Lecture 15: Intentional Injury - Family Violence

Question 1

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

Answer 1

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)

Question 2

where was data collected from?

Answer 2

2017-2019

• northland, auckland, waikato

Question 3

how mant people were included?

Answer 3

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

Question 4

what were the domains of the questionnaire?

Answer 4

• 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

Question 5

what was the representation by age-group?

Answer 5

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

Question 6

what was the representation

Answer 6

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

Question 7

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

Answer 7

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%

Question 8

what were the ACE scores for women?

Answer 8

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

Question 9

what were the ACE scores for men?

Answer 9

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

Question 10

what does this show?

Answer 10

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

Question 11

what does this show?

Answer 11

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

Question 12

what is positive stress?

Answer 12

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

Question 13

what is tolerable stress?

Answer 13

serious, temporary stress responses, buffered by supportive relationships

Question 14

what is toxic stress?

Answer 14

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

Question 15

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

Answer 15

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

Question 16

define non-partner physical violence, since age 15?

Answer 16

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

Question 17

define non-partner sexual violence, since age 15

Answer 17

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)?

Question 18

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

Answer 18

Question 19

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

Answer 19

Question 20

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

Answer 20

Question 21

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

Answer 21

Question 22

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

Answer 22

Question 23

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

Answer 23

Question 24

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

Answer 24

Question 25

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

Answer 25

Question 26

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

Answer 26

Question 27

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

Answer 27

Question 28

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

Answer 28

Question 29

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

Answer 29

Question 30

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

Answer 30

Question 31

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

Answer 31

Question 32

how did the different sexes experience non-partner violence?

Answer 32

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

Question 33

how did the different genders experience intimate partner violence?

Answer 33

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

Question 34

what are the physiologival pathways affected by intentional violence?

Answer 34

- 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

Question 35

what are the behavioural pathways affected by intentional violence?

Answer 35

- 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

Question 36

what are the cognitive pathways affected by intentional violence?

Answer 36

- 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

Question 37

what are the social pathways affected by intentional violence?

Answer 37

- 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

Question 38

what are the emotional pathways affected by intentional violence?

Answer 38

- 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

Question 39

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

Answer 39

_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