Nora Montalvo-Liendo

Cross-cultural factors in disclosure of intimate partner violence: an integrated review

AIM This paper is a report of an integrated review to identify cross-cultural factors that have an impact on womens disclosure of intimate partner violence, specifically related to Mexican-American women. BACKGROUND Intimate partner violence was once recognized as a private matter. Disclosure is a complex concept; furthermore in our multi-cultural society, a womans decision whether or not to disclose abuse can be attributed to several factors influenced by her culture. DATA SOURCES The World Wide Web and multiple databases including Academic Premier, Cumulative Index of Nursing and Allied Health Literature (CINAHL), PsychArticles, PsychInfo, Medline, Eric, MedicLatina, and Psychology and Behavioral Science Collection were searched for studies published between 1996 and 2007. METHODS A search was conducted using databases including the CINAHL, PsychINFO, MEDLINE, ERIC and MedicLatina. Both qualitative and quantitative studies published between May 1996 and July 2007 were included. Forty-two studies were included in the review. Appraisal of study quality was not undertaken. RESULTS Fear was the most common cross-cultural factor interfering with disclosure. Most of the literature examines factors influencing and interfering with disclosure of abuse among white and African-American women. Only one study was found to include a sample of Mexican-American women. CONCLUSION Increased efforts are needed to understand disclosure of intimate partner violence in minority women so that service providers can tailor services and ways to encourage disclosure with appropriate strategies based on womens culture. Further research is needed to understand the lived experiences of minority women, including Mexican-American women living in intimate partner violence.

Factors influencing disclosure of abuse by women of Mexican descent.

PURPOSE The purpose of this study was to describe the factors that influence disclosure of abuse by women of Mexican descent. Few published studies describe the experiences of women of Mexican descent with a history of intimate partner abuse, specifically in terms of their process of disclosure of abuse. METHODS A qualitative research design was used to conduct this study in south Texas adjacent to the United States-Mexico border. Twenty-six key informants were recruited from two different sites. An open-ended approach with a semistructured interview guide was used to collect the narrative information from the 26 participants. RESULTS The findings illuminated that many factors hindered disclosure. Some of these factors included protecting their partners, avoidance of worrying their mothers, and fear of losing their children. CONCLUSIONS The study may help healthcare providers to understand the complexity of disclosure by women with a history of intimate partner abuse and may help explain why women do not readily disclose their abusive situations. CLINICAL RELEVANCE This study on the disclosure decision process of abuse by women of Mexican descent provides some understanding on the cultural or situational factors that hindered or encouraged disclosure; ultimately this knowledge can help healthcare providers and others to provide for the womans health, welfare, and safety.

Ethnoracial Variation in Women’s Exposure to Intimate Partner Violence

While intimate partner violence (IPV) has been acknowledged as a national public health concern, little research exists that directly assesses differential exposure to IPV for distinct ethnoracial groups. The current study compared the rate, severity, and type of IPV exposure across samples of White, African American, and Latina women (N = 180). Participants reported rates of exposure to violence on measures of physical assault, psychological aggression, injury, and sexual coercion; each subscale contained items denoting both mild and severe levels of violence. Multiple regression analyses indicated that women’s frequency of exposure to sexual coercion, and severe and injurious violence significantly differed based on participants’ ethnoracial identification, such that Latina women experienced disproportionate levels of violence relative to White and African American peers. Mothers’ monthly income, level of education, general health, and relationship status also emerged as significant predictors of violence exposure. Results support the development of culturally sensitive adaptations of IPV interventions, targeting not only Latina populations but also women who are single, low-income, and educationally underserved.

Women's functioning following an intervention for partner violence: new knowledge for clinical practice from a 7-year study

Intimate partner violence affects one in three women worldwide, with women who experience violence almost twice as likely to experience poor mental health, especially depression, compared with women who are not abused. To learn the impact of interventions of safe shelter and justice services on improved mental health and behavior functioning, 300 abused women are interviewed every 4 months in a 7-year prospective study. For this paper, abuse, mental health and resiliency status of these women, 1 year after accessing services for the first time, are reported. Measures of mental health (depression, anxiety, post-traumatic stress disorder (PTSD), somatization), and adult behavioral functioning are reported. At 4 months following a shelter stay or justice services, a large effect size was measured for improvement in all mental health measures; however, improvement was the lowest for PTSD. All mental health measures plateaued at 4 months with minimum further improvement at 12 months. Both internal behavioral dysfunctions (withdrawal and somatic complaints) were worse with increased depressive symptoms, as were external behavioral dysfunctions (aggressive and rule-breaking behaviors). A concerning 39.2% of the women had clinical PTSD scores at 12 months following receipt of safe shelter or justice services, compared with a much lower percentage of women with clinical depression (14.2%), clinical somatization (9.4%), and clinical anxiety (13.5%). Depression was a significant positive predictor of internal and external behavioral dysfunctions, indicating that women who had higher levels of depression tended to report more internal dysfunctions (withdrawal, anxiety, somatization) and more external behaviors (aggression and rule-breaking).

The Intersection of Partner Violence and Adverse Childhood Experiences: Implications for Research and Clinical Practice

Violence against women continues to be a serious public health issue afflicting women worldwide. The intersection of Adverse Childhood Experiences (ACEs) and intimate partner violence is detrimental to a womans well-being. This review aims to identify the types of ACEs reported by women who also report partner violence and the subsequent negative impact of this combination of experiences on the womens health. The evidence supports the cumulative effects of Adverse Childhood Experiences on women, particularly when coupled with experiences of intimate partner violence. Early interventions by providers have the potential to mitigate negative health outcomes of abused women and interrupt the intergenerational transmission of violence to their children.

Ethnoracial Variation in Depression Symptoms

Introduction: While there is a long-standing tradition of research on the predictors of depression among women exposed to violence, little of this research has been conducted across ethnic and racial groups. Method: A cross-sectional study comparing a total of 191 women with a history of intimate partner violence were recruited from commercial, medical, and educational settings and by contact with agencies serving the needs of abused women, for example, shelters, community outreach. The study examined intimate partner violence and the adjustment of mothers of children ages 5 to 12 to explore both commonalities and differences in the ways in which four groups of women (African American, Biracial, Latina, and White women) cope with violence in their lives. In addition to demographic information, depression symptoms were assessed by self-report with the Center for Epidemiologic Studies Depression scale. Results: The findings indicate that Latina women had significantly higher depression symptoms than did African American and White women. Conclusion: While it is important to assess the mental health needs of all abused women, these results show additional need for Latina women, those with low income and high violence exposure.

Behavioral functioning of children of abused women who seek services from shelters or the justice system: new knowledge for clinical practice.

Millions of women worldwide are victims of partner violence annually and their children are at-risk for psychological and physical dysfunctions. A total of 300 children (ages 18 months to 16 years), whose abused mothers sought safe shelter or a protection order for the first time, were studied. Data revealed internalizing behaviors, such as depression and externalizing behaviors, such as bullying decreased 4 months after mothers obtained help. Children’s scores from the shelter group indicated more dysfunction. Although no direct program was offered to the children studied, routine child care presents opportunities for nurses in pediatric settings to assess mothers for abuse and intervene with guided referrals and safety information that may promote better child functioning.

U.S.-born compared to non-U.S.-born abused women: analysis of baseline data.

It is evident from recent studies that a womans citizenship status does not exempt her from exposure to partner violence. The purpose of this article was to examine if social support, self-efficacy, and marginalization of abused women differ based on U.S. born compared to non-U.S. born with and without documentation. The findings suggest that women who were born in the United States had significantly higher self-efficacy scores compared to non-U.S.-born women without documents. There were no significant differences in social support among abused women who are U.S. born compared to non-U.S. born with and without documentation. In addition, women who were not born in the United States and did not have documents had higher marginalization.

Ethno-Racial Differences in Children's Attitudes and Beliefs About Violence

One in 15 children in the United States are exposed to intimate partner violence (IPV) each year. Although much is known about the adverse effects of witnessing IPV on children, little attention has been given to the impact of IPV on children of diverse ethno-racial backgrounds. In particular, the association between IPV and children’s attitudes and beliefs about violence across different ethno-racial populations remains to be explored. One hundred ninety children between the ages of 4 and 12 years of varying ethno-racial backgrounds who had witnessed recent IPV were interviewed regarding their attitudes and beliefs about IPV. Results show that younger children and White, Black, and Biracial children exhibited more deleterious attitudes and beliefs about violence after exposure to IPV than did older and Latina or Latino children. These findings may indicate the need for more tailored intervention programs that target the specific maladaptive beliefs expressed by children of various demographic groups.

Predicting Abused Women With Children Who Return to a Shelter Development and Use of a Rapid Assessment Triage Tool

To develop a tool to predict risk for return to a shelter, 150 women with children, exiting a domestic violence shelter, were evaluated every 4 months for 24 months to determine risk factors for returning to a shelter. The study identified four risk factors, including danger for murder, woman’s age (i.e., older women), tangible support (i.e., access to money, transportation), and child witness to verbal abuse of the mother. An easy to use, quick triage tool with a weighted score was derived, which can identify with 90% accuracy abused women with children most likely to return to shelters.