Elise D Riley1, Jennifer Cohen, Kelly R Knight, Alyson Decker, Kara Marson, Martha Shumway. 1. Elise D. Riley, Jennifer Cohen, and Kara Marson are with the School of Medicine, Department of Medicine, University of California, San Francisco. Kelly R. Knight is with the School of Medicine, Department of Anthropology, History and Social Medicine, University of California, San Francisco. Alyson Decker is with the School of Nursing, University of California, San Francisco. Martha Shumway is with the School of Medicine, Department of Psychiatry, University of California, San Francisco.
Abstract
OBJECTIVES: We determined associations between co-occurring psychiatric conditions and violence against homeless and unstably housed women. METHODS: Between 2008 and 2010, we interviewed homeless and unstably housed women recruited from community venues about violence, socioeconomic factors, and psychiatric conditions. We used multivariable logistic regression to determine independent correlates of violence. RESULTS: Among 291 women, 97% screened positive for 1 or more psychiatric conditions. Types of violence perpetrated by primary partners and persons who were not primary partners (non-primary partners) included emotional violence (24% vs 50%; P < .01), physical violence (11% vs 19%; P < .01), and sexual violence (7% vs 22%; P < .01). The odds of primary partner and non-primary partner violence increased with each additional psychiatric diagnosis and decreasing levels of social isolation. CONCLUSIONS: All types of violence were more commonly perpetrated by non-primary partners, suggesting that an exclusive focus on domestic violence screening in health care or social service settings will miss most of the violence in this population. Contrary to some previous studies, the odds of violence decreased as social isolation increased, suggesting that social isolation may be protective in homeless and unstably housed communities with high levels of comorbidity and limited options.
OBJECTIVES: We determined associations between co-occurring psychiatric conditions and violence against homeless and unstably housed women. METHODS: Between 2008 and 2010, we interviewed homeless and unstably housed women recruited from community venues about violence, socioeconomic factors, and psychiatric conditions. We used multivariable logistic regression to determine independent correlates of violence. RESULTS: Among 291 women, 97% screened positive for 1 or more psychiatric conditions. Types of violence perpetrated by primary partners and persons who were not primary partners (non-primary partners) included emotional violence (24% vs 50%; P < .01), physical violence (11% vs 19%; P < .01), and sexual violence (7% vs 22%; P < .01). The odds of primary partner and non-primary partner violence increased with each additional psychiatric diagnosis and decreasing levels of social isolation. CONCLUSIONS: All types of violence were more commonly perpetrated by non-primary partners, suggesting that an exclusive focus on domestic violence screening in health care or social service settings will miss most of the violence in this population. Contrary to some previous studies, the odds of violence decreased as social isolation increased, suggesting that social isolation may be protective in homeless and unstably housed communities with high levels of comorbidity and limited options.
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