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The figures of Intimate Partner Violence are normally under reported therefore a lot of abuse is experienced behind the doors. Many partners within a societal setting encounter the effects of IPV and therefore there is an urgent need for addressing the issue of treatment of IPV/D especially when identified much earlier, (Harway, p3). According to the world report on violence and health in 2002, it shows that approximately 1.3 million partners are affected by domestic violence or intimate partner violence each year. This led to the establishment of Global Campaign for Violence Prevention which seeks to raise awareness concerning the IPV/DV whereby it illustrates the role that can be played by public health care system. In dealing with the problem among the couples, victims and abusers counseling can be used as a major treatment tool but more applicable to low to moderate experienced violence. (Etienne and Dahlberg, p87-113). This is quite effective because it helps in identifying the problem early enough and if efforts are made to deal with the violence then the abuser stands a better chance of coping and dealing with the abuser rather than just departing away.
Additionally IPV screening and implementation of the recommendations raised by the clinicians and health care organizations can be adopted as an equipping mechanism to the victims of the violence. It is the overall function of the health care sector through collaboration with the society to ensure identification, assessment, screening and evaluation of incidences and victims exposed to IPV abuse, (Mertin, 11). Such actions are able to reduce the levels of IPV rampantly by prevention and treatment. In addressing the issue of treatment the study seeks to understand IPV/DV, identifying the major causes and the likely effects experienced and finally arriving at treatment actions. In reduction of IPV/DV there are several recommendations that have been suggested for adoption by the concerned parties so as to equip them with coping means early enough mainly through use of counseling techniques and this can perfectly work in cases of low to moderate violence levels.
Intimate partner violence/ Domestic violence
Intimate partner violence refers to an abuse that normally occurs between two people in a very close relationship. Intimate means present and former spouses who are either in dating or in steady relationships, in steady it usually comprises of marriage couples and long term relationships. Intimate partner violence is a serious problem that is facing the today’s society in that it has resulted to very high expenses and cost in terms acquiring health care after the effect of actions associated with IPV. Intimate partner violence refers to an abuse that normally occurs between two people in a very close relationship. Intimate means present and former spouses who are either in dating or in steady relationships, in steady it usually comprises of marriage couples and long term relationships. Intimate partner violence is a serious problem that is facing the today’s society in that it has resulted to very high expenses and cost in terms acquiring health care after the effect of actions associated with IPV. For instance each year approximately $5.8 billion is spent in dealing with IPV Its effects poses the victims life at risk and therefore calls for an immediate due action of withdrawing one partner from the abuser, however not all domestic violence instances go to this extreme as at times it is usually a couple, with one or both having witnessed or been abused as a child, having a communication breakdown and violence ensues. Several case studies have shown that violence among couples is a just barrier therefore it should not lead to their complete separation from their love rather treatment should be sought as this could be a duplication of a past live abuse. The reality is that there are treatments available for IPV/DV and more people should be made aware of them.
Research studies carried out by researchers show that weight need to be put on by nations towards establishment of health care systems aimed at incorporating domestic violence, (Rennison, p19). Additionally according to (Theonnes, p58) studies shows that between 20% - 65% of all violence that are experienced by women, is normally from romantic partners and more than half the woman exposed to IPV live with children who are under the ages of twelve years. Pregnant women are also victims of increased Intimate partner violence. In the long run not only the women who suffers but more also their children and for the pregnant women their unborn babies usually develops some sought of stress, (Morland, p653-701).
Intimate partner violence is normally experienced by the victim in a sparse of incidences of violence that are left uncontained to a series of battements that prove to be detrimental to the assailant. There are four segments types of behaviors associated with IPV namely, physical violence, sexual violence, emotional abuse, and threats.
Physical abuse, here the partner is involved in beating, hitting, kicking, and burning the other partner, it is extremely an act of causing physical harm and injury to the other partner. Secondly there is the Sexual abuse, this can be described as a situation where by a partner is forced to do sexual acts that are not within their consents. Emotional abuse takes place in the form of one partner emotional stability is threatened by her/his sense of self worth being down played this can be effected by stalking, name calling, intimidation or being secluded not to see friends or relatives.
Threats of physical and sexual abuse can take the form of one partner using weapons, gestures and words to communicate his underlying intent to cause harm to his partner. Mostly the abuse starts with the emotional side of it, the victim is misused emotional after which it progresses to physical and sexual assault. Though, several types of IPV can take place simultaneously, in one incidence, such as in the case of domestic violence.
In a more precisely definition domestic violence is referred to as a pattern of behaviors that are abusive with an aim of instilling fear , harming or controlling behavior either within a marriage setting, family friends e.t.c . It can involve actions such as physical aggression, emotional and sexual threats, intimidation, domineering and passive abuse. Domestic violence may or may not constitute crime but it is dependent on the local statutes, duration and severity of acts. An example taking a case where by a husband comes home late at night very drunk and demands to have sex with the spouse, while on the other side the spouse doubts his faith fullness and therefore she refuses to have sex with him. Automatically this might result physical abuse, such as kicking, hitting, shoving, biting, restraining, throwing objects, slapping among others as he tries to force himself into her. The spouse on the other end of suffers emotional abuse when she is subjected to forced sexual intercourse , sexual abuse comes along with the act itself. Domestic violence is a prominent public health issue in the United States (Harway p94).
Research based in the above problem of battering have concluded that the following characteristics are prone in identifying a batterer; a person who in the past has been exposed to violent situations, a person who uses threats and violence to get what he wants, a person who vents his anger through breaking objects around the home, people who are always forceful in getting their own way during arguments. When a partner becomes jealous and over protective, when he is too controlling, when he takes quick steps in establishing a new relationship, when they resolve to accuse and blame others for their misfortunes, when they become cruel to children and animals and lastly when a partner has abrupt mood swings these are indications of potential harm full situation in other terms they are warning signs. (Harway, p105)
Intimate Partner Violence/Domestic Violence results to both long term and short term effects to the victims. The effects normally can take physical, psychological and also social and they can affect the people who are around and also the environment. The physical effects of the victim varies, they come as lacerations, bruises, broken bones, abdominal pains and gastrointestinal complaints, virginal and urinary tract infections and even worse they can have HIV transmission. According to (Bohn and Holz, p36) victims may experience pregnancy complications which correlate to miscarriage, low birth weight for the child and or death of the fetus. According to (Bohn, p 59) studies, it is evident enough that at least 42% of women and 20% of men usually sustain minor injuries from domestic violence and also unreported severe injuries occurs if there is continued and frequent harassment.
Psychological effects, consists of depression, this accounts almost 60 % of all battered partners tend to become depressed. The above can lead to suicidal attempts according to (Barnett ,p20) African American women are more susceptible to committing suicide at the percentage of 450 compared to the white women who stands at 25%. Along with stress victims are exposed to developing post traumatic stress disorder, whose main symptoms are those of experiencing flashbacks of the traumatic events, intrusive imagery, nightmares, anxiety and emotional numbness as for mentioned insomnia and hyper vigilance are also experienced. There is a significant connection between domestic violence as a breeding ground of Intimate partner violence and the subsequent development of posttraumatic stress disorder. In a research carried out by (Vitanza, p99), they rook a sample of study regarding 93 women who were in stressful relationships, they based their study on the psychological abuse and severity of the violence, the deduction they got was that there is a correlation between the IPV incidence and posttraumatic stress disorder. 56% of the women in the study who had experienced domestic violence had experienced posttraumatic stress disorder symptoms. (Mertin and Mohr, p115) again interviewed Australian women at rescue shelters and they deducted that 46% of the 100 women met the criteria of being diagnosed with posttraumatic stress disorder symptoms. When it comes to domestic violence the children too can develop posttraumatic stress disorder symptoms this they experience through anxiety, withdrawal and aggression, this they get when they are exposed to the violence being meted to their parents. The most aggravating problem in this situation is the carrying forward of the experience (long term side effects), meaning that the child in adult hood can experience the same and won’t budge because they think it’s right and normal
IPV can be termed as life threatening to partners it can result to injuries, immune disorders, and insomnia and digestive tract problems. It also makes a partner prone to mental instability, which include depression, low self esteem or self worth, psychological distress and post traumatic stress disorder this is according to Cascardi and Houskamp According to Vitanza and Bogat posttraumatic stress disorder is defined as a syndrome that includes the experiencing of avoidance and emotional numbing and hyper arousal symptoms that tend to occur in some individual as an aftermath of particular events that can be termed traumatic. According to the American psychiatric association a traumatic event can be defined as experiencing events that involves threat to life or physical integrity that results to feeling of fear, helplessness or horror.
Many partners especially women in their life time tend to experience some form of IPV or posttraumatic stress disorder which are associated with multiple mental health problems. These can be due to many reasons such as getting involved with someone who is prone to violence. Other times it could be a matter of having experienced abused when one was a child and unconsciously seeking out the familiar. It can also be a matter of attraction to the illusions of control and power in another person that on the surface seem protective but that only mask the underlying aggression and violence. Additionally it could be a matter of having a rebellious and argumentative nature in oneself thus the character of hostilities’ appears. (Raymond, p223)
According to Perkoningg, in a survey taken whose main aim was that of examining prevalence of posttraumatic stress disorder in a sample of young Germans ranging from the age of 14-24 years old indicated that most persons of at least 88% who met the criteria of experiencing posttraumatic stress disorder had connection with other mood and anxiety disorders, agoraphobia and they had some dependency to substance use which they used after the traumatic experience. According to varma, p42) and ( Alphonso 31) when posttraumatic stress disorder is chronic it tends to become co morbid with depression more than half the time. According to 8 the prevalence rate of PTSD in women who are battered is high it takes the range of 46- 85 %. According to varma and Pico Alphonso they argue that the high the number of ipv experiences (physical, emotional and sexual) the greater the number of posttraumatic stress disorder symptoms experienced by a woman. According to (Basile, p27), in a research carried out found out that posttraumatic stress disorder levels, depressive levels and somatic complaints were higher in women who were pregnant, this research was carried out in an Indian hospital it concluded that women who reported of having had a history of ipv and sexual coercion compared to those who didn’t. According to varma and Pico Alphonso in another study both physically and psychologically abused women displayed higher rates of posttraumatic stress disorder, depressive, and anxiety symptoms as well as having thoughts of suicide when compared to none abused controls.
For a battered victim the treatment option favors psychological treatment, according to (Hattendorf and Tollerud, p199) they recommend the use of feminist therapy approach. Feminist therapy is involved in putting up gender and power at core of therapeutic process which is built on bases of social and cultural that gears towards understanding a person’s problem. It puts much emphases on the psychological constrains and oppressions experienced by women. The primary focus the therapy approach is to ensure there is response that aims at empowerment of the victim, though at the beginning of the therapy session the safety of the victim especially if the victim is still in the abusive relationship. The assessor of the victim should assess the situation by wanting to know the character of the abuser is he was under the influence of drugs, does he mistreat animals also, does he poses weapons and also asses the level of rage of the batterer. According to (Harways and Hansen, p34) the presence of the aforementioned factors should help in gauging the potential of lethality of the batterer. Through this a safety plan can be devised in the wellness of the victim, a strategy like having an exit plan on hand that should consist of a safety kit that should contain money, clothing, car keys and copies of important documents. The above should include a prior arrangement with a shelter home or a friend’s house, this should be done without the consent of the abuser. After the safety and lethality have been covered then the therapists should cover long term goals pertaining to the victim. According to Hattendorf and Tollerud victims can be empowered by them regain their independence and regaining their social support like friends and relatives whom the victims had been cut off from. The children in these households too need their own therapeutic treatment to hamper them from long tern effects. All in all additional treatment for depression and posttraumatic stress disorder symptoms should be administered to the victims. The only problem that is left in domestic violence treatment is how to combat the issue of breaking the cycle which repetitive intimate terrorism in other terms, according to Harway, and Hansen, p199). The victims should have their own personal therapy session’s couple therapy should be discouraged as long as the violence is still on course. Each member of the relationship should be encouraged to visit a therapist individually and separately until they come to the point of acceptance.
Social support systems can also be used as a treatment method to the IPV, systems have proved to be an effective way of helping women experiencing Intimate partner violence not to contract post traumatic stress disorder thus their mental health is not affected. Otherwise tangible social support moderates the relationship between IPV and PTSD symptoms according to (Martin and Hassle, p131) found out that social support enhanced the capacity of resilience among incarcerated women with the history of victimization. The repeatedly act of severe abuse of a person by his partner can be termed as intimate terrorism according to Leone et al, people who sought help from such relationships compared to situational couple violence, the former ones were more likely to sought help other than the later. In the factor of personal characteristics in resilient women with IPV comes into play when the victim exercises self control, commitment, being goal oriented, increase levels of adaptability and practice high levels of self esteem, having high social skills and being humorous will contribute to high levels of mental well being of the victim experiencing ipv. According to Martin and Hassle brooks when the victim creates a positive mechanism in which he combats with the symptoms of IPV he tends to escalate to experiencing PTSD symptoms.
Adaptability can be used as a coping strategy to reduce IPV, according to (Reverie, p67), he found out that among low income earners, especially African American women, would rather commit suicide rather than combat the abusers meaning that they tend to accommodate the abusers. Those who didn’t use suicide used other coping strategies which were more focused on leaving the relationship or avoiding harm. In other words engagement coping strategies seems to predict better outcomes as compared to disengagement coping strategies. Specific cognitive styles have been associated with resilience of IPV, for instance (calveat, p82) concluded that cognitive schemes of rejection and disconnection created a link of violence and depression. For the survivors of child hood abuse, PTSD symptoms were persistent this is because of the negative emotions that they experienced. Finally Feldener and colleagues concluded that anxiety sensitivity cooled down the relationship between traumatic events and not specifically IPV and PTSD symptoms.
Effort to combat trauma symptoms have been successful, among adults their psychotherapy treatments of PTSD has so far been very effective. Exposure therapy is the most effective treatment according to the American psychological association divisions of clinical psychology. This can be combined with stress inoculation treatment, and eye movement desensitization and reprocessing (Wilson, p72) but the effectiveness of eye movement is debatable, in addition to psychotherapies. Medical treatment is helpful, for instance selective serotonin reuptake inhibitors have effectively treated PTSD.
New treatments are being evolved for effective treatment of PTSD, for example the use of cognitive processing therapy, this therapy was made to specifically help people from sexual abuse especially rape, though it has been applied to other forms of abuse. Narratives are used and are read aloud to enable the victims to shed their inhibitions of anger, guilt and depression.
Other researchers have been embedded on examination of the efficacy of treating acute stress disorder so that PTSD doesn’t develop to later stages. Apparently symptoms in acute stress disorder are more alike to the ones found in PTSD though they only last for about four weeks prior to the traumatic events then they tend to escalate (Bryant, p31). About 80% of victims experiencing acute stress disorder will develop into PTSD, according to Harvey using cognitive therapy on people who have experienced motor accidents and industrial accidents on a six week therapy will prevent them from developing chronic PTSD at six months and four years after the event, according to Bryant the above hasn’t been tested to women experiencing IPV, thus it offers a fertile ground in which this women can profit from research being carried out to see even if them they can benefit from it.
There are several factors that tend to suggest that women will develop PTSD as a result of experiencing ipv. PTSD that occurs in childhood due to childhood abuses matures into the adult hood stage, this is done through repeated victimization in adult hood. The above factor increases the chances of adult victimization. Child hood abuse increases the chances of a woman experiencing negative mental health in case of victimization. (Koopmans and colleagues , p162) found out that depressive symptoms are strongly associated with child hood physical and sexual abuse among women who were IPV victims. It was found out that child hood emotional abuse correlates the relationship between child hood exposure to family violence and PTSD which results to ipv in adult hood. Thus in conclusion it means a woman becomes susceptible to ipv if she had an abused childhood.
Secondly the nature of abusive behavior may act as a risk factor in women, for instance sexual abuse often takes place in conjunction with other forms of abuse, when this happen the increase risk factor in experiencing PTSD and other mental instability disease is placed on higher radar. According to (Weaver , p7) rape non partner or with partner increases the chance of experiencing PTSD and this implies to sexual assault. Sexual aggression by a partner is a stronger activator to PTSD symptoms, meaning it affects the victim more in a mental way other than physical aspect of it. In conclusion according to (Taft, p107) and Pico Alphonso et al, found that for IPV and PTSD to be experienced in their highest form could produce increased levels of depression and suicidal attempts from victims of sexual abuse.
Thirdly, the timing and exposure to IPV affects women mental health in the long run. When a woman is pregnant and gets the IPV exposure her mental health is affected, the number of partners and the timing of this exposure had varying effects. When both partners experience IPV at the same times the outcomes are devastating. The second worse out comes is experienced with pregnant women who experienced IPV with their current partners.
The efforts of prevention measures of IPV should be started during adolescence stage through open discussions and knowledge dispersion. (Cornelius and Resseguie P71-88) reviewed current intervention programmes for adolescence dating violence. Although these programmes are affected the implementation part is elusive when it comes to behavioral changes, and dating violence. For instance (Foshee P 10)and colleagues coined out a dating program to meet out violence in the dating scene, this was done with the consideration of ninth and eighth graders, its main focus was that of behavioral norms, gender stereotypes, and conflict resolution styles not to add cognitive therapy for those who seeked for help, this was for those who were in the dating scene after a year of follow up the authors deducted that there were no vital step when it came to behavioral changes, in beliefs and attitude towards dating relationships. In conclusion more research is needed to ascertain effective preventive measures to be used in curbing ipv from the grass roots that is from when people start dating i.e. The adolescence stage
The ultimate solution of IPV is finding an avenue to walk away from the situation by accepting that there is a form of abuse in the prevailing relationship. The victim should stop protecting the assailant by deeming his actions as normal, this can be evidenced mostly in developed relationship such as marriages where by the husband gets drunk on a daily basis and at the end of the day abuses the wife verbally and forces himself into her sexually. A woman in such a relationship should not let it to develop into intimate terrorism nature but should curtail the repetition by walking out before something worse happens to her and her children. By practicing pretence to the whole scene it gives the assailant more power over the victimized person thus manipulating them in each front.
As mentioned above women should become more enlightened in order to escape experiencing IPV. According to the centers for disease control prevention and the national center for injury prevention and control the strategy is that of being able to prevent IPV before it happens because as discussed it can develop to ptsd which is detrimental to ones mental health, thus factors that promote healthy dating relationship should be promoted from the societal stage, and these strategies should be focused and instilled on young people as the start dating, this will arm those who may fall victim of IPV because of the knowledge that have accrued they will know when it gets out of hand from being loving to being possessive, they will be able to detect the danger sign and run before it gets too late. Traditionally women have grouped themselves to address IPV this they have done through setting up of hot lines and shelters for battered women and rapped girls and mothers.
The whole society should be involved in mentoring the youths when it comes to the dating scene, guidance from the adults should be subjected while it’s still early, adults can change the norms of dating as they are currently perceived. This can be done by sending the message to young people that violence is not okay and we should not be victims. In order to prevent IPV the community has to be informed what is IPV and where it is found, through centre and development care program data is collected and research is done to prevent IPV in the community. From different ethnic settings adults should find a way of deeming old traditions that seem to favor the prevalence of IPV in relationships, in some communities there term women beatings as a lesson and that each man is priced when he beats his wife such sentiments should be eradicated by young men of such communities, by being taught on how to treat their women. The police force should implement ways through which victims will find it easy to report such incidence that they deem too personal while they need attention. For instance the police system should have a private office that deals with such complaints and all procedures like medical checkup points should be integrated in the system. The comfort ability of these victims should be considered for them to lose the fear of their assailants coming back after them. Women at the rural areas should be exposed to their rights within a relationship this doesn’t include being battered and being raped, this will make them know how to observe control measures and identification measures on the onset of ipv.
Victims should be advised to visit health centers for effective medication and counseling services. To avoid the victims from such adverse effects such experiencing low level of self esteem which can lead to alienation of the victim pouring over to suicidal attempts, bad eating disorders which include anorexia(the lack of eating food), obesity(the act of over eating), some experience sexual dysfunctional problems such as being frigid.
Research should be taken seriously in order to combat PTSD syndromes this will make therapy treatment to be more effective, pharmacology and medical treatment should also be delegated in the strongest form. This will help victims not to sink into deep alleys of insanity brought about by imbalances of their mental state. In conclusion according to this papers discussion it seems fit to label IPV as a national disaster that needs numerous and vigorous campaigns. This will promote public sensitization on awareness of their rights. The population will be well armed with information regarding their safety in relationships and limits that should be maintained. By doing this it will make partners feel better about themselves thus making them better people who can function well within the relationships and not assuming the roles of being mere parts of the relationships but core members of the relationship.
From the above discussion it’s evident that women exposed to IPV are candidates to experience even worst exposure of PTSD. The effects of ipv are profound on their victims by saying that their childhood experiences are the greatest factors that will determine whether the woman is resilient or not to contract PTSD symptoms.
It is important that doctors, health care organization, society handle the issue of IPV with much concern and they should put in mind the people around the victims especially the children and families are highly affected thus need for their assessment and treatment. Though they are chances that some factors can reduce the chances of women with IPV to experience PTSD, as aforementioned above through a well established support system that embraces the victims and makes them open up, this will decrease the chances of IVP growing into PTSD thus her mental health will be safeguarded.
All in all, with all the research that is being conducted on ways of effectively treating ipv and PTSD then we have hope, as we continue using therapies, pharmacological and psychological treatments that are available. For the effective prevention measures of not experiencing ipv which could develop to PTSD then everyone in the society is obligated to take responsibility in participating in public awareness programs that promote the disabling of IPV in relationship.non governmental and governmental organization should chip in research of identifying the weak areas found in the knowledge of ipv symptoms that can lead to a more serious disease PTSD. Preventive measures are well beyond curative procedures, when looked at the perspective of financial cost, damage accumulated and wasted lives. However on such incidences treatment should me sought early enough.