Article

Identifying intimate partner violence: Comparing the Chinese Abuse Assessment Screen with the Chinese Revised Conflict Tactics Scale

Department of Nursing Studies, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
BJOG An International Journal of Obstetrics & Gynaecology (Impact Factor: 3.45). 10/2007; 114(9):1065-71. DOI: 10.1111/j.1471-0528.2007.01441.x
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ABSTRACT

To assess the measurement accuracy and the utility of the Chinese Abuse Assessment Screen (AAS).
A cross-sectional study.
An antenatal clinic of a public hospital and a community centre in Hong Kong.
A total of 257 Chinese women consisting of 100 pregnant women and 157 nonpregnant women.
The Chinese AAS was administered first, followed by the Chinese Revised Conflict Tactics Scales (CTS2). This was performed in the same sitting, and each participant was interviewed once either at an antenatal clinic (for the pregnant women sample) or at a community centre (for the nonpregnant women sample).
Estimates of the sensitivity, specificity, positive and negative predictive values and positive and negative likelihood ratios.
Using the Chinese CTS2 as the standard, the specificity estimates of the Chinese AAS for emotional, physical and sexual abuse were > or = 89%, while the sensitivity estimates varied from 36.3 to 65.8%. The sensitivity improved in the screening for more severe cases (66.7%). The positive predictive values were > or = 80%, and the negative predictive values varied from 66 to 93%. Factors such as the age difference between the couple and the woman's need for financial assistance were found to be associated with intimate partner violence (IPV).
The Chinese AAS has demonstrated satisfactory measurement accuracy and utility for identifying IPV when the Chinese CTS2 was used as the standard.

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Available from: Agnes Tiwari, May 12, 2015
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    • "The five-item C-AAS, which has demonstrated satisfactory psychometric properties [42], will be used to screen potential participants for IPV. If a woman answers “yes” to being emotionally, physically, or sexually abused within the past three years and if the perpetrator is her former or current intimate partner, she is considered to be positive for IPV. "
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    ABSTRACT: Background Abused women, who suffer from chronic psychological stress, have been shown to have shorter telomeres than never abused women. Telomere shortening is associated with increased risk of cell death, and it is believed that adopting health-promoting behaviors can help to increase the activity of telomerase, an enzyme that counters telomere shortening. Qigong is an ancient Chinese mind-body integration, health-oriented practice designed to enhance the function of qi, an energy that sustains well-being. Therefore, an assessor-blind, randomized, wait-list controlled trial was developed to evaluate the effect of a qigong intervention on telomerase activity (primary objective) and proinflammatory cytokines, perceived stress, perceived coping, and depressive symptoms (secondary objectives) in abused Chinese women. Methods/Design A total of 240 Chinese women, aged ≥18 years, who have been abused by an intimate partner within the past three years will be recruited from a community setting in Hong Kong and randomized to receive either a qigong intervention or wait-list control condition as follows: the qigong intervention will comprise (i) a 2-hour group qigong training session twice a week for 6 weeks, (ii) a 1-hour follow-up group qigong exercise session once a week for 4 months, and (iii) a 30-minute self-practice qigong exercise session once a day for 5.5 months. The wait-list control group will receive qigong training after the intervention group completes the program. Upon completion of the qigong intervention program, it is expected that abused Chinese women in the intervention group will have higher levels of telomerase activity and perceived coping and lower levels of proinflammatory cytokines, perceived stress, and depressive symptoms than will abused Chinese women in the wait-list control group. Discussion This study will provide information about the effect of qigong exercise on telomerase activity and chronic psychological stress in abused Chinese women. The findings will inform the design of interventions to relieve the effects of IPV-related psychological stress on health. Also, the concept that health-promoting behaviors could slow down cellular aging might even motivate abused women to change their lifestyles. Trial registration Current Controlled Trials NCT02060123. Registered February 6, 2014.
    Full-text · Article · Aug 2014 · BMC Complementary and Alternative Medicine
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    • "The Chinese Version of the Abuse Assessment Screen (C-AAS) is a scale consisting of five dichotomous yes–no questions designed to determine the use of psychological abuse, physical violence, and sexual aggression by a former or current intimate partner within a defined period of time (i.e., lifetime and past 12 months), and whether the respondent was afraid of the perpetrator. The C-AAS has been validated as an instrument with satisfactory measurement accuracy and utility to detect intimate partner violence in the Chinese population [19]. If the woman answered affirmatively to having experienced intimate partner sexual aggression within the past 12 months, she was also asked to indicate whether her partner used physical force or threat of force to make her have sex with him. "
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    ABSTRACT: Although intimate partner sexual aggression has been shown to be associated with adverse mental health outcomes, there is scant information about sexual aggression in Chinese intimate relationships in general and about its mental health impact in particular. This article aimed to investigate sexual aggression in Chinese intimate relationships, including the use of force or threat of force and non-physical coercive tactics in unwanted sex. The quantitative and qualitative data used in this paper were drawn from a prospective cohort study conducted in Hong Kong between September 2010 and September 2012. A total of 745 Chinese women aged 18 or older who had been in an intimate relationship in the preceding 12 months were recruited from sites in all districts of Hong Kong. Multiple logistic regression analysis, ordinary linear regression, and t-tests were used in quantitative analysis. Directed content analysis was used to analyze the transcripts of 59 women who revealed experiences of intimate partner sexual aggression in individual in-depth interviews. Of the 745 Chinese women in the study, 348 (46.7%) had experienced intimate partner physical violence in the past year, and 179 (24%) had experienced intimate partner physical violence and sexual aggression in the past year. Intimate partner sexual aggression significantly predicted PTSD and depressive symptoms after controlling for intimate partner physical violence. Among the 179 women reporting intimate partner physical violence and sexual coercion in the past year, 75 indicated that their partners used force or threat of force to make them have sex, and 104 of them reported that they gave in to sex because of non-physical coercive tactics used by their partners. Qualitative data revealed a variety of non-physical coercive tactics with different degrees of subtlety used to coerce women into unwanted sex with their partners. Chinese women experiencing physically forced sex had significantly more depressive symptoms and PTSD symptoms. Our findings indicate that sexual aggression in Chinese intimate relationships has specific mental health consequences over and above those associated with physical violence. Assessment of partner violence in Chinese relationships should include screening for sexual aggression in order to provide appropriate interventions. Trial registration ClinicalTrials gov NCT01206192
    Full-text · Article · May 2014 · BMC Women's Health
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    • "If a participant answered " yes " to having been emotionally , physically, or sexually abused in the past year, and if the perpetrator was her current or former intimate partner, she was screened positive for IPV. The C-AAS has been validated and demonstrated satisfactory measurement accuracy in detecting IPV in Chinese women (Tiwari et al., 2007). Information relating to the types and frequency of IPV and abuse-related injury severity was collected using the Chinese version of the Revised Conflict Tactics Scales (C-CTS2; Chan, 2005). "
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    ABSTRACT: There is increasing recognition that chronic pain is a problem affecting women survivors of intimate partner violence (IPV), and in Western literature evidence is emerging about significant factors mediating the relationship between IPV and chronic pain. However, little is known about the factors mediating IPV and chronic pain in Chinese women for whom prior research has shown that Chinese culture may influence their response to IPV. This study was conducted to assess the roles of posttraumatic stress disorder (PTSD) symptoms, depressive symptoms, and IPV-related injury on the relationship between IPV and chronic pain in Chinese women, using structural equation modelling (SEM). Data were collected from 308 Chinese women survivors of IPV recruited at community setting (n = 228) and at domestic violence shelters (n = 82). Results showed that only the relationship between psychological abuse severity and chronic pain severity was mediated by PTSD symptom severity (β = .30, 95% CI = 0.14-0.45, p < .001). Furthermore, although depressive symptom severity was strongly correlated with PTSD symptom severity (β = .69, 95% CI = 0.61-0.76, p < .001), it was not found to be mediating the relationship between any types of IPV and chronic pain. Similarly, IPV-related injury severity was not shown to have a significant mediating effect on the relationship between IPV and chronic pain. The findings affirm the importance of recognizing the complex interrelationships among IPV, mental health symptoms, and physical health problems as well as the need for considering PTSD symptoms when designing interventions for abused Chinese women with complaints of chronic pain.
    Full-text · Article · Mar 2013 · Journal of Interpersonal Violence
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