). The qualitative analysts compared men's and women's accounts of male-to-female violence and observed gender-specific variations in style of reporting. Men used indirect language to describe their violent behavior, implied definitions of abuse, and justified their aggression. These findings have implications for clinical guidelines to screen and intervene with victims and perpetrators of intimate partner violence in primary care and emergency settings. Future research should focus on perpetrators of violence and examine effective ways for health care providers to identify and manage their care.

Is Readiness to Take Action Among Women in Violent Relationships a Catastrophic Phenomenon?

Taking action among women in violent relationships appears to involve sudden changes and reversals after periods of building stress, suggesting that decision making is a "catastrophic" phenomenon. This study sought to determine whether readiness-to-change is best modeled as a cusp catastrophic (CCM) phenomenon among women in violent relationships. A total of 143 women who experienced violence in the previous month completed baseline and end-of-study interviews assessing her hope, coping strategies, social network, and readiness-for-action (seeking help, taking legal action, and leaving) concerning the violence. Daily assessments of his violent behavior, forgiveness sought and given, and her perceived need-for-action were collected via telephone Interactive Voice Response for 8 weeks. Using regression analysis, the impact of factor-analyzed asymmetry (violence burden) and bifurcation (hope and cope, support, forgiveness, and number of children) variables on the outcomes (readiness-for-help, legal action, and leaving) was modeled, comparing the CCM against linear models to determine which model accounts for the most variance in each outcome. Cusp catastrophe models for all three actions accounted for more variance than either linear model comparison, but violence burden was only relevant to readiness-for-help and different bifurcation variables were at work for each action. While forgiveness was an important bifurcation factor in readiness-for-help and number of children served as the bifurcation factor for readiness-for-legal-action, readiness-to-leave was more complex with both number of children and hope-and-cope as bifurcation factors. Not only should we expect sudden changes in readiness but efforts to facilitate decision making should focus on addressing the bifurcation factors that may distort her interpretation of reality.

Psychometrics of the Violence Nonlinear Dynamics Scale.

OBJECTIVE: The trajectory of daily partner violence generally demonstrates nonlinear dynamics, and this nonlinearity is important to patient outcomes, as it is sometimes a stronger predictor of outcomes than violence frequency or severity. However, measurement of such dynamics is difficult, requiring complete time series data of sufficient length to yield stable measures. The purpose of this study was to develop a pencil-and-paper instrument to estimate violence nonlinearity and assess its psychometrics. METHODS: Adult women (N = 143) who experienced violence in the previous month were enrolled from 6 primary care clinics. Baseline surveys assessed factors known to correlate with nonlinearity (partner's control strategies, violence appraisal, hope, social support, coping style) and violence dynamics using a 30-item instrument based on traditional characteristics of complex adaptive systems. Participants completed daily assessments of the previous day's violence using interactive voice response via telephone for 8 weeks, with data collection occurring between August 2013 and March 2015. Three different measures of nonlinearity were computed: LZ complexity (algorithmic complexity), approximate entropy (lack of regularity), and Lyapunov exponent (sensitivity to initial conditions). RESULTS: Using factor analysis and reliability measures, the final 10-item Violence Nonlinearity Dynamics Scale (VNDS) was identified. The VNDS was found to have both internal consistency (0.817) and split-half reliability (0.796). In addition, the instrument demonstrated concurrent (correlating with both the combined nonlinearity factor score [r = 0.267] and Grassberger-Procaccia entropy [r = 0.338]) and construct (correlating with 9 of 13 previously identified nonlinearity correlates) validity. CONCLUSIONS: The VNDS has both reliability and validity and could facilitate the inclusion of nonlinearity assessment in both intimate partner violence research and clinical work.

Agent-Based Modeling of Day-to-Day Intimate Partner Violence.

The purpose of this study was to develop a mathematical model of mutual partner violence and assess impact of her controllable behaviors on reducing violence. An agent-based model was created of couples with history of violence based upon results of two multiple time series studies of partner violence. To explore factors that may alter model results, eight continuous variable parameters were created based upon significant (p=.05) but discrepant (opposite directions) results from previous studies. To assess the potential impact that random stress and her behavior (arguments, forgiveness, alcohol use, violence) could have on violence and stalking, the impact of variable parameter settings of these factors were also assessed. The model identified 18 unique patterns were observed, grouped into five general categories. Added random stress contributed to his violence in only two patterns. Although avoiding participation in arguments had no effect, her forgiveness and elimination of alcohol use often reduced her violence only. However, consistent violence or nonviolence on her part sometimes affected his violence and stalking. In conclusion, while increasing forgiveness and reducing alcohol intake could reduce her violence, they generally had little effect on his. However, if she eliminated her violence, it could eliminate his violence and stalking in some situations.

The Dynamics of Partner Violence and Alcohol Use in Couples: Research Methods.

OBJECTIVE: This research team uses complexity science to gain a deeper understanding of daily dynamics of intimate partner violence (IPV). This report describes research methods for gathering daily information about patterns of partner violence and alcohol use from couples in near-real time, and addresses recruitment and retention, adherence to study protocol, data validity, and participant safety. METHODS: Researchers enrolled 20 heterosexual couples with violent relationships from a primary healthcare center. Every day for 8 weeks, participants telephoned an interactive voice response (IVR) system and responded to 33 survey questions assessing violence, alcohol use, and household environment. They also completed baseline and end-of-study surveys. RESULTS: Of 20 enrolled couples, 15 completed the study, providing 90% adherence to daily reporting. Participants reported verbal aggression on an average of 11-13 days over 8 weeks, and physical abuse on an average of 2-4 days. Alcohol use was modest and infrequent. Women and men differed in their reports of women's physical aggression. No reports of physical violence were correlated with social desirability. CONCLUSIONS: We demonstrated the feasibility of enrolling and engaging both women and men in daily longitudinal research about partner violence and described advantages of IVR in daily longitudinal research.

Predictors of Perceived Need for and Actual Action Taking Among Women in Violent Relationships.

Decision-making of women in violent relationships is poorly understood. The study seeks to identify predictors of need-for-action and actions taken by women in violent relationships. The participants were 143 women who experienced violence in previous month from 6 primary care clinics. The methods involved multiple times series using daily assessments of household environment, marital relationship, concerns, violence, and need-for-action collected via telephone interactive voice response for 8 weeks. Outcomes include daily need-for-action and reports of actions taken. Same-day correlates and prior-day associations using vector autoregressions were sought, combined across subjects using meta-analytic techniques. Need for help depended on stalking, concern for child safety, forgiveness, and low perceived control; actually seeking help depended on sense of control with same-day stress and need for help. Need for legal action depended on concern for child safety and finances with desire to keep family together; actually taking legal action, correlated only with prior-day stalking and concerns about child safety but less about effects of violence on child. Need to leave depended on his violence, with concern about its effect on child, her forgiveness, and a low desire to keep family together, while actually leaving was primed by a day of his drinking, and triggered by same-day stress and need to leave, but lower levels of her drinking or his seeking forgiveness. Once gone, prior-day stalking and his alcohol use correlated with returning to the relationship. Taking action depends upon few prior- and same-day factors unique to each action.

Multi-day Patterns around Taking Action in Intimate Partner Violence.

This study was to determine the multi-day relationships among stressors, need and taking action (seeking counseling, taking legal action, leaving) by women in violent relationships. Women with recent husband-to-wife abuse but not at high-risk for life-threatening violence were recruited from six primary care clinics and asked to complete a daily description of the previous day's violence, need-for-action, and stressors using Interactive Voice Response via telephone for 8 weeks. Taking action (seeking counseling, taking legal action, leaving) was determined via weekly telephone contacts. To identify day-to-day recurrent strings, we used orbital decomposition, limiting time series to 29 women who took action during the study. Multi-day patterns were not common in taking action and are unrelated to violence. Only one 5-day string involving seeking counseling was identified in which women felt a lack of control. While taking legal action was part of five 5-days strings, each string consisted of one day of taking legal action within four days of no need-for-action, violence or stalking. Finally, one 4-day string that began with leaving coupled with spouse's excessive alcohol intake but no violence was noted. Hence, decisions to take action in violent relationships are not typically multi-day decisions linked to violence, but rather sudden events triggered by loss of control, his alcohol intake or unique situational factors.

Research or intervention or both? Women's changes after participation in a longitudinal study about intimate partner violence.

INTRODUCTION: The tensions between risk and benefit in research are particularly evident in studies about intimate partner violence. Recalling and relating traumatic experiences may deepen posttraumatic stress or relieve the burden of terrible events long borne in secret. In this article, we examine the effects of study participation in a longitudinal investigation of intimate partner violence using both qualitative and quantitative data. METHOD: Researchers enrolled 200 women in moderately violent intimate relationships and asked them to report about their relationships every day for 12 weeks. Daily, participants telephoned an automated survey and responded to 34 survey questions. They also completed baseline and end-of-study surveys and maintained telephone contact with 1 researcher weekly. Forty-2 participants completed qualitative end-of-study interviews to describe their relationships and their experiences in the study. RESULTS: Over 12 weeks, participants showed improvements in coping strategies, hope, and mental health, and increased readiness to leave their partners. In qualitative interviews, women reported gaining insight, feeling better emotionally, making behavioral changes, finding comfort in daily surveys, learning resources for help, and taking action to improve their lives. Fourteen percent left their partners by end-of-study; 35% sought counseling. DISCUSSION: The study's daily survey invited the participant to become more reflective about her relationship, which changed how she saw herself and her situation. The study methods also included weekly conversations with a compassionate researcher, allowing women to tell their stories. These 2 strategies may be incorporated into brief interventions for intimate partner violence in primary care settings. (PsycINFO Database Record

Using complexity science to examine three dynamic patterns of intimate partner violence.

INTRODUCTION: The partner violence literature describes 3 dominant models of dynamics of partner aggression: cycle of violence, family systems theory, and Duluth model (power and control wheel). Complexity science describes 3 patterns of system dynamics: periodic, chaotic, and random. Are these parallel patterns? In this analysis, investigators calculated dynamic patterns (periodic, chaotic, and random) using 84 daily reports of male-to-female aggression and assessed the "fit" between time-series-derived patterns of male partners' violent behaviors and literature-based models of violence dynamics. METHOD: Participants were 200 women in moderately violent intimate relationships who completed a telephone survey about their relationships every day for 12 weeks. They also completed baseline and end-of-study surveys and maintained telephone contact with the study team weekly. Of 200 participants, 135 women provided enough data to be assigned to period, chaotic, or random groups. RESULTS: Group membership included 16 women in periodic, 40 in chaotic, and 79 in random groups. Consistent with the cycle of violence, periodic women found violence to be predictable and controllable. Consistent with the Duluth model, women in the random group found violence to be unpredictable and out of their control, occurring with high frequency. The chaotic group had the lowest frequency and severity of violence, lowest stress and arguments, and the highest marital satisfaction. DISCUSSION: The most common dynamic pattern in partner violence is random, which exhibits high frequency and unpredictability of aggression. Complexity science suggests interventions in random systems have unpredictable outcomes, posing great challenges for clinicians who work with victims of violence.

Effects of religious and spiritual variables on outcomes in violent relationships.

OBJECTIVE: Religious and spiritual factors in intimate partner violence have received increasing attention. But are such factors related to outcomes in violent relationships? The purpose of this study was to assess the relative impact of spiritual symptoms and religious coping on attitudinal/behavioral and clinical outcomes among women in violent relationships. METHODS: Adult women with a recent history of husband-to-wife physical abuse were recruited from six primary care clinics. Once enrolled, 200 subjects completed a baseline interview and daily assessment of level of violence, using the Interactive Verbal Response for 12 weeks. At the completion of the study, contact with each participant was attempted to determine whether she had either sought professional help or left the relationship. Three religious/spiritual variables were assessed at baseline-number of visits to a religious/spiritual counselor, religious coping, and severity of spiritual symptoms. Stepped multiple linear regression was used to explain factor-analyzed outcomes (coping and appraisals, hope and support, symptomatology, functional status, readiness for change, and medical utilization), adjusting for demographic, marital, childhood, mental health, and violence variables. RESULTS: After controlling for duration, severity and dynamics of violence, the use of spiritual resources, and the level of spiritual symptoms were associated with most attitudinal/behavioral and clinical outcomes, while religious coping was only associated with staying in the relationship. CONCLUSIONS: Religious and spiritual factors were associated with most outcomes. Spiritual symptoms had a consistently negative effect on outcomes while use of spiritual resources had variable effects. Religious coping was only associated with refraining from leaving the relationship.

Coping with intimate partner violence: Qualitative findings from the study of dynamics of husband to wife abuse.

INTRODUCTION: Coping can be defined as an individual's efforts to manage a problem. In Intimate Partner Violence (IPV), coping depends heavily on relationship context, circumstances, and resource availability. The range of coping strategies utilized by women experiencing violence are not fully understood. METHOD: Two hundred female patients who screened positive for verbal or physical abuse were recruited from 6 primary care clinics in San Antonio. Subjects were instructed to complete a baseline survey, which included the COPE scale, as well as daily telephone reports, weekly contact with research staff, and an end-of-study survey. A total of 42 women completed an in-depth qualitative interview at the end of 3 months. RESULTS: Using a template approach to qualitative analysis, interview transcripts were analyzed and coded. "Coping" as a theme emerged independently and was categorized into 14 subcategories, according to the COPE scale; the most commonly endorsed themes from interviews were "avoidance" and "active coping." Previously undescribed methods of coping with IPV were also discovered using this approach, including "preventing escalation" and "ignoring." DISCUSSION: In a qualitative study of women living with IPV, coping emerged as an independent theme. We found that the women used methods not listed on the COPE standardized scale at least as often as more traditional categories. It is important for family medicine clinicians to be aware of the wide variety of coping mechanisms to best address safety planning.

Modeling Outcomes of Partner Violence Using Cusp Catastrophe Modeling.

Research suggests that intimate partner violence (IPV) is a complex, nonlinear phenomenon. In addition to the violence trajectory itself, IPV decision-making, help-seeking and leaving are nonlinear processes as well. The purpose of this study was to determine whether outcomes were best modeled as cusp catastrophic phenomena with measures of violence nonlinearity and wife-perpetrated violence serving as bifurcation variables. This 12-week time series study was conducted among 200 adult women in violent relationships. Women completed daily assessments of household environment and marital relationship using Interactive Verbal Response; missing violence data was imputed using TISEAN software to maintain its nonlinear characteristics. LZ complexity, approximate entropy, and largest Lyapunov exponents were used as measures of violence nonlinearity. Asymmetry variables included violence frequency and severity as well as its onset and duration. Factor-analyzed outcomes included coping and appraisals, hope and support, symptomatology, functional status, readiness-for-change, and medical utilization. When severity of wife's violence and nonlinearity of husband's violence were used as bifurcation variables, cusp catastrophe modeling helped explain positive and negative coping as well as readiness-for-change. In conclusion, measures of nonlinearity of husband's violence and wife's violence contributed to the variance of three outcomes in cusp catastrophe modeling. Sudden changes in coping and readiness-for-change in IPV should be expected and knowledge of violence nonlinearity may have applications when working with violent couples.

Recurrent multi-day patterns of intimate partner violence and alcohol intake in violent relationships.

Consistent links exist between male and female alcohol intake and intimate partner violence (IPV). However, the nature of the relationship remains unclear. This study explores the temporal relationships between violence and heavy alcohol intake, looking for multi-day patterns. 200 women with a recent history of husband-to-wife abuse from six primary care clinics were asked to complete daily assessments using Interactive Verbal Response (IVR) via telephone for 12 weeks. To identify recurrent strings of activities, we used orbital decomposition. Multi-day patterns were found at the 5-, 7- and 9-day levels, but most represented extensions of 4-day patterns. Overall, consecutive days of male-perpetrated, moderate-severe violence were common. In addition, heavy alcohol intake by the husband was underrepresented on days involving verbal abuse only but overrepresented in consecutive days of such abuse; husband's alcohol intake preceded his verbal abuse and a sequence of husband-perpetrated verbal abuse followed by mutual abuse followed by wife-perpetrated verbal abuse was noted. No patterns involved heavy alcohol intake by the wife. In conclusion, few patterns involved heavy alcohol intake by men and none by women. Although husband's heavy alcohol intake may contribute to onset and maintenance of verbal abuse, it plays little role in recurrent patterns of physical violence.

Webs of causation in violent relationships.

RATIONALE, AIMS AND OBJECTIVES: Predictors of intimate partner violence (IPV) include husband, wife and relational characteristics. However, we know little about the proximal, day-to-day triggering of abusive events. The purpose of the study was to analyse the daily temporal relationships among environmental, relational and violence variables in violent marital relationships. METHOD: Two hundred adult primary care women who experienced violence in the previous month were recruited from six primary care clinics. Women completed daily assessments of household environment, marital relationship and violence using telephone interactive verbal response for 12 weeks. Same-day correlates were sought using cross-correlations among the environmental, relational and violence factors. Prior-day and prior-week associations were sought using vector autoregressions. RESULTS: Except for wife's alcohol intake, all household environment and relationship factors demonstrated significant same-day correlations with IPV. However, prior-day violence by the husband, hassles, lack of husband's alcohol intake, emotional upset and marital distance were significantly related to current husband-perpetrated violence. Wife's violence depended upon her prior-day violence and alcohol intake only. All factors were related to husband-perpetrated violence in the subsequent week. Only wife's alcohol intake and husband's seeking forgiveness did not feedforward. In addition to the presence of multiple interdependent factors, circular causality was noted for marital distance and feeling upset. CONCLUSIONS: IPV was due to multiple interdependent factors, feedforward dynamics and circular causality as expected in complex systems. The complex dynamics imply that simple interventions may have little chance of success, but understanding couple-specific dynamics may allow women to recognize high-risk prior-day profiles and take preventive action.

Do violence dynamics matter?

RATIONALE, AIMS AND OBJECTIVES: Intimate partner violence is a complex, non-linear phenomenon. The purpose of this study was to determine whether violence dynamics (pattern, degree of non-linearity, optimal non-linearity) contributed to outcomes in violent relationships. METHODS: The study was conducted in six primary care clinics, enrolling 200 adult women in violent relationships. In addition to baseline and end-of-study interviews, women completed daily telephone assessments of household environment and partner violence using interactive verbal response. Three non-linearity measures of violence were computed with 'optimal' non-linearity estimated using Z-transformations. Assignment of dynamic patterns (periodic, chaotic, random) was made based upon Lyapunov exponent and correlation dimension. Outcomes across dynamic patterns were analysed using analysis of variance. In addition, stepped multiple linear regression explained factor-analysed outcomes, adjusting for demographic, childhood, mental health and marital variables; attitudinal/behavioural outcomes were also adjusted for when explaining clinical outcomes. RESULTS: Women experiencing periodic violence recognized the importance of violence and used their active coping to seek mental health care. Those with chaotic dynamics recognized that they were not responsible, experienced fewer psychological symptoms and emotional role limitations, and did not seek help. Those experiencing random violence recognized its unpredictability and uncontrollability. Violence non-linearity predicted negative coping, positive appraisals and hope/support in regression analyses, while optimal non-linearity contributed to readiness for change and symptoms functioning. Of the nine outcomes investigated, violence non-linearity contributed to five outcomes. CONCLUSION: Dynamic pattern of violence, degree of violence non-linearity and optimal non-linearity correlated with several attitudinal/behavioural and clinical outcomes. Knowledge of violence dynamics may have applications when working with violent couples.