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PUBH211 > Lecture 15: Intentional Injury - Family Violence > Flashcards

Lecture 15: Intentional Injury - Family Violence Flashcards

1
Q

what were the aims of the 2019 NZ family violence study?

A

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)
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2
Q

where was data collected from?

A

2017-2019

  • northland, auckland, waikato
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3
Q

how mant people were included?

A

9,276 households were approached to interview
- 2,875 eligible people agreed to talk (63%)

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4
Q

what were the domains of the questionnaire?

A
  • 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
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5
Q

what was the representation by age-group?

A

sample was slightly older than the population as a whole
young people didn’t have the time and space to talk to

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6
Q

what was the representation

A

sample represented the population quite accurately
- the survey sample was pretty close to the NZ population

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7
Q

how many adults in NZ reported each adverse childhood experiences in 2019?

A

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%

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8
Q

what were the ACE scores for women?

A

20% had 1 ACE
14% had 2 ACEs
9% had 3 ACEs
14% had 4+ ACEs
43% had 0 ACEs

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9
Q

what were the ACE scores for men?

A

23% had 1 ACE
13% had 2 ACEs
8% had 3 ACEs
9% had 4+ ACEs
47% had 0 ACEs

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10
Q

what does this show?

A

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
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11
Q

what does this show?

A

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

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12
Q

what is positive stress?

A

brief increases in heart rate, mild elevations in stress hormone levels

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13
Q

what is tolerable stress?

A

serious, temporary stress responses, buffered by supportive relationships

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14
Q

what is toxic stress?

A

prolonged activation of stress response systems in the absence of protective relationships

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15
Q

how do ACEs influence health and well-being throughout the lifespan?

A

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

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16
Q

define non-partner physical violence, since age 15?

A

since age of 15, has anyone other than a partner ever hit, beaten or done anything else to hurt you physically

17
Q

define non-partner sexual violence, since age 15

A

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)?

18
Q

what is the prevalence of physical violence by non-partners, age 15+ in females?

A
19
Q

what is the prevalence of physical violence by non-partners, age 15+ in males?

A
20
Q

what was the prevalence of sexual violence by non-partners age 15+ in females?

A
21
Q

what is the prevalence of sexual violence by non-partners age 15+ in males?

A
22
Q

what is the lifetime prevalence of physical and/or sexual violence by a partner for women?

A
23
Q

what is the lifetime prevalence of physical and/or sexual violence by a partner for males?

A
24
Q

what is the lifetime prevalence of 2 or more acts of psychological abuse by a partner for women?

A
25
Q

what is the lifetime prevalence of 2 or more acts of psychological abuse by a partner for men?

A
26
Q

what is the past 12-month prevalence of physical and/or sexual violence by a partner for women?

A
27
Q

what is the past 12-month prevalence of physical and/or sexual violence by a partner for men?

A
28
Q

what is the past 12-month prevalence of 2 or more acts of psychological abuse by a partner for women?

A
29
Q

what is the past 12-month prevalence of 2+ act of psychological abuse by a partner for men?

A
30
Q

what is the proportion of reported lifetime IPV experience (none, single, multiple forms) for females?

A
31
Q

what is the proportion of lifetime IPV experience (none, single, multiple) for males?

A
32
Q

how did the different sexes experience non-partner violence?

A

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

33
Q

how did the different genders experience intimate partner violence?

A

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
34
Q

what are the physiologival pathways affected by intentional violence?

A
  • 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
35
Q

what are the behavioural pathways affected by intentional violence?

A
  • 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
36
Q

what are the cognitive pathways affected by intentional violence?

A
  • 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
37
Q

what are the social pathways affected by intentional violence?

A
  • 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
38
Q

what are the emotional pathways affected by intentional violence?

A
  • 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
39
Q

what are the direct and indirect economic costs and benefits of interpersonal violence?

A

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

PUBH211 (31 decks)

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