Lecture 15: Intentional Injury - Family Violence Flashcards
what were the aims of the 2019 NZ family violence study?
Overall objective: to measure the population prevalence of family violence
For:
- females and males over 16
this was the first study that:
- inclues males
- includes 65 and over
- measure of economic abuse, use of electronic media for abuse
also included:
- better measures of disability and adverse childhood experiences
- Looked at attitudes and behaviours related to family exposure (risk and protective factors)
- health and social outcome (e.g. chronic disease, injuries)
where was data collected from?
2017-2019
- northland, auckland, waikato
how mant people were included?
9,276 households were approached to interview
- 2,875 eligible people agreed to talk (63%)
what were the domains of the questionnaire?
- helpseeking
- socio-demographics
- neighbourhood characteristics
- health outcomes
- IPV exposure (intimate partner violence)
- non-partner violence exposure
- adverse childhood experiences
- attitudes and norms
- understanding of healthy relationships
what was the representation by age-group?
sample was slightly older than the population as a whole
young people didn’t have the time and space to talk to
what was the representation
sample represented the population quite accurately
- the survey sample was pretty close to the NZ population
how many adults in NZ reported each adverse childhood experiences in 2019?
physical abuse: 18%
emotional abuse: 29%
social abuse: 18%
physical neglect: no data
emotional neglect:no data
mental illness: 19%
mother treated violently: 16%
divorce: 22%
incarcerated relative: 4%
substance abuse: 20%
what were the ACE scores for women?
20% had 1 ACE
14% had 2 ACEs
9% had 3 ACEs
14% had 4+ ACEs
43% had 0 ACEs
what were the ACE scores for men?
23% had 1 ACE
13% had 2 ACEs
8% had 3 ACEs
9% had 4+ ACEs
47% had 0 ACEs
what does this show?
prevalence of violence exposure bt ACE score
- dose-response effect between what happens to you during childhood and your likelihood of experiencing them later on in life
e. g. 0 aces, 30% will experience IPV
what does this show?
Ace score and likelihood of developing poor mental health, disability or different forms of chronic health conditions
E.g. of those with 4 aces, 45% will have experiences of poor mental health
what is positive stress?
brief increases in heart rate, mild elevations in stress hormone levels
what is tolerable stress?
serious, temporary stress responses, buffered by supportive relationships
what is toxic stress?
prolonged activation of stress response systems in the absence of protective relationships
how do ACEs influence health and well-being throughout the lifespan?
ACEs can lead to disrupted neurodevelopment -> social, emotional and cognitive impairment -> adoption of health-risk behaviours -> disease, disability and social problems -> early death
most care is focused on the top 3 parts of the pyramid, but maybe putting more focus into ACEs can be more useful
define non-partner physical violence, since age 15?
since age of 15, has anyone other than a partner ever hit, beaten or done anything else to hurt you physically
define non-partner sexual violence, since age 15
since the age of 15, has anyone (other than a partner) ever forced you to have sex or to perform a sexual act when you did not want to (by threatening you, holding you down, or putting you in a position that you could not say no)?
what is the prevalence of physical violence by non-partners, age 15+ in females?
what is the prevalence of physical violence by non-partners, age 15+ in males?
what was the prevalence of sexual violence by non-partners age 15+ in females?
what is the prevalence of sexual violence by non-partners age 15+ in males?
what is the lifetime prevalence of physical and/or sexual violence by a partner for women?
what is the lifetime prevalence of physical and/or sexual violence by a partner for males?
what is the lifetime prevalence of 2 or more acts of psychological abuse by a partner for women?
what is the lifetime prevalence of 2 or more acts of psychological abuse by a partner for men?
what is the past 12-month prevalence of physical and/or sexual violence by a partner for women?
what is the past 12-month prevalence of physical and/or sexual violence by a partner for men?
what is the past 12-month prevalence of 2 or more acts of psychological abuse by a partner for women?
what is the past 12-month prevalence of 2+ act of psychological abuse by a partner for men?
what is the proportion of reported lifetime IPV experience (none, single, multiple forms) for females?
what is the proportion of lifetime IPV experience (none, single, multiple) for males?
how did the different sexes experience non-partner violence?
women were more likely to experience non partner violence (8.2%) compared with men (2.2%)
men were more likely to experience non-partner physical violence (29% compared with 11% of women)
men were the predominant perpretrators of physical and sexual NPV against both genders
how did the different genders experience intimate partner violence?
while overall lifetime rates of physical and psychological IPV were comparable for women and men,
- women experienced these acts with more:
frequency, greater fear, more reported injuries, more reported physical and mental impacts, and were more likely to experience sexual IPV
what are the physiologival pathways affected by intentional violence?
- trauma changes the body
- sympathetic nervous system becomes more reactive
- levels of stress hormones and inflammatory cytokines become disregulated
- pain thresholds are lower
- children are especially vulnerable to these changes
- changes more likely when trauma is severe
what are the behavioural pathways affected by intentional violence?
- abuse survivors are more likely to engage in harmful behaviours (esp substance abuse and high-risk sexual activity)
- less likely to participate in health-promoting behaviours
what are the cognitive pathways affected by intentional violence?
- survivors more likely to have negative beliefs of themselves and others
- negative beliefs can undermine health, lead to harmful behaviours and harmful relationships
- need to take harmful beliefs as seriously as harmful behaviours
what are the social pathways affected by intentional violence?
- revictimisation
- divorce, marital disruptions, social isolation
- more likely to be poor, have a hard time in school, be homeless
- all of these can also have harmful effects on health
what are the emotional pathways affected by intentional violence?
- depression and PTSD are common sequelae
- depression supresses the immune system and is linked to health problems, including increasing risk of heart attacks
- need to think about these as pathways to ill-health as well as outcomes
what are the direct and indirect economic costs and benefits of interpersonal violence?
interpersonal violence:
- child abuse and neglect
- IPV
- elder abuse
- sexual violence
- workplace violence
- other violent calm
direct costs and benefits:
- costs of legal services
- direct medical costs
- direct perpetrator control costs
- costs of policing
- costs of incarceration
- costs of foster care
- private security contracts
- economic benefits to perpetrators
indirect costs and benefits:
- lost earnings and lost time
- lost investments in human capital
- indirect protection costs
- benefits to law enforcement
- productivity
- domestic investment and tourism
- psychological costs
- other non-monetary costs
