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BACKGROUND/RATIONALE:
BACKGROUND/RATIONALE.
According to recent research, 21% of current IPV nation-wide is indirectly attributable to combat exposure (mediated by the development of posttraumatic stress disorder--PTSD), making combat veterans a particularly high-risk group for IPV perpetration. Research has confirmed that veterans with PTSD are more likely to be intimately violent than veterans without PTSD. And yet, we know that not all veterans with combat exposure and PTSD are intimately violent, but do not know what distinguishes these two groups. Additionally, there is very little evidence nationally about IPV perpetrator access to healthcare, and NO (beyond the pilot work of the study PI), evidence on IPV perpetrator healthcare access in the VHA
OBJECTIVE(S):
OBJECTIVES:
The main objective is to describe the differences between VA PTSD clinic patients with and without IPV, and to examine the factors that may be related to the accurate detection of IPV perpetration in the sample. The second object is to describe the IPV/Non-IPV (perpetration) documentation practice in VA PTSD treatment settings.
METHODS:
METHODS.
To determine if veterans with PTSD (who are intimately violent) differ from those who are not, we will compare them on the following research variables: PTSD severity, relationship mutuality, early exposure to IPV, and substance abuse. We will recruit veterans who are currently attending PTSD treatment programs at the VAPSHCS and the Tacoma Vet Center, and their partners. We will conduct a 2-hour interview in which the veteran will be asked to complete 5 research measures, and a structured interview. Their intimate partner will complete a 1-hour interview and will answer 2 research measures to assess for IPV and relationship mutuality.
To determine if an IPV perpetration assessment is documented by providers, we will review the medical record of a random sample of 507 veterans enrolled into PTSD-specific treatment during the first six months of the project to answer the following questions: 1. Was an IPV perpetration assessment documented?, if so; 2. When, which clinic, and what discipline of the individual entering the note?, and 3. How was IPV perpetration detected (i.e. provider inquiry, third party report, or veteran's report)?
This study uses a non-experimental design of a cross-sectional interview with 460 patient/partner dyads, recruited from a stratified random sample. To answer the main research question we will determine if IPV and non-IPV can be reliably discriminated based on the research measures (discriminant analysis). To determine if the research measures are key indicators associated with accuracy of therapists' categorizations of IPV or non-IPV status, logistic regression will be used. And, to examine documentation of IPV perpetration, descriptive statistics (frequencies and percentiles) will be used.
FINDINGS/RESULTS:
We have completed the review of the medical record phase of the project, in which we sought to determine the nature of providers' IPV perpetration assessment and documentation practices. That data is now undergoing analysis and should be available in the fall of 2008.
IMPACT:
Emerging research reveals that perpetrating intimate partner violence (IPV) has significant health and mental health implications for the perpetrator as well as the victim. A stronger evidence base is needed to help healthcare providers identify IPV perpetrators, and ultimately to improve the response once identified. Information from this foundational work will help in the development of screening protocols, and will contribute to the knowledge base needed for clinical decision making in designing intervention strategies when IPV is detected.
PUBLICATIONS:
None at this time.
DRA:
Military and Environmental Exposures, Substance Abuse, Addictive Disorders
DRE:
Epidemiology
Keywords:
Dual diagnosis – substance abuse and mental health, PTSD
MeSH Terms:
none
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