Domestic Violence - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

DOMESTIC VIOLENCE A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R EFERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2003 by ICON Group International, Inc. Copyright ©2003 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Domestic Violence: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-83593-4 1. Domestic Violence-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on domestic violence. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes & Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON DOMESTIC VIOLENCE ............................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Domestic Violence......................................................................... 9 E-Journals: PubMed Central ....................................................................................................... 57 The National Library of Medicine: PubMed ................................................................................ 58 CHAPTER 2. ALTERNATIVE MEDICINE AND DOMESTIC VIOLENCE ............................................. 171 Overview.................................................................................................................................... 171 National Center for Complementary and Alternative Medicine................................................ 171 Additional Web Resources ......................................................................................................... 175 General References ..................................................................................................................... 176 CHAPTER 3. DISSERTATIONS ON DOMESTIC VIOLENCE ............................................................... 177 Overview.................................................................................................................................... 177 Dissertations on Domestic Violence .......................................................................................... 177 Keeping Current ........................................................................................................................ 197 CHAPTER 4. CLINICAL TRIALS AND DOMESTIC VIOLENCE .......................................................... 199 Overview.................................................................................................................................... 199 Recent Trials on Domestic Violence .......................................................................................... 199 Keeping Current on Clinical Trials ........................................................................................... 200 CHAPTER 5. BOOKS ON DOMESTIC VIOLENCE ............................................................................. 203 Overview.................................................................................................................................... 203 Book Summaries: Federal Agencies............................................................................................ 203 Book Summaries: Online Booksellers......................................................................................... 208 The National Library of Medicine Book Index ........................................................................... 228 Chapters on Domestic Violence ................................................................................................. 229 Directories.................................................................................................................................. 229 CHAPTER 6. MULTIMEDIA ON DOMESTIC VIOLENCE ................................................................... 231 Overview.................................................................................................................................... 231 Video Recordings ....................................................................................................................... 231 Bibliography: Multimedia on Domestic Violence ...................................................................... 233 CHAPTER 7. PERIODICALS AND NEWS ON DOMESTIC VIOLENCE ................................................ 235 Overview.................................................................................................................................... 235 News Services and Press Releases.............................................................................................. 235 Newsletters on Domestic Violence............................................................................................. 239 Academic Periodicals covering Domestic Violence .................................................................... 240 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 243 Overview.................................................................................................................................... 243 NIH Guidelines.......................................................................................................................... 243 NIH Databases........................................................................................................................... 245 Other Commercial Databases..................................................................................................... 249 APPENDIX B. PATIENT RESOURCES ............................................................................................... 251 Overview.................................................................................................................................... 251 Patient Guideline Sources.......................................................................................................... 251 Finding Associations.................................................................................................................. 259 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 261 Overview.................................................................................................................................... 261 Preparation................................................................................................................................. 261 Finding a Local Medical Library................................................................................................ 261 Medical Libraries in the U.S. and Canada ................................................................................. 261

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ONLINE GLOSSARIES................................................................................................................ 267 Online Dictionary Directories ................................................................................................... 267 DOMESTIC VIOLENCE DICTIONARY .................................................................................. 269 INDEX .............................................................................................................................................. 303

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with domestic violence is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about domestic violence, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to domestic violence, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on domestic violence. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to domestic violence, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on domestic violence. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON DOMESTIC VIOLENCE Overview In this chapter, we will show you how to locate peer-reviewed references and studies on domestic violence.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and domestic violence, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “domestic violence” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Dental Detection of Domestic Violence Victims Source: Texas Dental Journal. 111(3): 25-26. March 1994. Contact: Available from Texas Dental Association. 1946 South Interregional Highway, Austin, TX 78704-3698. (512) 443-3675. Summary: Dentists are in a unique position to detect domestic violence victims, as most injuries occur in the head and neck areas and will be seen during the dental examination. This article reviews the dental detection of domestic violence victims. The authors stress that dentists must be able to diagnose, treat, or refer patients with diseases or injuries of the oral-perioral structures secondary to domestic violence before irreversible changes have occurred. The authors note that it is easier to detect victims of

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domestic violence by using a classification system for patients using general categories (types of maltreatment, behavioral patterns, signs, and symptoms) and by using a protocol of basic questions to get their history of domestic violence. Topics include physical abuse, physical neglect, psychological abuse or neglect, financial abuse or neglect, orofacial trauma (including fractures), unrealistic expectations (on the part of caregivers), tissue lesions (due to sexual abuse, stressful psychological conditions, or poor oral hygiene), and patient history. The authors conclude with a brief section reviewing these issues and imploring dentists to learn to recognize actual or potential abuse before a catastrophic event occurs. Dentists should also be familiar with materials describing their patients' legal rights, prevention strategies, and state, local, and county resources that can help stop domestic violence. •

Recognizing and Reporting Victims of Domestic Violence Source: JADA. Journal of American Dental Association. 123(9): 44, 46, 48, 50. September 1992. Summary: Domestic violence can be defined as any violent behavior directed against an individual within the home or family. It occurs in all segments of society and is not limited to a single ethnic or socioeconomic group. This article familiarizes dentists with domestic violence. The authors note that since most intentional injuries occur in the head and neck area, the dentist might be the first to treat the domestic violence victim. Topics include spouse abuse, elder abuse, the dental implications of abuse, examination and documentation considerations, and intervention. The authors stress that all health professionals should be familiar with their state's mechanism for reporting suspected domestic violence. 2 figures. 26 references. (AA-M).

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Head, Neck, and Facial Injuries as Markers of Domestic Violence in Women Source: Journal of Oral and Maxillofacial Surgery. 57(7): 760-762. July 1999. Contact: Available from W.B. Saunders Company. Periodicals Department, P.O. Box 628239, Orlando, FL 32862-8239. (800) 654-2452. Summary: The diagnosis of domestic violence (DV) is difficult because of a lack of clearly defined signs and symptoms. This article reports on a study undertaken to confirm and refine the role of head, neck, and face (HNF) injuries as markers of DV. The cross sectional study used a sample of female trauma patients treated in an inner city hospital emergency room. The predictor study variable was injury location (HNF or other location); the outcome variable was traumatic origin (DV or other cause). A victim of DV was defined as a patient who gave a history of being injured by her spouse or sexual partner. Other data included age, nature of the injury (blunt or penetrating), and injury severity score (ISS). The sample consisted of 100 injured women, with a mean age of 40 years (plus or minus 16.3 years). Thirty-four women were victims of DV. The mean age of the DV victims was 32.5 years (plus or minus 7.3 years) compared with a mean age of 43.9 years (plus or minus 18.2 years) in the other causes group. DV victims were 7.5 times more likely to have HNF injuries than other trauma patients. Age was associated with cause and location of injury. The authors conclude that although HNF injuries and age were sensitive predictors of DV, they remain poor in their specificity as markers. Appended to the article is a commentary. 3 tables. 19 references. (AA-M).

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SOUNDING BOARD: Partner Notification and the Threat of Domestic Violence Against Women With HIV Infection Source: The New England Journal of Medicine; Vol. 329, No. 16, Oct. 14, 1993.

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Contact: Massachusetts Medical Society, Medical Publishing Group, New England Journal of Medicine, 860 Winter St, Waltham, MA, 02451, (781) 893-3800, http://www.massmed.org. University of Maryland Baltimore, School of Law, 510 W Baltimore St, Baltimore, MD, 21201, (410) 328-3295. Summary: This article looks at ways a physician may resolve the conflict of partner notification and domestic violence against women in the context of the AIDS epidemic. Public health dictates the physician should notify all partners but the physician must balance the severity of potential harm to the patient, as well as weigh the risk that violence will occur, before making the decision to breach confidentiality. The article suggests clinical assessment screens to identify potential violence. In addition, pre- and post-test counseling should include a safety plan, if the physician intends to notify the partner. •

Dental Team's Role in Recognizing and Reporting Domestic Violence Source: Journal of the CDA (Colorado Dental Association). 74(1): 36-39. January 1996. Contact: Available from Colorado Dental Association (CDA). 3690 Yosemite Street, Suite 100, Denver, CO 80237. (303) 740-6900. Summary: This article outlines the dental team's role in recognizing and reporting domestic violence. The authors stress that the location of injuries associated with nonaccidental trauma suffered by victims of domestic violence is critically important to dentists and their auxiliary personnel. Topics covered include spouse abuse; elderly abuse; implications for the dental team; examination and documentation; and recommendations for intervention, including legal considerations. 4 figures. 30 references.

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Domestic Violence Identification and Referral Source: Journal of Dental Hygiene. 70(2): 74-79. March-April 1996. Summary: This article reminds readers of the ethical responsibility of oral health care providers in the area of domestic violence identification and referral. Focusing on the act of partner abuse by a male adult against a female adult, the author covers topics including a definition of domestic violence, the impact of violence on the U.S. economy, the role of government and healthcare organizations, the role of the dental hygienist and the profession, the physical signs of domestic violence, the behavioral indicators of domestic violence, communication strategies, and ethical responsibilities. The author hopes to increase readers' awareness of the signs of suspected domestic violence and to emphasize the importance of being involved in prevention and early intervention. One chart lists the addresses and telephone numbers of domestic violence national information centers; a second provides a brief suggested reading list. 2 tables. 23 references.

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Dentists' Attitudes and Behaviors Regarding Domestic Violence: The Need for an Effective Response Source: JADA. Journal of the American Dental Association. 132(1): 85-93. January 2001. Contact: Available from American Dental Association. ADA Publishing Co, Inc., 211 East Chicago Avenue, Chicago, IL 60611. (312) 440-2867. Website: www.ada.org. Summary: This article reports on a study that examined the attitudes and behaviors of a national sample of dentists regarding domestic violence and the barriers dentists face in

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intervening to help victims. The authors surveyed a national random sample of 321 dentists by mail from November 1997 to March 1998 about their attitudes and clinical practice behaviors related to domestic violence. Eighty-seven percent of responding dentists never screened for domestic violence; 18 percent never screened even when patients had visible signs of trauma on their heads or necks. Overall, respondents intervened only minimally to help patients whom they had identified as victims. Respondents reported that the major barriers to screening were the presence of a partner or children (77 percent), lack of training (68 percent), concern about offending patients (66 percent), and their own embarrassment about bringing up the topic of abuse (51 percent). Respondents who had received domestic violence education were significantly more likely to screen for domestic violence and to intervene. The authors conclude by suggesting that dentists follow a model with the acronym AVDR when approaching abused patients in their practice: Ask about abuse; provide Validating messages; Document presenting signs; and Refer victims to domestic violence specialists. 4 tables. 47 references. •

Maxillofacial Injuries Associated with Domestic Violence Source: Journal of Oral and Maxillofacial Surgery. 59(11): 1277-1284. November 2001. Contact: Available from W.B. Saunders Company. Periodicals Department, P.O. Box 629239, Orlando, FL 32862-8239. (800) 654-2452. Summary: This article reports on a study undertaken to report the incidence, causes (etiology) and patterns of maxillofacial (jaw and face) injury associated with domestic violence. The authors conducted a retrospective review of patients treated for domestic violence injuries at an inner city hospital over a 5 year period; data were collected on type and location of injury, mechanism of injury, alcohol involvement, and treatment. The sample consisted of 236 emergency room admissions. The majority (81 percent) of victims presented with maxillofacial injuries. The fist was a favorite means for assaults (67 percent). The middle third of the face was most commonly involved (69 percent). Soft tissue injuries were the most common type of injury (61 percent). Facial fractures were present in 30 percent of victims. The average number of mandible fractures per patient was 1.32. The majority of facial fractures (40 percent) were nasal fractures. Leftsided facial injuries were more common than right sided. These data confirm that most victims of domestic violence sustain maxillofacial injuries. The preponderance of facial injuries makes it very likely that oral and maxillofacial surgeons will be involved in the care of these patients. Appended to the article is a commentary. 6 figures. 6 tables. 21 references.

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Domestic Violence: Recognizing Signs of Abuse in Patients Source: Dental Teamwork. 7(3): 23-25. May-June 1994. Summary: This continuing education article explores aspects of spouse and elder abuse and the role of dental professionals in recognizing signs of abuse in patients. Topics covered include the incidence of spouse abuse and elder abuse; questioning the suspected victim; factors contributing to elder abuse; differentiating between abuse and neglect, and the problems arising from both; self-neglect; risk factors for abuse; gender factors in abuse; sexual abuse; skin lesions resembling traumatic injuries; actions to follow upon suspicion of intentional trauma; psychological factors; documenting injury patterns, including photographs; and state requirements for reporting mechanisms. 3 figure. 27 references.

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No more! Stopping domestic violence Source: Ms. 5(2): 3-64. September/October 1994. Summary: This issue of 'Ms.' contains a special feature on domestic violence. It includes: two editorial statements on the problem; a victim's view of spouse abuse; effects on children of witnessing violence and parental partner abuse; federal legislation contained in the Violence Against Women Act (VAWA) which is part of the 1994 crime bill; criminal justice or judicial system, treatment programs for men who batter; and a general look at the status of domestic violence with prescriptive ideas for interventions. Side bars are used throughout this feature to describe local intervention programs and to provide statistics on several aspects of the problem. The sources for the statistics are included in an appendix.

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Domestic violence and children Source: Los Altos, CA: David and Lucile Packard Foundation. 1999. 144 pp., 7 pp. (exec. summ.). Contact: Available from David and Lucile Packard Foundation, 300 Second Street, Suite 102, Los Altos, CA 94022. Telephone: (650) 948-3696 / fax: (415) 948-6498 / e-mail: [email protected] / Web site: http://www.futureofchildren.org. Available at no charge. Summary: This issue of The Future of Children, written for legislators, professionals, practitioners, and policy makers, focuses on the topic of domestic violence and its impact on children. Among the many chapters included in this publication are: prevalence and effects of child exposure to domestic violence; the impact of federal and state laws on children exposed to domestic violence; the legal system's response to children exposed to domestic violence; child protective services and domestic violence; community based domestic violence services; mental health services for children who witness domestic violence; and emerging strategies in the prevention of domestic violence among other categories.

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Relationship Between Spouse Abuse and the Maltreatment of Dementia Sufferers by their Caregivers Source: American Journal of Alzheimer's Disease. 14(4): July-August 1999. Summary: This journal article reviews the family violence literature for possible connections between spouse abuse and the abuse of older people with dementia by their family caregivers. Some cases are classified as spouse abuse of dementia patients and others involve abuse by adult children who had grown up witnessing interparental violence. Because the spouse abuse literature indicates that perpetrators of domestic violence typically underreport their levels of aggression, it is possible that the levels of abuse reported by caregivers of dementia patients also is less than the actual levels occurring in these relationships. Finally, the author suggests that the spouse abuse literature may offer valuable information about effective interventions for abusive caregivers such as educating violent caregivers about effective ways to manage their anger and alternative non-violent ways of responding to hostile situations initiated by the care recipient. 23 references.

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Domestic violence intervention calls for more than treating injuries Source: JAMA: Journal of the American Medical Association. 264(8): 939-940. August 2229, 1990.

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Summary: This medical news brief points out shortcomings of the medical community in addressing domestic violence to women, and suggests that the medical model reinforces a detached stance that protects physicians from the awareness of their own feelings and those of their patients. For example, the language used on the medical chart to describe the injury (e.g. hit by lead pipe, hit on left wrist with jackhammer) is often passive, disembodied phrases that disregard the presence of both the batterer and the victim. •

Domestic violence begets other problems of which physicians must be aware to be effective Source: JAMA: Journal of the American Medical Association. 264(8): 940, 943-944. August 22-29, 1990. Summary: This medical news brief suggests that an increasing number of physicians think that treatment of domestic violence to women belongs within the realm of medicine. It supports a change in the medical setting toward probing the patient on the cause of injuries or illnesses instead of on prescribing anti-pain and antidepressant medications for symptomatic relief.

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Las Mujeres con VIH/SIDA Denuncian la Violencia Domestica. [Women With HIV/AIDS Speak Out on Domestic Violence] Source: WomanCare News, October 1997; 10 p. Contact: Center for Women Policy Studies, National Resource Center on Women and AIDS Policy, 1211 Connecticut Ave NW Ste 312, Washington, DC, 20036, (202) 872-1770, http://www.centerwomenpolicy.org. Summary: This newsletter provides information about the connection between the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), domestic violence, and women. HIV prevention programs and policies that attempt to serve women with HIV/AIDS must include strategies to respond to domestic violence and to collaborate with battered women's programs and shelters to develop such strategies. The newsletter provides statistics on the incidence rates of domestic violence in the metropolitan Washington, DC area. Research shows that women who are at the highest risk for HIV/AIDS also face an increased risk for domestic violence. Programs should be designed to aid women, maintain their confidentiality in the partner notification process, and help them deal with the stress of domestic violence and HIV/AIDS. Personal anecdotes tell the stories of women who face domestic violence and HIV/AIDS-related issues such as getting out of an abusive relationship, possibly being infected on purpose by abusive partners, negotiating condom use, and finding or sustaining self-esteem that can help them better deal with these problems. The newsletter supplies information about the services and programs offered by the Center for Women Policy Studies. The newsletter provides contact information for services from which women in the Washington, DC area can learn more about HIV/AIDS and domestic violence.

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Domestic violence, stalking, and anti-stalking legislation: An annual report to Congress under the Violence Against Women Act Source: Washington, DC: National Institute of Justice, U.S. Department of Justice. 1996-. annual.

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Contact: Available from National Criminal Justice Reference Service, 1600 Research Boulevard, Rockville, MD 20850. Telephone: (800) 851-3420 or (301) 251-5500 / fax: (301) 251-5212 / e-mail: askncjrs@ncjrs@org / Web site: http://www.ncjrs.org. Available at no charge. Summary: Written for Congress, this annual report focuses on the problem of stalking, examines the anti-stalking laws in each state, and discusses connections between stalking and domestic violence. It explains the legal issues involved in stalking and offers a model anti-stalking code for states. The report assembles existing information available on these issues and includes citations for existing state statutes and constitutional challenges up to the date of its publication.

Federally Funded Research on Domestic Violence The U.S. Government supports a variety of research studies relating to domestic violence. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to domestic violence. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore domestic violence. The following is typical of the type of information found when searching the CRISP database for domestic violence: •

Project Title: A PROSPECTIVE STUDY OF SUICIDE PREVENTION IN THE USAF Principal Investigator & Institution: Knox, Kerry L. Assistant Professor; Community and Prev Medicine; University of Rochester Orpa - Rc Box 270140 Rochester, NY 14627 Timing: Fiscal Year 2002; Project Start 22-JUL-2002; Project End 30-JUN-2007 Summary: (provided by applicant): The overall goal of this proposal is to allow me to develop the skills necessary to become an independent investigator and a leading scholar in the design and evaluation of the effectiveness of community-based preventive mental health intervention research. My primary focus will be on prevention of suicide. I have a unique opportunity to assess, both retrospectively and prospectively, the effects of a program developed in the United States Air Force that may have implemented effective strategies for reducing the suicide rate among its members. The program in the USAF is an unusual example of a community level prevention to address suicide prevention specifically, and mental health illness in general, integrating universal and targeted approaches to prevention. In the United States, research and programs on prevention of suicide and related morbidities has languished while other public health challenges have not. In part this has been due to the lack of political and social will to address mental health problems, especially suicide. Recently, our nation's top leading

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Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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public health official, the U.S. Surgeon General recognized prevention of suicide and suicidal behaviors as a national priority. Taken together, my current capacity to access a "naturalistic laboratory", in a climate of political imperative to advance the status of the field of suicide prevention, renders a prospect of tremendous potential for participating in advancing the field of mental preventive mental health. As the field of preventive trials for mental health moves forward, the availability of investigators who are broadly trained not only to conduct program evaluations but also can direct and carry out field trials for the evaluation of the effectiveness of interventions will become vital. I propose to transition to this level of competency, through engaging in a rigorous training program with a interdisciplinary team of mentors, expert consultants and collaborators. This career development award will build upon my already strong skills in epidemiology and public health, social sciences, and basic science research. It is designed to enhance my knowledge and skills in preventive mental health, focusing on suicide, and to develop new skills in investigative methodologies applicable to field trials. The major research question of this proposal is to investigate whether the USAF Suicide Prevention Program results in a reduction in events of suicide, attempted suicide, and related morbidities, such as domestic violence, alcoholism and depression and maintains the reduction over time. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: A RCT OF COMPUTER SCREENING FOR DOMESTIC VIOLENCE Principal Investigator & Institution: Howes, David; Medicine; University of Chicago 5801 S Ellis Ave Chicago, IL 60637 Timing: Fiscal Year 2002; Project Start 30-SEP-2000; Project End 31-AUG-2003 Summary: Victims of domestic violence frequently seek medical care in emergency departments (EDs) and health care providers have the opportunity to detect DV and intervene. Unfortunately ED personnel often do not screen for DV due to time pressures and the sensitive nature of the problem. Novel methods are needed to improve detection and intervention in the ED. We developed and piloted a self-administered computer health risk assessment (ED Prevent) that is completed by patients before their ED visit. High-risk behaviors are provided to the ED physician. Our pilot demonstrated significant improvement in the chart documentation of DV by physicians in patients receiving ED Prevent (19 chart notes of DV) compared to controls (1 chart note).This study is a randomized control trial to test the effect of ED Prevent on the communication between physicians/nurses and patients about DV. 800 women patients presenting to two different EDs (a urban ED with largely African American patients and a suburban community ED with mainly Caucasian patients) will be randomized to either ED Prevent or Usual Care. All visits will be audio-taped. Primary outcomes for the study will be patient disclosure and physician/nurse discussion of DV based on the audiotapes. Secondary outcomes will include patient knowledge of, or contact with, DV services, patient satisfaction with communication with ED staff, and chart documentation of DV. The effect of ED Prevent on rates of disclosure and discussion will be evaluated using logistic regression controlling for hospital site and patient demographics. In addition a qualitative analysis will explore the effect of ED Prevent on DV communication variables [such as the timing and initiation of discussions about DV and ED provider/patient affective responses] The study has the potential to provide a novel way to screen women in the ED relying on a computer instead of a busy physician and potentially shifting the role of the physician to discussion and referral, ultimately improving the likelihood that women will change the abusive situation. The study

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results may be generalizable to many other EDs with a variety of populations. Further the data will be available for future investigations of communication in the ED. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: A THEORECTICAL MODEL OF RELATIONSHIP ABUSE Principal Investigator & Institution: Borjesson, Wiveca I. Psychology; University of Central Florida 4000 Central Florida Blvd Orlando, FL 32816 Timing: Fiscal Year 2003; Project Start 21-NOV-2003 Summary: (provided by candidate): A better understanding of the relationship between perceived control, alcohol use, and relationship violence could inform the development of effective secondary and tertiary intervention efforts. The present study is proposed as a first step toward testing a theoretical model of the relationship between perceived control, aggressive alcohol expectancies, alcohol use during aggressive acts, and actual relationship abuse. Multiple indicators of each of these variables will be completed by a large sample of college students at a large open enrollment state university. The decision to conduct this research in a university setting stems from the results of several studies that have found that college students engage in as many, and possibly more, abusive behaviors as married couples in the general population. Therefore, college students may be an ideal population for theory development and early intervention with high-risk individuals. The theoretical model will be evaluated with structural equation modeling. It is hypothesized that perceived control will be a significant predictor of early relatively mild abusive behaviors and that aggressive alcohol expectancies will partially mediate this relationship. It is also hypothesized that the effect of expectancies on actual abuse will be moderated by alcohol use during aggressive acts. If this model is validated, it could facilitate identification of high-risk individuals before serious violence occurs. Furthermore, this model could guide development of interventions based on increasing perceived control and challenging aggressive alcohol expectancies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: AGGRESSION AND VILOLENCE AMONG RURAL TEEN Principal Investigator & Institution: Galliher, Renee V. Psychology; Utah State University Logan, UT 84322 Timing: Fiscal Year 2003; Project Start 01-MAR-2003; Project End 29-FEB-2004 Summary: The overall goal of the proposed project is to gain a more comprehensive understanding of the relational and interactional processes contributing to dating aggression among rural adolescent couples. In contrast to the majority of research examining adolescent dating aggression, the current study conceptualizes the couple as the unit of analysis and uses an observational methodology to assess adolescent couple members' own subjective understandings of their interactions. As part of a larger ongoing research plan, this study will also begin to examine the role of ethnicity in understanding communication patterns in adolescent couples and how they relate to dating aggression. A mediational model of dating aggression is proposed in which couple members' perceptions of their communication with their romantic partners mediate the association between family of origin variables and the report of aggression in the relationship. One hundred Euro-American and Latino adolescent couples who have been dating a minimum of four weeks will be recruited from high schools in rural western communities. Couple members will individually complete questionnaires assessing parent relationship qualities and conflict management strategies (both between parents and between participant couple members). In addition, couples will be

12 Domestic Violence

videotaped having three brief conversations adapted from previous observational work with adolescent couples. Adolescents will then individually view and rate their own and their partners' behaviors using a video-recall procedure. The conversations will be divided into 20-second segments and couple members will rate themselves and their partners on several behavioral dimensions using Likert rating scales for each segment. Analyses will examine the nature of adolescent couple members' perceptions of their interaction and the associations among parent relational quality, couple communication, and dating aggression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: AN INTERVIEW FOR FAMILIES OF DRUG USERS Principal Investigator & Institution: Kirby, Kimberly C. Associate Professor; Treatment Research Institute, Inc. (Tri) 600 Public Ledger Bldg Philadelphia, PA 19106 Timing: Fiscal Year 2002; Project Start 30-SEP-2000; Project End 31-AUG-2004 Summary: (Adapted from the Applicant's Abstract): This is a revision of grant application DA 1272-01, The Family Impact Survey: An Interview for Families of Drug Users, which was reviewed in March 1999. This research will further the development of the Family Impact Survey; a comprehensive assessment tool that measures the special problems faced by family member and significant others (FSOs) of drug abusers. The instrument addresses drug and alcohol use of family members and seven problem areas: Emotional, Relationship, Lifestyle, Legal, Financial, Health, and Physical Abuse. While research has documented increased prevalence of illness and increased domestic violence among FSOs of drug users, most studies have focused on psychological and interpersonal functioning of the family members of alcoholics. Systematic research exploring multiple aspects of the problems faced by FSOs of variety of drug users is virtually nonexistent, despite acknowledgment in both professional and lay literature that drug addiction affects the entire family. One factor hindering a comprehensive approach to the problems faced these FSOs is the lack of a multidimensional instrument to assess the wide range of problems they face. The Family Impact Survey collects standard, comprehensive, clinically pertinent information about the wide variety, of problems that beset families of drug abusers. This research will utilize a broad clinical sample to establish the interrater agreement and test-retest reliability of the instrument, develop standardized scores for different areas of the instrument, conduct psychometric/statistical analyses to refine the areas, establish internal consistency, and determine inter-correlation of problem area scores. The work proposed does not complete all the steps necessary for establishing a psychometrically sound instrument. Later studies will address issues of instrument validity and will examine whether the psychometric properties initially established here are maintained with a much large, representatively sampled population. Further development of this instrument is an important step in better understanding the impact of drug abuse on families, informing clinical assessment and treatment planning facilitating clinical research, and developing health policy for drug abuse treatment and for individuals dealing with the stress of a close relationship with a drug user. In addition, it could be a useful outcome measure in drug abuse treatment, providing information about improvements and cost-offsets that extend beyond the drug abuser to his or her family. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: AREA-BASED SOCIOECONOMIC MEASURES FOR HEALTH DATA Principal Investigator & Institution: Krieger, Nancy; Health Policy and Management; Harvard University (Sch of Public Hlth) Public Health Campus Boston, MA 02460

Studies 13

Timing: Fiscal Year 2002; Project Start 30-SEP-1998; Project End 30-JUN-2004 Summary: This epidemiologic investigation will establish area-based measures of socioeconomic position appropriate for US public health surveillance systems and health research. To create these measures, we propose a cross-sectional study involving two US states, Massachusetts (MA) and Rhode Island (RI), using public health surveillance data from the mid-1980s to mid-1990s in conjunction with 1990 census tract, census block-group, and zip code socioeconomic data. We will: (1) geocode public health surveillance data bases containing individuals' residential addresses by appending codes for each address's census tract, block-group, and zip code; (2) create different area-based socioeconomic measures that we will apply to each geographic unit (census tract, block-group, zip code), following and extending approaches used in extant public health and social science literature; (3) link each geocoded record to the relevant census tract, block-group, and zipcode area-based socioeconomic measures; (4) investigate the comparability of the area-based socioeconomic measures, by state, with regard to both socioeconomic ranking of geographic units (centus tract, block-group, zip code) and sensitivity and specificity in predicting available individual-level socioeconomic data obtained in three public health data bases (birth and death certificates and the RI Health Interview Survey); (5) compare quantification of associations of the area-based socioeconomic measures with health outcomes, within and across geographic units (census tract, block-group, zip code), by state, for outcomes expected to exhibit socioeconomic gradients in health: birth rate, birth weight, gestational age, infant mortality, adult mortality (all-cause and cause-specific), cancer incidence, sexually transmitted diseases, tuberculosis domestic violence, gun shot and stab wounds, and childhood lead screening, as well as compare results to gradients in health detected with individual-level socioeconomic data, using the birth and death certificate and RI Health Interview Survey data, and (6) select the most valid, powerful, and easily understood area-based socioeconomic measure(s) and prepare a monograph explaining our methodology, to facilitate use of area-based socioeconomic measures by health agencies and researchers. In doing so, our project incorporates socioeconomic data, a powerful determinant of population health, disease, and well-being, into routinely collected public health data and greatly augments capacity to: (a) monitor socioeconomic inequalities in health in the United States, (b) analyze the contribution of socioeconomic inequality to racial/ethnic inequalities in health, and (c) guide allocation of resources and interventions to attain social equity in health. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ASIAN AMERICAN FAMILY CONFLICT ASSESSMENT TOOL IN HAWAIIAN CHINESE FAMILIES Principal Investigator & Institution: Willgerodt, Mayumi A.; University of Washington Seattle, WA 98195 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 30-JUN-2007 Summary: Chinese-Americans are the largest component of the 10 million AsianAmericans (AA) residing in the United States. Previous research has shown that immigration and acculturation have been linked to anxiety, depression, behavior disorders, domestic violence, substance abuse and suicide. Intergenerational conflict (IC) resulting from cultural orientation differences within families may be a key source of stress for immigrant families which, in turn may affect family functioning and mental health. The Asian American Family Conflict Assessment Tool (AAFCAT) was developed by the principal investigator to identify and measure issues related to conflict in Chinese immigrant families from the perspective of multiple family members. The

14 Domestic Violence

purpose of this study is to explore AAFCAT's validity among Chinese immigrant families in Hawaii. Ultimately, this will allow comparison of integenerational conflict in Chinese-American families in Washington and Hawaii. One hundred families will be recruited to participate in this study, which will employ a mailed questionnairre. Data analysis will consist of Pearson product moment correlations and analysis of variance. Results from this study will provide the foundation for a larger multi-site cross-cultural study to be conducted in Washington and Hawaii that will seek to understand individual, family and environmental factors associated with poor psychological and physical health among Chinese immigrant families. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BEHAVIORAL COUPLES THERAPY FOR DRUG ABUSE Principal Investigator & Institution: Fals-Stewart, William S. Senior Research Scientist; None; State University of New York at Buffalo 402 Crofts Hall Buffalo, NY 14260 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-JUL-2006 Summary: (provided by applicant): The results of multiple studies over the last 25 years indicate that, compared to traditional individual-based treatments, use of Behavioral Couples Therapy (BCT) for married or cohabiting alcoholic and drug-abusing patients results in superior outcomes across multiple domains of psychosocial functioning, including reduced substance use, increased relationship satisfaction, reduced levels of domestic violence, and improved family adjustment. However, despite its demonstrated efficacy, the results of a recent survey indicate BCT is rarely used in community-based substance abuse treatment programs. One of the barriers identified in the survey as interfering with the transfer of BCT from research settings into these programs was that BCT was perceived as costly to deliver, due largely to the staff resources required to provide BCT in the standard conjoint format (i.e., one or two therapists treating a patient and his or her partner for a clinical hour). The mandate for investigators is to develop a version of BCT that is less costly to deliver and yet retains the clinical effectiveness of standard BCT. A potential solution to the problem of the high treatment delivery costs for BCT is to develop a clinically effective version of BCT that can be conducted in a multi-couple group; such a format would allow for the more efficient use of limited staff resources. Thus, the proposed project has two primary aims which will be addressed in two sequential phases. In Phase I, we will develop and refine a 12-session treatment manual for conducting Behavioral Couples Therapy in a group therapy format (G-BCT) for married or cohabiting substance-abusing men and their nonsubstance-abusing intimate female partners. In Phase II of the project, we will conduct a small pilot study in which subjects participating in G-BCT plus Individual Drug Counseling (IDC) will be compared to subjects who participate in an equally intensive Standard BCT (S-BCT) plus IDC and those who receive treatment as usual [i.e., group-based drug abuse counseling (GDQ plus IDC] in terms of clinical outcomes (e.g., substance, dyadic adjustment, family functioning), as well as cost outcomes (e.g., costbenefit and cost-effectiveness). If the objectives of the proposed study are met, an efficacious variant of BCT would be available that community-based treatment programs could provide using a comparatively efficient delivery format. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: BIOSOCIAL RISK FACTORS FOR CHILDHOOD BEHAVIOR PROBLEMS Principal Investigator & Institution: Liu, Jianghong; Social Science Research Inst; University of Southern California 2250 Alcazar Street, Csc-219 Los Angeles, CA 90033

Studies 15

Timing: Fiscal Year 2003; Project Start 09-SEP-2003; Project End 08-SEP-2006 Summary: (provided by applicant): This study aims to investigate the link between early biosocial risk factors and childhood externalizing behavior problems. Specifically, the study will examine how prenatal health factors interact with postnatal psychosocial risk factors in predisposing to later externalizing behavior. The specific aims are to: (1) assess the direct effect of prenatal biological and postnatal psychosocial risk factors on childhood externalizing behavior; (2) examine the interactive effect of biological and psychosocial risk factors on childhood externalizing behavior; (3) test what factors mediate the above direct and interactive effects of biological/social risk factors on childhood externalizing behavior; (4) identify the specific components of biological and social risk factors which give rise to childhood externalizing behavior; (5) test the relationship between internalizing behavior in relation to the above risk and mediating factors in predisposing to childhood internalizing behavior. Prenatal biological risk factors include maternal smoking during pregnancy, and pregnancy/birth complications. Postnatal psychosocial risk factors include parenting, child rearing disagreements, domestic violence, and home environment. Further, the mediating role of cognitive ability, and temperament, will also be explored. Hypotheses will be tested in the context of an ongoing prospective longitudinal study of approximately 600 threeyear-old male and female children using structural equation modeling. By attempting to further establish the early, modifiable health risk factors for externalizing behavior, and by examining a biosocial perspective on antisocial behavior, the proposed study aims to illustrate how the Nursing profession can potentially impact this significant societal problem as well as better inform future prevention programs. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BRIEF INTERVENTION TO REDUCE DRINKING AMONG BATTERERS Principal Investigator & Institution: Stuart, Gregory L.; Butler Hospital (Providence, Ri) 345 Blackstone Blvd Providence, RI 02906 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 30-JUN-2008 Summary: (provided by applicant): Intimate partner violence results in a wide variety of devastating consequences, including physical and mental health problems, divorce, suicide, and spousal homicide. There is substantial evidence for the association between alcohol and partner violence. Recent research has shown that violence is 8-20 times more likely to occur on a drinking day than on a non-drinking day. In populations of individuals with alcohol problems, research has shown that extended interventions specifically designed to reduce alcohol use also produce decreases in partner violence. However, research suggests that treatment for intimate partner violence is relatively ineffective, particularly among individuals who use alcohol excessively. Batterer treatment outcome research has shown that individuals with alcohol problems are 16 times more likely to recidivate to violence after the intervention than individuals without alcohol problems. To date, methods for reducing alcohol use in male batterers have not been explored, and the extent to which treatment for hazardous alcohol use will ameliorate subsequent partner violence is currently unknown. We propose to conduct a randomized clinical trial in which 326 hazardous drinking men who are arrested and court-mandated to attend batterers' intervention groups will be randomly assigned to: (a) a brief, motivationally focused alcohol intervention (adapted from the Motivational Enhancement Therapy Manual used in Project MATCH) plus standard batterers' intervention or (b) standard batterers' intervention alone. Batterers' alcohol use, problems arising from alcohol use, and partner physical and psychological

16 Domestic Violence

aggression will be assessed at baseline, 3-, 6-, and 12-month follow-up. Batterers' relationship partners will be included in the study to provide corroborating reports of alcohol use and violence, and arrest records and protection orders will be obtained as further indices of violence recidivism. We hypothesize that adding a brief alcohol treatment to standard batterers' intervention will result in less alcohol use and partner violence at all follow-up assessments, relative to standard batterers' intervention alone. If it is effective, this brief alcohol treatment can be readily integrated into existing batterer intervention programs. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CANCER UNDERSERVED

SCREENING,

MANAGED

CARE,

AND

THE

Principal Investigator & Institution: Pasick, Rena J. Associate Director; Northern California Cancer Center 32960 Alvarado-Niles Rd, Ste 600 Union City, CA 94587 Timing: Fiscal Year 2002; Project Start 30-SEP-1992; Project End 30-NOV-2003 Summary: Low-income women are at high risk for developing cervical cancer due not only to the higher prevalence of risk factors and lack of access to screening, but also because of barriers to timely follow-up when screened and found to have an abnormality. Lack of follow-up, therefore, contributes to the racial and ethnic health outcome disparities that exist for cervical cancer. While other interventions have shown some success at improving Pap smear follow-up rates, there is no existing randomized intervention trial that has demonstrated such high rates of improvement in follow-up as the Pathfinders study that addresses follow-up barriers in a very high-risk population of ethnically diverse, low-income, inner city women. The intervention consisted of computer-assisted tracking, education, counseling in consumer skills and ways of coping, transportation vouchers, and referrals for suspected mental health, alcohol/drug abuse, and domestic violence. When analyzed by intention to treat, of 348 women who were randomized at the time of the institutional receipt of the abnormal result, twice as many women in the intervention group were confirmed to have a follow-up test within 6 mos. of their abnormal Pap smear than in the control group, 70% versus 36% (p