Despite compelling evidence that victimization and offending co-occur, it remains unclear what types of victimization are linked to specific forms of perpetration. Here we examined the relationship between physical, psychological, and sexual violence with respect to influencing variables including mental health, risk-taking behaviors, and coping strategies. Data from 5385 men were collected as part of an epidemiological study on violence experience. A classification and regression tree analysis identified the main predictors of violence perpetration and classified violent offending into high-and low-risk groups.Results indicate that violence is best predicted by previous exposure to violence and polyvictimization. Physical violence is best predicted by prior exposure to physical violence and this is further influenced by the frequency of and the age at which violence was experienced. Drug use was a strong predictor of physical and psychological violence. The latter is best predicted by a history of polyvictimization, the severity and the originator of violence. Sexual violence is strongly predicted by one's sexual violence experience. Other factors such as demographic characteristics are less predictive. Our results may contribute to the development of early prevention and intervention approaches that account for different risk factors. The significance of violence exposure suggest that intervention measures must focus on victims of early and prolonged experience of violence. On the strength of the link between drug use and violence, exposure to violence should be considered in drug prevention and intervention and vice versa. K E Y W O R D S classification and regression tree analysis, exposure to violence, perpetration, polyvictimization, risk factors, violent offending This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Violence is a known risk factor for health problems. In this epidemiological study across 5,385 male patients, we investigate the prevalence of perpetrated violence, exposure to violence, their overlap and the relationship between violence, mental, and psychosomatic health, as well as adverse health behaviors, such as self-harming behavior and the consumption of drugs. Participants completed an anonymous questionnaire addressing violence experience (i.e., both expose and perpetration), age of victimization/perpetration, frequency, and perceived severity of violence exposure. We considered physical, psychological as well as sexual violence. Information on health status and adverse health behaviors complemented the data. Results showed that 48.4% of the sample reported having experienced violence (perpetration, victimization, or both). The victim-perpetrator overlap formed the largest group, in which the incidence of having experienced multiple types of violence was significantly higher compared to victims and perpetrators. The age-crime curve flattened more slowly with increasing age in this group. Although the perceived severity of exposure to violence is lower in the overlap group, its health status and adverse health behaviors were worse. Interventions should focus on this group since they constitute a burden for the healthcare system.
BackgroundHealth care systems remain a key entry point for support and care for survivors of gender-based violence (GBV), yet their involvement in disclosure and referral remain low. Some of the reasons may be lack of referral systems and/or lack of training and resources.MethodsAn environmental scan was conducted as part of the EU funded IMPLEMENT project in six European countries (Austria, Bulgaria, France, Germany, Italy, Romania) to orient the implementation of health system capacity building seminars aiming to empower health care providers in increasing specialised support to survivors of GBV. The environmental scan focused on identifying baseline information on leadership, infrastructure and capacity of the health care system where the seminars were to be implemented, i.e. in one setting (emergency departments and obstetric clinics) in each participating country.ResultsIn France, Italy and Germany, certain health providers already receive some training on GBV and victim protection during their residency or medical/nursing school, but in Austria and Bulgaria there is no specific training. In Romania, only resident doctors receive 1–2 hours training on risk assessment of GBV victims, as there is a referral system that allows early identification and rapid response to GBV. In Austria, Bulgaria and Germany there is no referral system in place yet, while in France and Italy, similar to Romania, there is a system but only for cases participating in the project. Networks of GBV prevention practitioners that could provide support for implementing referral systems were identified in all participant countries.ConclusionsThe implementation of a direct referral system between health professionals and specialised GBV services creates the link needed to strengthen the health system response to gender-based violence in the EU. Examples of effective referral system are well needed in order to reduce the burden of GBV.
Despite compelling evidence that victimization and offending co-occur, it remains unclear what types of victimization are linked to specific forms of perpetration. Here we examined the relationship between physical, psychological, and sexual violence with respect to influencing variables including mental health, risk-taking behaviors, and coping strategies. Data from 5,385 men were collected as part of an epidemiological study on violence experience. A classi-fication and regression tree analysis identified the main predictors of violence perpetration and classified violent offending into high- and low risk groups. Results indicate that violence is best predicted by previous exposure to violence and polyvictimization. Physical violence is best predicted by prior exposure to physical violence and this is further influenced by the fre-quency of and the age at which violence was experienced. Drug use was a strong predictor of physical and psychological violence. The latter is best predicted by a history of polyvictimiza-tion, the severity and the originator of violence. Sexual violence is strongly predicted by one´s sexual violence experience. Other factors such as demographic characteristics are less predic-tive. Our results may contribute to the development of early prevention and intervention ap-proaches that account for different risk factors. The significance of violence exposure suggest that intervention measures must focus on victims of early and prolonged experience of vio-lence. On the strength of the link between drug use and violence, exposure to violence should be considered in drug prevention and intervention and vice versa.
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