Temporal and spatial convergence: the major depressive disorder burden attributed to intimate partner violence against women.

Background: There is a strong causal relationship between intimate partner violence and major depressive disorder, which partly endangers women's safety across the life course and potentially affects the development of future generations. The international community has placed a high priority on addressing the intimate partner violence and the resulting burden of mental illness. Data collection needs to be captured across the temporal trend and spatial distribution for major depressive disorder attributed to intimate partner violence, to reflect the priorities and expectations of survivors.Method: This research obtained raw disability-adjusted life years (DALYs) information for major depressive disorder attributed to intimate partner violence from the Global Burden of Disease 2019. Using estimated annual percentage change and two-way fixed effects models, a secondary spatio-temporal analysis of the age-standardized DALYs rate from 1990 to 2019 was performed.Results: In 2019, DALYs lost among women experiencing major depressive disorder (3.16 million) accounted for 37.18% of the DALYs lost worldwide due to intimate partner violence. The age-standardized DALYs rate of major depressive disorder attributed to intimate partner violence was 108.57 per 100,000. The highest was concentrated in the menopausal transition (45-55), with 133.61 per 100,000, and particularly distributed in Uganda (429.31 per 100,000). The early reproductive period (15-19) showed the increasing age-standardized DALYs rate from 1990 to 2019, which was mainly driven by Malaysia (3.73% per year). Furthermore, countries with higher initial levels of the age-standardized DALYs rate were growing faster than those with lower levels.Conclusions: The burden of major depressive disorder attributed to intimate partner violence showed biological and spatial inequality, prioritized intervention should be targeted at vulnerable stage women in their early reproductive period and menopausal transition. Combined political, socio-cultural as well as medical measures to prevent violence and treat major depressive disorder should be implemented and developed.

Vulnerability to different biological stages of the burden of experiencing intimate partner violence leading to major depressive disorder in women. Women in their reproductive years and during the menopausal transition were more vulnerable.Intimate partner violence-induced depressive disorder is trending younger, with an increasing burden on girls aged 15­19 over the past 30 years.The burden of major depressive disorder attributed to intimate partner violence varies increasingly across countries.

Perinatal intimate partner violence among teen mothers and children's attachment disorders in Rwanda: potential mediating factors.

Background: The alarming prevalence of teen mothers' exposure to perinatal intimate partner violence (IPV, 8.3-67%) and attachment disorders (ADs) among their children is a global concern, especially in sub-Saharan Africa with high teenage pregnancy rates. This study, therefore, aimed to examine the link between teen IPV and AD in their offspring. We sought also to explore the mediating roles of postpartum depression symptoms, maternal sensitivity, parenting stress, and perceived social support in the relationship between perinatal IPV and children's ADs.Method: This cross-sectional study selected a random sample of 309 teen mothers from Nyanza district. This sample size was determined using Yamane's formula, with random sampling. Various instruments were used for data collection, including questionnaires on intimate partner violence, social support, maternal sensitivity, postpartum depression symptoms and parenting stress and early trauma-related disorders. The data was analysed using SPSS, with mediation analyses performed using the PROCESS macro (version 4.1).Results: IPV was found to be significantly associated with attachment disorders. Simple mediation models showed that parenting stress completely mediated these relationships, while postpartum depression, perceived social support, and maternal sensitivity partially mediated the relationship between IPV and children's ADs. In parallel mediation model, the combined roles of all mediators fully mediated the associations between IPV and ADs.Conclusion: These findings offer valuable insights in designing or strengthening the appropriate interventions to prevent and mitigate the perinatal intimate partner violence and its detrimental impact on children's attachment disorders. Combating intimate partner violence in post-conflict situations is challenging in teen mothers, however, our results suggest that efforts to address maternal mental health and parenting practices may protect children from attachment disorders.

Parenting stress was identified as a significant mediator, fully mediating the relationship between perinatal IPV and children's attachment disorders.Postpartum depression, perceived social support, and maternal sensitivity partially mediated the link between perinatal IPV and children's attachment disorders.The study underscores the necessity for multifaceted support programmes for adolescent mothers to address IPV, alleviate parenting stress, and enhance maternal mental health and social support, promoting better attachment outcomes for their children.

[Impact of gender violence on girls and adolescents]. / Impacto de la violencia de género en las niñas y las adolescentes.

Gender is an important determinant of health. Its relationship with inequality and violence allows us to consider being a woman as a risk factor for health. Girls and teenager girls are not exempt from this circumstance, which conditions their lives from before birth and can determine their health status throughout life. It can vary according to social contexts, as various factors intersect with gender, adding risk and vulnerability to being a woman. Gender-based violence is often identified as a problem for adult women; however, the experience of discriminatory gender-based violence is constructed throughout women's lives, producing serious individual and social consequences from childhood. Accepting this violence as a «private or domestic matter¼ often prevents seeing the true dimension of the problem, its consequences, and the need to address it as a global issue.

Differential Treatment Response of Proactive and Reactive Partner Abusive Men: Results from a Laboratory Proximal Change Experiment / [La respuesta al tratamiento diferencial de hombres maltratadores proactivos y reactivos: los resultados de un experimento de cambio proximal de laboratorio]

Objective: The current study reexamines data from Babcock et al. (2011) proximal change experiment to discern the differential utility of two communication skills-based interventions for proactive and reactive partner violence offenders. Method: Partner violent men were randomly assigned to the Editing Out the Negative skill, the Accepting Influence skill, or to a placebo/timeout and reengaged in a conflict discussion with their partners. Proactivity was tested as a moderator of immediate intervention outcomes. The ability to learn the communication skills, changes in self-reported affect, observed aggression, and psychophysiological responding were examined as a function of proactivity of violence. Results: Highly proactive men had some difficulty learning the Accepting Influence skill and they responded poorly to this intervention. They responded positively to the Editing Out the Negative technique, with less aggression, more positive affect, and lower heart rates. Low proactive (i.e., reactive) men tended to feel less aggressive, more positive, and less physiologically aroused after completing the Accepting Influence technique. Conclusions: This study lends support for tailoring batterer interventions specific to perpetrator characteristics.(AU)

Objetivo: El presente estudio reexamina los datos de Babcock et al. (2011) con respecto a un experimento de cambio proximal para discernir la utilidad diferencial de dos intervenciones basadas en habilidades de comunicación para agresores de violencia de pareja proactivos y reactivos. Método: A los agresores se les asignó aleatoriamente a las condiciones habilidad de eliminar lo negativo, habilidad de aceptación de la influencia, o placebo/tiempo fuera y volvieron a participar en una discusión conflictiva con sus parejas. Se evaluó la proactividad como moderadora de los resultados proximales de la intervención. Se examinó la capacidad de aprender habilidades de comunicación, los cambios en el afecto autoinformado, la agresión observada y la respuesta psicofisiológica en función de la proactividad de la violencia. Resultados: Los hombres muy proactivos tuvieron algunas dificultades para aprender la habilidad de aceptación de la influencia y respondieron escasamente a esta intervención. Sin embargo, respondieron positivamente a la técnica de eliminar lo negativo, con menor agresión, más afecto positivo y una frecuencia cardíaca más baja. Los hombres poco proactivos (es decir, reactivos) tendían a sentirse menos agresivos, más positivos y menos activados fisiológicamente después de completar la técnica de aceptación de la influencia. Conclusiones: Este estudio proporciona apoyo a la adaptación de las intervenciones para maltratadores a las características específicas del agresor.(AU)

Estrangulación/sofocación no fatal en el contexto de violencia de género: Aspectos médico-legales e implicancias para la práctica clínica / Non-fatal strangulation/suffocation in context of gender violence: Medicolegal aspects and implications in clinical practice

RESUMEN A pesar de los numerosos esfuerzos de la comunidad internacional en pos de erradicar todas las formas de violencia contra las mujeres, esta problemática se encuentra lejos de ser resuelta. Según la ONU, una de cada tres mujeres ha sufrido violencia física o sexual por parte de la pareja, violencia sexual fuera de la pareja, o de ambas, al menos una vez en su vida. El abordaje de esta problemática, en tanto necesidad social de salud de grupos poblacionales, permite una aproximación a la violencia de género como un problema de salud colectiva. En el plano de la violencia física, la estrangulación/sofocación ha sido identificada como una de las formas más letales de violencia doméstica y agresión sexual; se ha reportado que una víctima que es estrangulada una primera vez tiene 7,5 más probabilidades de ser asesinada posteriormente por el mismo abusador. Una víctima de estrangulación/sofocación puede perder la conciencia en segundos o morir en minutos, días o semanas después del ataque o sufrir daño cerebral permanente o invalidez, además del trauma emocional. Recientemente, se han generado cambios legales en la configuración de este delito; las penas han aumentado en el Reino Unido, Estados Unidos, Australia y Nueva Zelandia. El propósito de esta revisión de literatura de tipo narrativo, no sistemática, está orientada a presentar aspectos médico-legales actualizados de la estrangulación/sofocación no fatal en el contexto de la violencia de género, y se resaltan aquellas implicancias relevantes para la práctica clínica.

ABSTRACT Despite the numerous efforts of the international community to eradicate all forms of violence against women, this problem is far from being resolved. According to the UN, one in three women has suffered physical or sexual violence from an intimate partner, sexual violence outside the couple, or both at least once in their life. Addressing this problem as a social health need of population groups allows an approach to gender violence as a collective health problem. At the level of physical violence, strangulation/suffocation has been identified as one of the most lethal forms of domestic violence and sexual assault. Victims of domestic violence who have been choked or strangled are 7.5 times more likely to be killed by their partner. A victim of strangulation/suffocation can lose consciousness in seconds or die within minutes, days or weeks after the attack, as well as suffer permanent brain damage or disability or emotional trauma. Recently, legal changes have been generated in the configuration of this crime, the penalties have increased in United Kingdom, the United States, Australia and New Zealand. The current non-systematic narrative review of literature sought to explore updated medico-legal aspects of non-fatal strangulation/suffocation in the context of gender violence, and are highlightedrelevant implications for clinical practice.

Violência contra mulher parda e preta durante a pandemia: revisão de escopo / Violencia contra mujeres pardas y negras durante la pandemia: revisión de alcance / Violence against brown and black women during the pandemic: a scoping review

Resumo Objetivo Mapear e sumarizar as principais evidências disponíveis sobre a violência por parceiro íntimo contra a mulher parda e preta durante a pandemia COVID-19. Métodos Trata-se de uma revisão de escopo nas bases de dados National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Excerpa Medica DataBASE, PsycINFO - APA PsycNET e Literatura Latino-Americana e do Caribe em Ciências da Saúde. Os critérios de inclusão foram estudos sobre violência interpessoal contra a mulher parda e preta após o decreto de pandemia COVID-19, perpetrada por parceiro íntimo, publicados a partir de 2020, nos idiomas português, espanhol ou inglês. Excluíram-se editoriais, cartas resposta, retratações e estudos voltados à violência autoprovocada. Foi realizada análise descritiva. Resultados Foram obtidos 26 estudos e após a seleção obteve-se a amostra de oito artigos, publicados entre 2020 e 2022. Os resultados evidenciaram estudos majoritariamente norte-americanos, contudo apontaram para a violência por parceiro íntimo contra a mulher parda e preta como um fenômeno global durante a pandemia. As vítimas apresentavam múltiplas condições de vulnerabilidade e encontraram várias barreiras de acesso aos serviços de saúde e segurança pública, incluindo o racismo. Medidas de prevenção e controle foram escassas e geraram consequências à saúde integral da mulher. Conclusão O fenômeno foi caracterizado como um agravo global durante a pandemia COVID-19. Estratégias de enfrentamento individuais, coletivas e políticas foram criadas pelas vítimas. Políticas públicas de prevenção e controle da violência por parceiro íntimo não foram adequadamente aplicadas em muitos países durante a pandemia.

Resumen Objetivo Mapear y resumir las principales evidencias disponibles sobre la violencia contra mujeres pardas y negras por parte de la pareja íntima durante la pandemia de COVID-19. Métodos Se trata de una revisión de alcance en las bases de datos National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Excerpa Medica DataBASE, PsycINFO - APA PsycNET y Literatura Latinoamericana y del Caribe en Ciencias de la Salud. Los criterios de inclusión fueron estudios sobre violencia interpersonal contra mujeres pardas y negras después del decreto de pandemia de COVID-19, ejercida por su pareja íntima, publicados a partir de 2020, en idioma portugués, español o inglés. Se excluyeron editoriales, cartas de respuesta, retractaciones y estudios sobre violencia autoprovocada. Se realizó análisis descriptivo. Resultados Se obtuvieron 26 estudios y, después de la selección, se obtuvo una muestra de ocho artículos, publicados entre 2020 y 2022. Los resultados evidenciaron estudios mayormente norteamericanos, pero señalaron que la violencia contra mujeres pardas y negras por parte de su pareja íntima fue un fenómeno global durante la pandemia. Las víctimas presentaron múltiples condiciones de vulnerabilidad y encontraron varias barreras de acceso a los servicios de salud y seguridad pública, inclusive racismo. Las medidas de prevención y control fueron escasas y generaron consecuencias en la salud integral de las mujeres. Conclusión El fenómeno fue caracterizado como un agravio global durante la pandemia de COVID-19. Las estrategias de enfrentamiento individuales, colectivas y políticas fueron creadas por las víctimas. Las políticas públicas de prevención y control de la violencia por parte de pareja íntima no fueron aplicadas adecuadamente en muchos países durante la pandemia. Open Science Framework: https://osf.io/bdsf7/

Abstract Objective To map and summarize the main available evidence on intimate partner violence against brown and black women during the COVID-19 pandemic. Methods This is a scoping review carried out in the National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Excerpa Medica DataBASE, PsycINFO - APA PsycNET and Latin American and Caribbean Literature in Health Sciences databases. Studies on interpersonal violence against brown and black women after the COVID-19 pandemic decree, perpetrated by an intimate partner, published from 2020 onwards in Portuguese, Spanish or English, were included. Editorials, response letters, retractions and studies focused on self-inflicted violence were excluded. Descriptive analysis was carried out. Results A total of 26 studies were obtained, and after selection, a sample of eight articles was obtained, published between 2020 and 2022. The results showed mostly North American studies, however, they pointed to intimate partner violence against brown and black women as a global phenomenon during the pandemic. The victims presented multiple conditions of vulnerability and encountered several barriers to accessing health and public safety services, including racism. Prevention and control measures were scarce and had consequences for women's overall health. Conclusion The phenomenon was characterized as a global problem during the COVID-19 pandemic. Individual, collective and political coping strategies were created by the victims. Public policies to prevent and control intimate partner violence were not adequately implemented in many countries during the pandemic. Open Science Framework: https://osf.io/bdsf7/

Intimate partner violence during pregnancy and time to return to sexual activity after childbirth: analysis of the BRISA prenatal cohort / Violencia por pareja íntima durante el embarazo y el tiempo para volver a la actividad sexual después del parto: análisis de la cohorte de prenatal BRISA / Violência por parceiro íntimo na gestação e tempo de retorno das atividades sexuais após o parto: análise da coorte de pré-natal BRISA

Abstract: This study aimed to analyze whether there is an association between intimate partner violence during pregnancy and time to return to sexual activity after childbirth in the BRISA cohort in São Luís, Maranhão State, Brazil, between 2010 and 2013. This is a longitudinal study conducted with 665 women. Intimate partner violence during pregnancy was measured using an instrument created and validated by the World Health Organization to measure violence against women. Time to return to sexual activity after childbirth was investigated using a structured questionnaire. Logistic regression models were used to analyze whether there is an association between intimate partner violence during pregnancy and time to return to sexual activity after childbirth. The prevalence of violence by an intimate partner during pregnancy was 24.06%. The prevalence of women who returned to sexual activity within 3 months after childbirth was 67.96%. When analyzing the association between exposure and outcome, no association was found in the crude model (OR = 0.88; 95%CI: 0.60-1.30), nor in the adjusted model (OR = 1.00; 95%CI: 0.61-1.63). The study results highlight the importance of providing comprehensive care to women, considering both physical and psychological aspects, since violence has a significant impact on several aspects of women's lives.

Resumen: El objetivo de este estudio fue analizar si existe asociación entre la violencia por pareja íntima durante el embarazo y el tiempo para volver a la actividad sexual después del parto en la cohorte BRISA, en São Luis, Maranhão, Brasil, entre 2010 y 2013. Se trata de un estudio longitudinal realizado con 665 mujeres. Se midió la violencia por pareja íntima durante el embarazo a través de un instrumento para medir la violencia contra la mujer creado y validado por la Organización Mundial de la Salud. Se investigó el tiempo para volver a la actividad sexual después del parto a través de un cuestionario estructurado. Se utilizaron modelos de regresión logística para verificar si existe asociación entre la violencia por pareja íntima durante el embarazo y el tiempo para volver a la actividad sexual después del parto. La prevalencia de violencia perpetrada por pareja íntima durante el embarazo fue del 24,06%. La prevalencia de mujeres que volvieron a la actividad sexual dentro de los tres meses posteriores al parto fue del 67,96%. Al analizar la asociación entre la exposición y el resultado, se constató que no hubo asociación en el modelo crudo (OR = 0,88; IC95%: 0,60-1,30), ni en el modelo ajustado (OR = 1,00; IC95%: 0,61-1,63). Los resultados del estudio resaltan la importancia de proporcionar asistencia integral a la salud de la mujer, teniendo en cuenta tanto aspectos físicos como psicológicos, una vez que la violencia afecta significativamente varios aspectos de la vida femenina.

Resumo: O objetivo deste estudo foi analisar se existe associação entre violência por parceiro íntimo na gestação e o tempo de retorno das atividades sexuais após o parto na coorte BRISA, em São Luís, Maranhão, Brasil, entre os anos de 2010 e 2013. Trata-se de estudo longitudinal conduzido com 665 mulheres. A violência por parceiro íntimo na gestação foi medida por meio de instrumento criado e validado pela Organização Mundial da Saúde para medir violência contra a mulher. O tempo de retorno das atividades sexuais após o parto foi investigado por meio de questionário estruturado. Modelos de regressão logística foram utilizados para verificar se existe associação entre violência por parceiro íntimo na gestação e tempo de retorno das atividades sexuais após o parto. A prevalência de violência perpetrada pelo parceiro íntimo na gestação foi de 24,06%. A prevalência de mulheres que retornaram às atividades sexuais em até três meses após o parto foi de 67,96%. Ao analisar a associação entre exposição e desfecho, observou-se que não houve associação no modelo bruto (OR = 0,88; IC95%: 0,60-1,30), nem no modelo ajustado (OR = 1,00; IC95%: 0,61-1,63). Os resultados do estudo evidenciam a importância de prestar assistência integral à saúde da mulher, considerando tanto aspectos físicos quanto psicológicos, uma vez que a violência tem impacto significativo em diversas áreas da vida feminina.

Intimate partner violence during pregnancy and quality of life in Southern Brazil: a cross-sectional study, 2022 / Violencia de pareja durante el embarazo y calidad de vida en el sur de Brasil: estudio transversal, 2022 / Violência por parceiro íntimo durante a gestação e qualidade de vida no Sul do Brasil: estudo transversal, 2022

ABSTRACT Objective To analyze the association between intimate partner violence during pregnancy (IPVP) and quality of life (QOL). Methods A cross-sectional study was conducted with pregnant women receiving care in Primary Health Care in the municipality of Criciúma, Santa Catarina state, Brazil, in 2022; QOL was assessed in the physical, psychological, social relationship and environmental domains using WHOQOL-Bref instrument; IPVP was evaluated by means of the World Health Organization Violence Against Women; Crude and adjusted linear regression analyses were performed. Results A total of 389 pregnant women were evaluated; IPVP was observed in 13.6% of cases; in the adjusted analysis, IPVP remained associated with physical, psychological and social relationship domains; pregnant women who experienced IPVP had a reduction in their QOL score by 9.77, 11.07 and 8.95 points, respectively, when compared to those who did not experience IPVP. Conclusion IPVP was associated with poorer QOL in the physical, psychological and social relationships domains. Health services equipped to address and prevent violence against pregnant women are essential.

RESUMEN Objetivo Analizar la asociación entre violencia de pareja durante el embarazo (VPE) y calidad de vida (CV). Métodos Estudio transversal con mujeres embarazadas en Atención Primaria de Salud, se evaluó la CV en los dominios físico, psicológico, relaciones sociales y entorno (WHOQOL-Bref); la VPE fue evaluada por la Organización Mundial de la Salud; se realizaron análisis de regresión lineal bruta y ajustada. Resultados Se evaluaron 389 gestantes. La VPE estuvo presente en el 13,6% de las gestantes; en el análisis ajustado, la violencia de género permaneció asociada a aspectos físicos, psicológicos y a las relaciones sociales; las mujeres embarazadas que sufrieron VPE presentaron disminución de 9,77; 11,07 y 8,95 puntos de CV en comparación con quienes no sufrieron VPE. Conclusión La VPE se asocia con una peor calidad de vida en los ámbitos físico, psicológico y de relaciones sociales; los servicios de salud preparados para combatir la violencia son esenciales para prevenir los casos de violencia durante el embarazo.

RESUMO Objetivo Analisar a associação entre violência por parceiro íntimo na gestação (VPIG) e qualidade de vida (QV). Métodos Estudo transversal, com gestantes atendidas na Atenção Primária à Saúde, em Criciúma, Santa Catarina, Brasil, em 2022; avaliou-se a QV quanto aos domínios físico, psicológico, das relações sociais e do meio ambiente (WHOQOL-Bref); a VPIG foi avaliada pela World Health Organization Violence Against Women; foram realizadas análise de regressão linear bruta e ajustada. Resultados Foram avaliadas 389 gestantes; a VPIG esteve presente em 13,6%; na análise ajustada, a VPIG manteve-se associada aos aspectos físico, psicológico e das relações sociais; gestantes que sofreram VPIG tiveram reduzidos 9,77, 11,07 e 8,95 pontos no escore de QV, respectivamente, quando comparadas às que não sofreram VPIG. Conclusão A VPIG esteve associada à pior QV nos domínios físico, psicológico e das relações sociais; serviços de saúde preparados para o enfrentamento e prevenção da violência contra gestantes são essenciais.

Le couple et ses déliaisons violentes: dimensions sociales, subjectives et intersubjectives / O casal e suas rupturas violentas: dimensões sociais, subjetivas e intersubjetivas / The couple and its violent untied: social, subjective, and intersubjective dimensions / La pareja y sus violentas roturas: dimensiones social, subjetiva e intersubjetiva

Comment aujourd'hui articuler la réalité sociale du couple et sa réalité inconsciente afin de rendre compte de la violence conjugale contemporaine? Après un bref retour sur les fondements anthropologiques du couple et du lien d'alliance symbolique (mariage, Pacs) ou "libre" qui le fonde, nous évoquerons l'imaginaire de la conjugalité autrement dit le fantasme de réalisation idéale de soi et de ses affects au travers de la mise en couple pour en venir à poser les coordonnées conjugales et subjectives impliquées dans le passage à l'acte violent. Deux vignettes cliniques permettent de saisir comment opère dans le lien conjugal le passage de l'amour à l'hainamoration. Seront ainsi ouvertes les possibles déliaisons, sources de violence, entre les dimensions sociale, imaginaire, subjective et intersubjective de la conjugalité.

Resumes Como articular a realidade social do casal e a sua realidade inconsciente para dar conta da violência conjugal contemporânea? Depois de uma breve revisão dos fundamentos antropológicos do casal e do vínculo de aliança simbólica (casamento, PACS) ou "livre" que lhe está subjacente, discutiremos o imaginário da conjugalidade, ou seja, a fantasia da auto-realização ideal e os seus efeitos através da relação de casal, a fim de estabelecer as coordenadas conjugais e subjectivas envolvidas na passagem à violência. Duas vinhetas clínicas permitem-nos apreender como se opera a passagem do amor ao ódio no laço conjugal. Isto abrirá as possíveis deslocações, fontes de violência, entre as dimensões sociais, imaginárias, subjectivas e intersubjectivas da conjugalidade.

How can we articulate the social reality of the couple and its unconscious reality to account for contemporary conjugal violence? After a brief review of the anthropological foundations of the couple and the symbolic (marriage, civil solidarity pact - PACS) or "free" alliance link that underpins it, we will evoke the imaginary of conjugality. In other words, the fantasy of the ideal realization of oneself and one's affects via the couple relationship, in order to pose the conjugal and subjective coordinates involved in the passage to the violent act. Two clinical vignettes allow us to comprehend how the passage from love to hatred operates in the conjugal bond. Such understanding will open up possible dislocations, roots of violence, among social, imaginary, subjective and intersubjective dimensions of conjugality.

¿Como articular la realidad social de la pareja y su realidad inconsciente para dar cuenta de la violencia conyugal contemporânea? Tras un breve repaso de los fundamentos antropológicos de pareja y del vínculo simbólico (matrimonio, PACS) o de alianza "libre" que la sustenta, abordaremos el imaginario de la conyugalidad, es decir, la fantasia de la realización ideal de uno mismo y de sus afectos a través del hecho de estar en pareja, para establecer las coordenadas conyugales y subjetivas implicadas en el paso al acto violento. Dos vinetas clínicas permiten captar cómo opera el paso del amor al odio en el vínculo conyugal. Esto abrirâ las posibles dislocaciones, fuentes de violencia, entre las dimensiones social, imaginaria, subjetiva e intersubjetiva de la conyugalidad.

Violência em relacionamentos homoafetivos entre adolescentes / Violence in same-sex relationships among adolescents / Violencia en las relaciones homosexuales entre adolescentes

RESUMO: Objetivo: descrever o perfil da violência em relacionamentos homoafetivos entre adolescentes no estado de Pernambuco-Brasil, notificados no período de 2017 a 2021. Método: a amostra foi composta por adolescentes de 10 a 19 anos (n=925), selecionados de acordo com a orientação sexual. Dados extraídos das fichas de notificação individual de violência interpessoal/autoprovocada no Sistema de Informação de Agravos de Notificação. Efetuou-se a análise estatística descritiva e as proporções pelo qui-quadrado de Pearson. Resultados: vítimas com faixa etária entre 15-19 anos (61,8%), sexo masculino (93,9%), raça/cor parda (77,5%), até oito anos de estudo (51,7%) e residiam na zona urbana (77,2%). A maioria dos agressores era do sexo masculino, era namorado (a) e/ou cônjuge. Predominou as violências: sexual, física e psicológica. Conclusão: traçou-se o perfil da violência em relações homoafetivas apontando que o público masculino foi o mais propenso a sofrer e praticar a violência.

ABSTRACT Objective: to describe the profile of violence in same-sex relationships among adolescents in the state of Pernambuco-Brazil, reported between 2017 and 2021. Method: The sample consisted of adolescents aged between 10 and 19 (n=925), selected according to their sexual orientation. Data extracted from the individual notification forms for interpersonal/self-inflicted violence in the Notifiable Diseases Information System. Descriptive statistics and Pearson's chi-square analysis of proportions were carried out. Results: victims were aged 15-19 (61.8%), male (93.9%), brown (77.5%), had up to eight years of schooling (51.7%) and lived in urban areas (77.2%). Most of the aggressors were male, boyfriends, and/or spouses. Sexual, physical, and psychological violence predominated. Conclusion: a profile of violence in same-sex relationships was drawn up, showing that men were the most likely to suffer and practice violence.

RESUMEN: Objetivo: describir el perfil de la violencia en las relaciones homosexuales entre adolescentes en el estado de Pernambuco-Brasil, reportado entre 2017 y 2021. Método: La muestra estaba formada por adolescentes de entre 10 y 19 años (n=925), seleccionados según su orientación sexual. Datos extraídos de los formularios de notificación individual de violencia interpersonal/autoinfligida en el Sistema de Información de Enfermedades de Declaración Obligatoria. Se analizaron las estadísticas descriptivas y se calcularon las proporciones mediante la prueba chi-cuadrado de Pearson. Resultados: las víctimas tenían entre 15 y 19 años (61,8%), eran hombres (93,9%), morenos (77,5%), tenían hasta ocho años de escolarización (51,7%) y vivían en zonas urbanas (77,2%). La mayoría de los agresores eran hombres, novios y/o cónyuges. Predominaba la violencia sexual, física y psicológica. Conclusión: se elaboró un perfil de la violencia en las relaciones homosexuales que mostraba que los hombres eran los más propensos a sufrir y practicar la violencia.

Características sociodemográficas y personales de la víctima - feminicida en Lima Metropolitana

Introducción. El feminicidio es un problema de salud mundial. América Latina presenta altas tasas, el Perú implementó su legislación, normativas, sanciones penales y programas preventivos; pero las estadísticas y desaparición de las mujeres siguen en aumento. Objetivo. Determinar las características sociodemográficas y personales en los protagonistas del feminicidio. Métodos. Se realizó un diseño descriptivo, de recolección de datos secundarios. Se analizó documentación forense del Instituto de Medicina Legal y Ciencias Forenses del Perú constituido por 46 protocolos de necropsia médico legal de víctimas de feminicidio en Lima Metropolitana durante los años 2019 al 2020 e informes periciales físicos y psiquiátricos de los feminicidas. Resultados. El perfil común de las víctimas fue tener 18 a 29 años, soltera, secundaria con un trabajo formal, la causa muerte fue por proyectil de arma de fuego y el lugar de muerte fue en su domicilio. El perfil de los feminicidas incluyó ser esposo/conviviente, con antecedentes policiales, familia disfuncional y tener hijos con la víctima. Conclusión. Se encontraron principales características de víctimas y sus homicidas como la edad, grado de instrucción, el domicilio de la víctima, antecedentes policiales, familias disfuncionales. En caso de los homicidas eran disociales y el argumento del homicidio fueron los celos.

Introduction. Femicide is a global health problem, Latin America presents high rates, Peru has implemented its legislation, regulations, criminal sanctions and preventive programs; but the statistics and disappearance of women continue to rise. Objectives. Determine the sociodemographic and personal characteristics of the protagonists of Femicide. Methods. Forensic documentation from the Institute of Legal Medicine and Forensic Sciences of Peru was analyzed, consisting of 46 medical legal autopsy protocols for victims of intimate femicide in Metropolitan Lima during the years 2019 to 2020, physical and psychiatric expert reports from the murderers. Descriptive design, census sampling of secondary data collection. Results. The common profile of the victims was to be 18 to 29 years old, single, high school with a formal job and the cause of death was by firearm projectile and the place of death was at his home. The profile of the murderers included being a husband/partner with a police record and a dysfunctional family and have children with the victim. Conclusion. The main characteristics of the victims and their homicides were found, such as age, level of education, the victim's address, police records, dysfunctional families. In the case of the homicides, they were dissocial and the argument for the homicide was jealousy.

Vulnerability in women primary caregivers of children in palliative care due to intimate partner violence in a pediatric hospital in Mexico / Vulnerabilidad en mujeres cuidadoras primarias de menores en cuidados paliativos debida a violencia de pareja en un hospital de niños en México

Abstract Background: Women are the primary caregivers of children in palliative care. Research has shown that the presence of intimate partner violence at home exacerbates the vulnerability of the caregiver. Current statistics indicate a high prevalence of violence in Mexico present in the intersectionality between intimate partner violence and the role of the primary caregiver. This study aimed to describe the frequency of intimate partner violence among primary palliative caregivers at the Hospital Infantil de México Federico Gómez. Methods: We conducted a cross-sectional and prospective study with convenience sampling; no sample calculation was performed. All female primary caregivers of children in the palliative care unit were invited to participate. The Scale of Violence and Index of Severity of Violence was used as the measuring instrument. Results: One hundred women participated in the study by submitting their survey in a designated mailbox. No sociodemographic data or patient diagnoses were collected. The frequency of intimate partner violence was 28%, of which 16% were considered severe cases. Women reported psychological violence (36%), sexual violence (23%), and physical violence (22%). Conclusions: Almost one-third of female primary caregivers of pediatric patients at the Hospital Infantil de México Federico Gómez have been victims of some form of violence by current partners. This study highlights a previously unreported problem and opens the door for studies to correlate intimate partner violence among primary caregivers and the quality of life of children in palliative care.

Resumen Introducción: Las mujeres son las principales cuidadoras de los niños en cuidados paliativos. Las investigaciones han demostrado que la violencia de pareja en el hogar exacerba la vulnerabilidad del cuidador. Las estadísticas actuales sobre violencia en México indican una alta prevalencia presente en la interseccionalidad entre la violencia de pareja y el rol de cuidador principal. El objetivo de este estudio fue describir la frecuencia de violencia de pareja entre los cuidadores primarios del Hospital Infantil de México Federico Gómez (HIMFG). Métodos: Se llevó a cabo un estudio transversal y prospectivo con muestreo por conveniencia; no se realizó ningún cálculo de muestra. Se invitó a participar a todas las mujeres cuidadoras primarias de niños en la Unidad de Cuidados Paliativos. Se utilizó como instrumento la Escala de Violencia e Índice de Severidad de la Violencia. Resultados: Cien mujeres participaron en el estudio; no se recogieron sus datos sociodemográficos ni diagnósticos. La frecuencia de violencia de pareja fue del 28%: 16% se consideraron casos graves. Las mujeres reportaron violencia psicológica (36%), violencia sexual (23%) y violencia física (22%). Conclusiones: Alrededor de la tercera parte de las mujeres cuidadoras principales de pacientes pediátricos del HIMFG han sido víctimas de algún tipo de violencia por parte de sus parejas actuales. Este estudio destaca un problema no informado previamente y abre la puerta a estudios para correlacionar la violencia de pareja íntima entre los cuidadores primarios y la calidad de vida de los niños en cuidados paliativos.

Vulnerability in women primary caregivers of children in palliative care due to intimate partner violence in a pediatric hospital in Mexico.

BACKGROUND: Women are the primary caregivers of children in palliative care. Research has shown that the presence of intimate partner violence at home exacerbates the vulnerability of the caregiver. Current statistics indicate a high prevalence of violence in Mexico present in the intersectionality between intimate partner violence and the role of the primary caregiver. This study aimed to describe the frequency of intimate partner violence among primary palliative caregivers at the Hospital Infantil de México Federico Gómez. METHODS: We conducted a cross-sectional and prospective study with convenience sampling; no sample calculation was performed. All female primary caregivers of children in the palliative care unit were invited to participate. The Scale of Violence and Index of Severity of Violence was used as the measuring instrument. RESULTS: One hundred women participated in the study by submitting their survey in a designated mailbox. No sociodemographic data or patient diagnoses were collected. The frequency of intimate partner violence was 28%, of which 16% were considered severe cases. Women reported psychological violence (36%), sexual violence (23%), and physical violence (22%). CONCLUSIONS: Almost one-third of female primary caregivers of pediatric patients at the Hospital Infantil de México Federico Gómez have been victims of some form of violence by current partners. This study highlights a previously unreported problem and opens the door for studies to correlate intimate partner violence among primary caregivers and the quality of life of children in palliative care.

INTRODUCCIÓN: Las mujeres son las principales cuidadoras de los niños en cuidados paliativos. Las investigaciones han demostrado que la violencia de pareja en el hogar exacerba la vulnerabilidad del cuidador. Las estadísticas actuales sobre violencia en México indican una alta prevalencia presente en la interseccionalidad entre la violencia de pareja y el rol de cuidador principal. El objetivo de este estudio fue describir la frecuencia de violencia de pareja entre los cuidadores primarios del Hospital Infantil de México Federico Gómez (HIMFG). MÉTODOS: Se llevó a cabo un estudio transversal y prospectivo con muestreo por conveniencia; no se realizó ningún cálculo de muestra. Se invitó a participar a todas las mujeres cuidadoras primarias de niños en la Unidad de Cuidados Paliativos. Se utilizó como instrumento la Escala de Violencia e Índice de Severidad de la Violencia. RESULTADOS: Cien mujeres participaron en el estudio; no se recogieron sus datos sociodemográficos ni diagnósticos. La frecuencia de violencia de pareja fue del 28%: 16% se consideraron casos graves. Las mujeres reportaron violencia psicológica (36%), violencia sexual (23%) y violencia física (22%). CONCLUSIONES: Alrededor de la tercera parte de las mujeres cuidadoras principales de pacientes pediátricos del HIMFG han sido víctimas de algún tipo de violencia por parte de sus parejas actuales. Este estudio destaca un problema no informado previamente y abre la puerta a estudios para correlacionar la violencia de pareja íntima entre los cuidadores primarios y la calidad de vida de los niños en cuidados paliativos.

Influencia de una intervención educativa en el conocimiento y en el manejo de la violencia de pareja por parte de enfermeras obstetras en Nigeria / Influence of educational intervention on nurse-midwives’ knowledge and management practices of Intimate Partner Violence (IPV) in healthcare facilities in Ekiti-State, Nigeria

Objetivo: Evaluar la influencia de una intervención educativa sobre el conocimiento, la detección y el manejo de la violencia de pareja íntima (VPI) por parte de matronas. Método: Estudio quasi-experimental donde participaron 158 matronas procedentes de 2 distritos en el estado de Ekiti (Nigeria). La muestra se dividió en grupos: experimental y de control (79 matronas por grupo). Los datos se recogieron mediante un cuestionario y una lista de verificación de observación. Se realizó un programa de capacitación educativa adaptado sobre detección y manejo de la VPI en el grupo experimental. Se realizó una medición antes de la intervención, inmediatamente después y 6 semanas después. Los datos se analizaron utilizando estadística descriptivas e inferenciales (Chi-cuadrado y regresión logística binaria) con un nivel de significancia establecido en p<0,05. Resultados: El conocimiento previo respecto a la detección y el manejo de la VPI entre las matronas en ambos grupos fue deficiente, ya que tan solo el 16,5% del grupo experimental y el 17,7% del grupo control tenían un buen conocimiento en la fase previa a la intervención. El grupo experimental tuvo una mejora significativa en el conocimiento de la detección y el manejo de la VPI, con un 82,1% con buenos conocimientos inmediatamente después de la intervención y un 92,0% a las 6 semanas después de la intervención (p=0,001). La práctica observada de detección y manejo de la VPI obtuvo mejora significativa, pasando de un 21,9% de práctica satisfactoria antes de la intervención, a un 63,5% después de la intervención (p=0,001) en el grupo experimental, no detectándose una mejora apreciable en la práctica en el grupo control (21,9 versus 36,5%; p=0,682). Conclusión: El uso programa de capacitación educativa adaptado mejoró el conocimiento de las matronas y su práctica sobre la detección y el manejo de la violencia de pareja íntima.(AU)

Objective: To assess the influence of an educational intervention on midwives’ knowledge, detection and management of intimate partner violence (IPV). Methods: A quasi-experimental study involving 158 midwives from two districts in Ekiti State, Nigeria. The sample was divided into experimental and control groups (79 midwives per group). Data were collected using a questionnaire and an observation checklist. A customized educational training program on IPV detection and management was conducted in the experimental group. Measurement was performed before the intervention, immediately after and 6 weeks later. Data were analyzed using descriptive and inferential statistics (Chi-square and binary logistic regression) with a level of significance set at P<.05. Results: Prior knowledge regarding IPV detection and management among midwives in both groups was poor, with only 16.5% of the experimental group and 17.7% of the control group having good knowledge in the pre-intervention phase. The experimental group had a significant improvement in knowledge of IPV screening and management, with 82.1% having good knowledge immediately after the intervention and 92.0% at 6 weeks after the intervention (P=.001). Observed practice of IPV detection and management improved significantly from 21.9% satisfactory practice before the intervention to 63.5% after the intervention (P=.001) in the experimental group, with no appreciable improvement in practice detected in the control group (21.9 versus 36.5%; P=.682). Conclusion: The use of a customized educational training program improved midwives’ knowledge and practice in the detection and management of intimate partner violence.(AU)

Influence of educational intervention on nurse-midwives' knowledge and management practices of Intimate Partner Violence (IPV) in healthcare Facilities in Ekiti-State, Nigeria.

OBJECTIVE: To assess the influence of an educational intervention on midwives' knowledge, detection and management of intimate partner violence (IPV). METHODS: A quasi-experimental study involving 158 midwives from two districts in Ekiti State, Nigeria. The sample was divided into experimental and control groups (79 midwives per group). Data were collected using a questionnaire and an observation checklist. A customized educational training program on IPV detection and management was conducted in the experimental group. Measurement was performed before the intervention, immediately after and 6 weeks later. Data were analyzed using descriptive and inferential statistics (Chi-square and binary logistic regression) with a level of significance set at p < 0.05. RESULTS: Prior knowledge regarding IPV detection and management among midwives in both groups was poor, with only 16.5 % of the experimental group and 17.7 % of the control group having good knowledge in the pre-intervention phase. The experimental group had a significant improvement in knowledge of IPV screening and management, with 82.1 % having good knowledge immediately after the intervention and 92.0 % at 6 weeks after the intervention (p = 0.001). Observed practice of IPV detection and management improved significantly from 21.9 % satisfactory practice before the intervention to 63.5 % after the intervention (p = 0.001) in the experimental group, with no appreciable improvement in practice detected in the control group (21.9% versus 36.5%; p = 0.682). CONCLUSION: The use of a customized educational training program improved midwives' knowledge and practice in the detection and management of intimate partner violence.

Perfil de homens autores de violência contra as mulheres: revisão sistemática da literatura brasileira / Profile of male perpetrators of violence against women: a systematic review of the Brazilian literature / Perfil de hombres autores de violencia contra las mujeres: una revisión sistemática de la literatura brasileña

Este estudo tem como objetivo analisar o perfil dos homens autores de violência contra as mulheres na literatura científica brasileira, intencionando auxiliar no direcionamento de práticas socioeducativas das políticas públicas no enfren-tamento desse tipo de violência. O estudo proposto configura uma revisão sistemática realizada por meio dos descritores "violência contra a mulher", "autor de violência", "violência por parceiro íntimo" e "violência doméstica contra a mulher". As bases de dados pesquisadas foram: SciELO, Oasisbr e BVS, compondo a amostra final de 15 artigos. Diante dos estudos que compuseram o estudo, verifica-se características como idade, situação laboral, escolari-dade, uso de álcool e outras drogas, além de histórico de violência familiar. Evidencia-se que o perfil identificado neste artigo apresenta divergências entre pontos das pesquisas nacionais realizadas. Com isso, recomenda-se a formu-lação de um instrumento que uniformize as investigações acerca da temática, assim como a participação ativa de homens autores de violência nas pesquisas. (AU)

This study aims to analyze the profile of men who commit violence against women in Brazilian scientific literature, with the intention of aiding in the development of socio-educational practices within public policies to address this type of violence. The proposed study constitutes a systematic review conducted using the descriptors "violence against women," "perpetrators of violence," "intimate partner violence," and "domestic violence against women." The data-bases searched included SciELO, Oasisbr, and BVS, resulting in a final sample of 15 articles. Based on the studies included in the review, characteristics such as age, employment status, education, and substance use (including alcohol and other drugs), as well as a history of family violence were examined. It is evident that the profile identified in this article presents variations among different national research findings. Consequently, it is recommended to develop an instrument that standardizes investigations on this subject, as well as to actively involve male perpetrators of violence in research. (AU)

Este estudio tiene como objetivo analizar el perfil de los hombres autores de violencia contra las mujeres en la literatura científica brasileña, con la intención de ayudar a orientar las prácticas socioeducativas de las políticas públicas en el tratamiento de este tipo de violencia. El estudio propuesto es una revisión sistemática realizada utilizando los descriptores "violencia contra la mujer", "perpetradores de violencia", "violencia de pareja íntima" y "violencia doméstica contra la mujer". Las bases de datos pesquisadas fueron: SciELO, Oasisbr y BVS, componiendo la muestra final de 15 artículos. En vista de los artículos que integraron el estudio, se verificaron características como edad, situación laboral, escolaridad, uso de alcohol y otras drogas, además de ante-cedentes de violencia familiar. Se evidencia que el perfil identificado en este artículo presenta diferencias entre los puntos de las investigaciones nacionales realizadas. Con esto, se recomienda la formulación de un instrumento que estandarice las investigaciones sobre el tema, así como la participación de hombres perpetradores de violencia en las investigaciones. (AU)

Association between HIV Perceived Risk and Intimate Partner Violence among Women / Asociación entre Percepción de Riesgo de VIH y Violencia de Pareja en Mujeres

Abstract HIV risk perception and Intimate partner violence (IPV) are related to HIV infection in women. However, there is a lack of information regarding on the association between risk perception and IPV in the Mexican population. This study aimed to identify and characterize subgroups based on their risk perception through the analysis of latent classes and to evaluate the variables associated with HIV risk perception. An online survey was conducted to assess sexual and preventive behavior, HIV risk perception, and intimate partner violence. Three hundred thirty-two women participated; the sampling was for convenience. Two latent classes were identified: a group with risk perception (85%) and one without risk perception (14.6%). The variables associated with the risk perception were a sexual attraction to men, not having a stable partner, perceiving oneself as at risk of acquiring HIV due to sexual behavior, and the presence of IPV. HIV prevention programs for women must address the stigmas related to HIV, such as the idea that the risk only occurs when they have multiple sexual partners, promote accurate HIV risk perception and prevent IPV in all its expressions and contexts.

Resumen En mujeres, la violencia de pareja está relacionada a una mayor probabilidad de adquirir la infección por VIH. De igual forma, una inadecuada percepción de riesgo de adquirir el virus coloca a las mujeres en una situación vulnerable. Existe una falta de información ente la asociación de la VPI y la percepción de riesgo es mujeres mexicanas. Este estudio persiguió dos objetivos: el primero fue identificar y caracterizar subgrupos en función de su percepción de riesgo a través del análisis de clases latentes; el segundo objetivo consistió en evaluar las variables asociadas con la percepción de riesgo de VIH. Se realizó una encuesta en línea para evaluar el comportamiento sexual y preventivo, la percepción del riesgo de VIH y la VP. Participaron 332 mujeres; el muestreo fue por conveniencia. Se identificaron dos clases latentes: un grupo con percepción de riesgo (85%) y otro sin percepción de riesgo (14,6%). Las variables asociadas a la percepción de riesgo fueron atracción sexual por hombres, no tener pareja estable, percibirse en riesgo de adquirir el VIH por la conducta sexual y haber sufrido de violencia de pareja en los últimos seis meses. Se concluye que los programas de prevención del VIH para mujeres deben abordar los estigmas relacionados con el VIH, como la idea de que el riesgo solo ocurre cuando tienen múltiples parejas sexuales, promover una percepción precisa del riesgo del VIH y principalmente, prevenir la VP en todas sus expresiones y contextos; así como también dar atención personalizada a mujeres que ya sufren de violencia de pareja.

Asociación entre la exposición a violencia íntima de pareja contra la mujer y el reporte de secreción y úlceras genitales

Objetivo: Evaluar la asociación entre la violencia íntima de pareja emocional, física y sexual con el auto reporte de secreción y úlcera genital en mujeres participantes de una encuesta poblacional. Métodos: Se realizó un análisis de la Encuesta Demográfica y de Salud Familiar del Perú, 2021. Los criterios de inclusión fueron tener 15 a 49 años, ser casadas o convivientes, y estar seleccionadas y entrevistadas para el módulo de violencia doméstica. Se estimó la prevalencia de auto reporte de secreción y úlcera genital. La asociación con la violencia íntima de pareja fue realizada mediante regresión logística binaria con la estimación de la razón de momios, considerando el diseño muestral complejo. Resultados: La prevalencia del reporte de úlcera o secreción genital fue 10,0%. La razón de momios para reportar secreción o úlcera genital entre las mujeres que sufrieron violencia física leve comparado con las no expuestas fue 2,25 (IC95%: 1,72 a 2,94), el riesgo incrementó a 3,42 (IC95%; 2,39 a 4,90) entre las mujeres que sufrieron violencia física severa. La razón de momios generada por la exposición a violencia sexual para reportar secreción o úlcera fue mayor (OR: 3,84, IC95%: 2,47 a 5,96). Conclusiones: Las mujeres expuestas a cada uno de los tres tipos de violencia íntima de pareja tuvieron mayor chance de reportar secreción o úlcera genital en los últimos 12 meses. El riesgo se incrementa cuando coexisten la forma física y sexual.

Objective: To assess the association between emotional, physical, and sexual intimate partner violence with self-reported discharge and genital ulcer in women from participants in a population-based survey. Methods: An analysis of the Demographic and Family Health Survey of Peru, 2021 was performed. Inclusion criteria were 15-49 years of age, married or cohabiting, and selected and interviewed for the domestic violence module. The prevalence of self-reported discharge and genital ulcer was estimated. The association with intimate partner violence was performed by binary logistic regression with odds ratio estimation, considering the complex sample design. Results: The prevalence of reporting genital ulcer or discharge was 10.0%. The odds ratio for reporting genital discharge or ulcer among women who suffered mild physical violence compared with those not exposed was 2.25 (95%CI: 1.72-2.94), the risk increased to 3.42 (95%CI: 2.39-4.90) among women who suffered severe physical violence. The odds ratio generated by exposure to sexual violence for reporting discharge or ulcer was higher (odds ratio: 3.84, 95% CI: 2.47-5.96). Conclusions: Women exposed to each of the three types of intimate partner violence had a higher chance of reporting genital discharge or ulcer in the last 12 months. The risk increases when physical and sexual violence coexist.

Patrones de victimización por violencia en el noviazgo y consumo de alcohol en adolescentes estudiantes del sur de Jalisco, México / Patterns of dating violence victimization and alcohol consumption among adolescent students from southern Jalisco, Mexico

Resumen Estudios sugieren la presencia de patrones de violencia en las relaciones de noviazgo durante la adolescencia. En la población adolescente mexicana se conoce poco sobre los patrones de abuso cara a cara y digital en el noviazgo y cómo pueden ser explicados por el consumo de alcohol. El objetivo de esta investigación fue identificar los patrones de victimización por abuso en las relaciones de noviazgo y determinar si el consumo de alcohol predice los patrones encontrados. Fue un estudio transversal con alcance explicativo. Participaron 398 adolescentes estudiantes (62.8% mujeres) de 15 a 18 años de edad (M = 16.1 años; DT = 1). Se usó un análisis de clases latentes y se encontraron tres clases: 1) violencia generalizada baja (45%), 2) violencia psicológica moderada y control digital alto (38%) y 3) violencia generalizada alta (17%). Se encontró que el consumo de alcohol se asoció con la pertenencia a la clase de violencia psicológica moderada y control digital alto (β = 0.48, p = .022) y con la pertenencia a la clase de violencia generalizada alta (β = 0.66, p = .004). Es importante considerar, en la generación de intervenciones, la existencia de patrones de violencia en el noviazgo en adolescentes y la influencia que tiene el consumo de alcohol sobre estos.

Abstract Studies suggest the existence of patterns of dating violence during adolescence. In the adolescent Mexican population, little is known about the patterns of face-to-face and cyber dating abuse and to what extent they can be explained by alcohol consumption. The aim of this research was to identify patterns of dating abuse victimization and to determine whether alcohol use predicts the patterns found. It was a cross-sectional study with an explanatory scope. A total of 398 adolescent students (62.8% women) from 15 to 18 years of age (M = 16.1 years; SD = 1) participated in the study. Latent class analysis was used, and three classes were found: 1) low generalized violence (45%); 2) moderate psychological violence and high digital control (38%); and 3) high generalized violence (17%). Alcohol consumption was found to be associated with the membership in the moderate psychological violence and high digital control (β = 0.48, p = .022) and were included in the high generalized violence class (β = 0.66, p = .004). It is important to consider, in the generation of interventions, the existence of patterns of violence in dating relationships among adolescents and the influence that alcohol consumption has on them.

Comparison of two psychotherapies in cortisol response and their efficacy in reducing symptoms of anxiety and depression in women victims of intimate partner violence / Comparación de dos psicoterapias en la respuesta del cortisol y en su eficacia para reducir los síntomas de ansiedad y depresión en mujeres víctimas de violencia de pareja

Abstract Introduction There is a growing need to implement evidence-based psychological treatments for women victims of intimate partner violence (IPV) who commonly experience stress-related disorders such as anxiety, depression, or suicide risk, as well as altered cortisol reactivity. Objective 1. To compare the changes in depressive and anxious symptomatology, quality of life, and cortisol reactivity after two different interventions, Acceptance and Commitment Therapy (ACT, based on psychological flexibility) or Interpersonal Therapy (IPT, based on empowerment) in women exposed to IPV. 2. To compare the changes in relation to the presence of suicide thoughts. Method A clinical sample of 50 women (ages 21-74) randomly assigned to attend ACT or IPT, completed pre- and post-intervention questionnaires about intimate partner violence, quality of life, depression, anxiety, and measurements of salivary cortisol reactivity (basal, 15, 30, and 45 minutes after a cognitive challenge). We used Generalized Estimating Equation Models for data analysis. Results There was a significant improvement post-intervention in all variables, regardless of the type of psychotherapy or the presence of suicide thoughts. Before interventions, women that reported suicide thoughts had severe symptoms of depression, anxiety, worse quality of life, and a cortisol hyper-response profile, in contrast to women without suicide thoughts who had moderate symptoms and no cortisol response. Cortisol response to the cognitive test decreased in all women after both therapies. Discussion and conclusion Although different psychological approach, ACT, and IPT effectively improved mental health, quality of life, and changed cortisol reactivity of women exposed to IPV, including women at suicide risk.

Resumen Introducción Son necesarios tratamientos basados en evidencia para mujeres víctimas de violencia de pareja (IPV), con trastornos relacionados con estrés como ansiedad, depresión y riesgo suicida y alteraciones en la reactividad del cortisol. Objetivo Comparar los cambios en la sintomatología depresiva, ansiosa, calidad de vida y reactividad del cortisol después de aplicar Terapia de Aceptación y Compromiso (ACT, basada en la flexibilidad psicológica) o Terapia Interpersonal (IPT, basada en el empoderamiento) en mujeres expuestas a IPV y compararlos en función al pensamiento suicida. Método Una muestra clínica de 50 mujeres (entre 21 y 74 años) fueron asignadas aleatoriamente a recibir ACT o IPT, completaron antes y después, cuestionarios sobre IPV, calidad de vida, depresión y ansiedad, y mediciones de cortisol (basal, 15, 30 y 45 minutos después de un reto cognitivo) en saliva en respuesta a un reto cognitivo. Utilizamos modelos de Ecuaciones de Estimación generalizada para analizar los datos. Resultados Mejoraron significativamente todas las variables, independientemente del tipo de psicoterapia y del pensamiento suicida. Antes de la intervención, las mujeres con ideación suicida presentaron depresión y ansiedad severas, peor calidad de vida e hiper-respuesta de cortisol, en contraste con las mujeres sin ideación, quienes presentaron síntomas moderados y una respuesta de cortisol plana. El cortisol disminuyó en todas las mujeres después de ambas terapias. Discusión y conclusión Ambas terapias IPT y ACT mejoraron la salud mental y calidad de vida de las mujeres con IPV y modificaron la reactividad del cortisol, incluyendo a las pacientes que reportaron ideación suicida.