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Concept: Violence against women

205

Many high-profile societal problems involve an individual or group repeatedly attacking another - from child-parent disputes, sexual violence against women, civil unrest, violent conflicts and acts of terror, to current cyber-attacks on national infrastructure and ultrafast cyber-trades attacking stockholders. There is an urgent need to quantify the likely severity and timing of such future acts, shed light on likely perpetrators, and identify intervention strategies. Here we present a combined analysis of multiple datasets across all these domains which account for >100,000 events, and show that a simple mathematical law can benchmark them all. We derive this benchmark and interpret it, using a minimal mechanistic model grounded by state-of-the-art fieldwork. Our findings provide quantitative predictions concerning future attacks; a tool to help detect common perpetrators and abnormal behaviors; insight into the trajectory of a ‘lone wolf’; identification of a critical threshold for spreading a message or idea among perpetrators; an intervention strategy to erode the most lethal clusters; and more broadly, a quantitative starting point for cross-disciplinary theorizing about human aggression at the individual and group level, in both real and online worlds.

Concepts: Psychology, Violence against women, Terrorism, Domestic violence, Conflict, Sociology, Aggression, Violence

171

BACKGROUND: High levels of gender-based violence (GBV) persist among conflict-affected populations and within humanitarian settings and are paralleled by under-reporting and low service utilization. Novel and evidence-based approaches are necessary to change the current state of GBV amongst these populations. We present the findings of qualitative research, which were used to inform the development of a screening tool as one potential strategy to identify and respond to GBV for females in humanitarian settings. METHODS: Qualitative research methods were conducted from January-February 2011 to explore the range of experiences of GBV and barriers to reporting GBV among female refugees. Individual interview participants (n=37) included female refugees (>=15 years), who were survivors of GBV, living in urban or one of three camps settings in Ethiopia, and originating from six conflict countries. Focus group discussion participants (11 groups; 77 participants) included health, protection and community service staff working in the urban or camp settings. Interviews and discussions were conducted in the language of preference, with assistance by interpreters when needed, and transcribed for analysis by grounded-theory technique. RESULTS: Single and multiple counts of GBV were reported and ranged from psychological and social violence; rape, gang rape, sexual coercion, and other sexual violence; abduction; and physical violence. Domestic violence was predominantly reported to occur when participants were living in the host country. Opportunistic violence, often manifested by rape, occurred during transit when women depended on others to reach their destination. Abduction within the host country, and often across borders, highlighted the constant state of vulnerability of refugees. Barriers to reporting included perceived and experienced stigma in health settings and in the wider community, lack of awareness of services, and inability to protect children while mothers sought services. CONCLUSIONS: Findings demonstrate that GBV persists across the span of the refugee experience, though there is a transition in the range of perpetrators and types of GBV that are experienced. Further, survivors experience significant individual and system barriers to disclosure and service utilization. The findings suggest that routine GBV screening by skilled service providers offers a strategy to confidentially identify and refer survivors to needed services within refugee settings, potentially enabling survivors to overcome existing barriers.

Concepts: Psychology, Scientific method, Quantitative research, Domestic violence, Violence against women, Focus group, Violence, Qualitative research

60

The nature of inter-group relations among prehistoric hunter-gatherers remains disputed, with arguments in favour and against the existence of warfare before the development of sedentary societies. Here we report on a case of inter-group violence towards a group of hunter-gatherers from Nataruk, west of Lake Turkana, which during the late Pleistocene/early Holocene period extended about 30 km beyond its present-day shore. Ten of the twelve articulated skeletons found at Nataruk show evidence of having died violently at the edge of a lagoon, into which some of the bodies fell. The remains from Nataruk are unique, preserved by the particular conditions of the lagoon with no evidence of deliberate burial. They offer a rare glimpse into the life and death of past foraging people, and evidence that warfare was part of the repertoire of inter-group relations among prehistoric hunter-gatherers.

Concepts: Lake Turkana, Violence against women, Domestic violence, Kenya, War, Life, Holocene, Violence

56

Bystander-based programs have shown promise to reduce interpersonal violence at colleges, yet limited rigorous evaluations have addressed bystander intervention effectiveness in high schools. This study evaluated the Green Dot bystander intervention to reduce sexual violence and related forms of interpersonal violence in 26 high schools over 5 years.

Concepts: Violence against women, College, High school

54

Background Little is known about the relative extent of crime against people with severe mental illness (SMI). Aims To assess the prevalence and impact of crime among people with SMI compared with the general population. Method A total of 361 psychiatric patients were interviewed using the national crime survey questionnaire, and findings compared with those from 3138 general population controls participating in the contemporaneous national crime survey. Results Past-year crime was experienced by 40% of patients v. 14% of controls (adjusted odds ratio (OR) = 2.8, 95% CI 2.0-3.8); and violent assaults by 19% of patients v. 3% of controls (adjusted OR = 5.3, 95% CI 3.1-8.8). Women with SMI had four-, ten- and four-fold increases in the odds of experiencing domestic, community and sexual violence, respectively. Victims with SMI were more likely to report psychosocial morbidity following violence than victims from the general population. Conclusions People with SMI are at greatly increased risk of crime and associated morbidity. Violence prevention policies should be particularly focused on people with SMI.

Concepts: Violent crime, Crime, Violence against women, Psychiatry, Violence, Mental illness, Odds ratio, Domestic violence

52

The first research conducted on violence against women in the university context in Spain reveals that 62% of the students know of or have experienced situations of this kind within the university institutions, but only 13% identify these situations in the first place. Two main interrelated aspects arise from the data analysis: not identifying and acknowledging violent situations, and the lack of reporting them. Policies and actions developed by Spanish universities need to be grounded in two goals: intransigence toward any kind of violence against women, and bystander intervention, support, and solidarity with the victims and with the people supporting the victims.

Concepts: Business intelligence, Student, Spain, Sociology, Violence against women, Domestic violence, Violence, University

29

Rape and sexual violence occur in all societies, and cut across all social classes. Prevalence estimates of rape victimisation range between 6 and 59% of women having experienced sexual abuse from their husbands or boyfriends in their lifetime. Two population-based studies from South Africa have found that 28% and 37% of men, respectively, have perpetrated rape. Estimates of rape perpetration from high-income countries seem to be lower than those from low- and middle-income countries; however, current data make it impossible to confirm this. Women and girls are much more likely to be the victims and men the perpetrators and, in most instances, the perpetrator is known to the victim. Children are particularly vulnerable to sexual abuse, with girls being at greater risk, especially while at school and at home. High rates of child sexual abuse are emerging from the research, with an increasing understanding of the effect of child sexual abuse on later perpetration and victimisation, highlighting the importance of primary prevention for sexual violence to address childhood exposures to violence. Much of our knowledge about sexual violence has historically been based on research undertaken in high-income countries. This, however, is changing with the emergence of good-quality studies from other settings, particularly in Africa, alongside an increasing number of multi-country studies looking at interpersonal and sexual violence. Most countries lack population data on perpetration of sexual violence, across all categories, including children, and a major gap exists in research on sexual violence among sub-groups and populations. Much of the existing research has limitations that affect cross-study comparability, owing to differences in definitions, research tools, methods and sampling used. Improved research is essential. Research priorities for understanding the magnitude of sexual violence prevalence include assessment of the prevalence and patterns of sexual violence victimisation and perpetration in a range of settings, across a range of acts of sexual violence, in men and women, in adults and children, using methodologies based on best practice in gender-based violence research and standard measures of different forms of sexual violence; research on the social context of sexual violence perpetration and victimisation by both men and women; and methodological research to measure sexual violence for particular population sub-groups or violence types, such as child perpetrators or young child victims, or sexual harassment at work and school.

Concepts: Child abuse, Violence, Victim, Sexual abuse, Abuse, Domestic violence, Violence against women, Rape

29

Violence against women is a major health and human rights problem yet there is little rigorous evidence as to how to reduce it. We take advantage of the randomized roll-out of Ecuador’s cash transfer program to mothers to investigate how an exogenous increase in a woman’s income affects domestic violence. We find that the effect of a cash transfer depends on a woman’s education and on her education relative to her partner’s. Our results show that for women with greater than primary school education a cash transfer significantly decreases psychological violence from her partner. For women with primary school education or less, however, the effect of a cash transfer depends on her education relative to her partner’s. Specifically, the cash transfer significantly increases emotional violence in households where the woman’s education is equal to or more than her partner’s.

Concepts: Primary school, Wife, Woman, Primary education, School, Violence, Violence against women, Domestic violence

28

Sexual violence is a major public health issue, affecting 35% of women worldwide. Major risk factors for sexual assault include inadequate indoor sanitation and the need to travel to outdoor toilet facilities. We estimated how increasing the number of toilets in an urban township (Khayelitsha, South Africa) might reduce both economic costs and the incidence and social burden of sexual assault.

Concepts: South Africa, Violence against women, Ecological sanitation, Hygiene, Rape, Public health, Epidemiology, Mathematics

27

Intimate partner violence (IPV) and sexual violence (SV) are widespread among adolescents and place them on a lifelong trajectory of violence, either as victims or perpetrators. The aim of this review was to identify effective approaches to prevent adolescent IPV and SV and to identify critical knowledge gaps. The interventions reviewed in this article reflect the global focus on interventions addressing violence perpetrated by men against women in the context of heterosexual relationships. Interventions for girls and boys (10-19 years) were identified through electronic searches for peer-reviewed and gray literature such as reports and research briefs. Studies were excluded if they were published before 1990 or did not disaggregate participants and results by age. Programs were classified as “effective,” “emerging,” “ineffective,” or “unclear” based on the strength of evidence, generalizability of results to developing country settings, and replication beyond the initial pilot. Programs were considered “effective” if they were evaluated with well-designed studies, which controlled for threats to validity through randomization of participants. A review of 142 articles and documents yielded 61 interventions, which aimed to prevent IPV and SV among adolescents. These were categorized as “parenting” (n = 8), “targeted interventions for children and adolescents subjected to maltreatment” (n = 3), “school based” (n = 31; including 10 interventions to prevent sexual assault among university students), “community based” (n = 16), and “economic empowerment” (n = 2). The rigor of the evaluations varies greatly. A good number have relatively weak research designs, short follow-up periods, and low or unreported retention rates. Overall, there is a lack of robust standardized measures for behavioral outcomes. Three promising approaches emerge. First, school-based dating violence interventions show considerable success. However, they have only been implemented in high-income countries and should be adapted and evaluated in other settings. Second, community-based interventions to form gender equitable attitudes among boys and girls have successfully prevented IPV or SV. Third, evidence suggests that parenting interventions and interventions with children and adolescents subjected to maltreatment hold promise in preventing IPV or SV by addressing child maltreatment, which is a risk factor for later perpetration or experience of IPV or SV. Results suggest that programs with longer term investments and repeated exposure to ideas delivered in different settings over time have better results than single awareness-raising or discussion sessions. However, lack of rigorous evidence limits conclusions regarding the effectiveness of adolescent IPV and SV prevention programs and indicates a need for more robust evaluation.

Concepts: Child abuse, Human sexual behavior, Violence, Violence against women, Domestic violence