Excerpt

In the United States, intimate partner violence (IPV) poses a significant public health burden that affects both men and women. Over a third (35.6%) of women and a fourth (28.5%) of men in the United States have experienced rape, physical violence, or stalking by an intimate partner in their lifetime. Outcomes associated with IPV include a wide range of social, physical, and mental issues such as family dissolution, adverse pregnancy outcomes, mental health issues (depression, posttraumatic stress disorder [PTSD], anxiety), incarceration, and death. IPV affects many facets of society including medical, mental health, social services, and criminal justice systems. Moreover, productivity losses and costs attributable to IPV are significant.

Military service has unique psychological, social, and environmental factors that may contribute to elevated risk of IPV among active duty servicemembers and Veterans. Multiple deployments, family separation and reintegration, demanding workloads at home and while on duty, histories of head trauma, mental illness, and substance abuse can contribute to partner conflict and elevated risk of IPV among active duty servicemembers, Veterans, and their intimate partners.

Currently the VA does not have a comprehensive national program to address IPV. Thus, the VA convened the Domestic Violence Task Force to define the scope of, and design a plan for evaluating domestic violence among Veterans. In order to support the goals and mission of this task force, the Durham VA Evidence-based Synthesis Program conducted a systemic review of the literature to synthesize the evidence on the prevalence of IPV among active duty servicemembers and Veterans and to conduct an evidence synthesis of the systematic review (SR) literature on intervention strategies to address IPV.

Key Question 1. What is the prevalence of intimate partner violence among Veterans and active duty servicemembers, and does the prevalence vary by cohort (e.g., Vietnam era, OEF/OIF/OND era), gender, or race?

Key Question 2. For persons who are at risk for, experience, or commit intimate partner violence, what interventions are associated with decreased exposure to intimate partner violence and its associated physical harms, mental harms, or mortality?

Contents

• PREFACE
• EXECUTIVE SUMMARY
  • BACKGROUND
  • METHODS
  • DATA SYNTHESIS
  • RATING THE BODY OF EVIDENCE
  • PEER REVIEW
  • RESULTS
  • CLINICAL AND POLICY IMPLICATIONS
  • RECOMMENDATIONS FOR FUTURE RESEARCH
  • CONCLUSION
  • ABBREVIATIONS TABLE
• INTRODUCTION
• METHODS
  • TOPIC DEVELOPMENT
  • ANALYTIC FRAMEWORK
  • SEARCH STRATEGY
  • STUDY SELECTION
  • DATA ABSTRACTION
  • QUALITY ASSESSMENT
  • DATA SYNTHESIS
  • RATING THE BODY OF EVIDENCE
  • PEER REVIEW
• RESULTS
  • LITERATURE SEARCH
  • KEY QUESTION 1 What is the prevalence of intimate partner violence among Veterans and active duty servicemembers, and does the prevalence vary by cohort (e.g., Vietnam era, OEF/OIF/OND era), gender, or race?
  • KEY QUESTION 2 For persons who are at risk for, experience, or commit intimate partner violence, what interventions are associated with decreased exposure to intimate partner violence and its associated physical harms, mental harms, or mortality?
• SUMMARY AND DISCUSSION
  • SUMMARY OF EVIDENCE BY KEY QUESTION
  • CLINICAL AND POLICY IMPLICATIONS
  • APPLICABILITY
  • STRENGTHS AND LIMITATIONS
  • RECOMMENDATIONS FOR FUTURE RESEARCH
  • CONCLUSION
• REFERENCES
• APPENDIX A SEARCH STRATEGIES
• APPENDIX B INCLUDED STUDIES
• APPENDIX C CRITERIA USED IN QUALITY ASSESSMENT
• APPENDIX D PEER REVIEW COMMENTS
• APPENDIX E GLOSSARY

Research Associate: Avishek Nagi, MS; Medical Editor: Liz Wing, MA

Prepared for: Department of Veterans Affairs, Veterans Health Administration, Quality Enhancement Research Initiative, Health Services Research & Development Service, Washington, DC 20420. Prepared by: Evidence-based Synthesis Program (ESP) Center, Durham Veterans Affairs Healthcare System, Durham, NC, John W. Williams Jr., M.D., M.H.Sc., Director.

Suggested citation:

Gierisch JM, Shapiro A, Grant NN, King HA, McDuffie JR, Williams JW. Intimate Partner Violence: Prevalence Among U.S. Military Veterans and Active Duty Servicemembers and a Review of Intervention Approaches. VA-ESP Project #09-010; 2013.

This report is based on research conducted by the Evidence-based Synthesis Program (ESP) Center located at the Durham VA Medical Center, Durham, NC, funded by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Health Services Research and Development. The findings and conclusions in this document are those of the author(s) who are responsible for its contents; the findings and conclusions do not necessarily represent the views of the Department of Veterans Affairs or the United States government. Therefore, no statement in this article should be construed as an official position of the Department of Veterans Affairs. No investigators have any affiliations or financial involvement (e.g., employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties) that conflict with material presented in the report.