Elucidating Heterogeneity of Intimate Partner Violence Among Women: Latent Class Analysis of Daily IPV,PTSD,and Substance Use Collected via Experience Sampling Methodologies

Abstract

The co-occurrence of physical, psychological, and sexual intimate partner violence (IPV) is associated with heightened risk for deleterious mental and physical health outcomes, including PTSD symptoms and substance use. However, few studies have investigated the heterogeneity of experiences with respect to this co-occurrence among women who experience IPV as it unfolds naturally in women’s daily lives. In this study, we developed a novel approach to classify and visualize daily patterns of IPV experiences, PTSD-related distress, and substance use among women who experience IPV. Women (N = 244, Mage = 37.1 years) who reported experiencing IPV and using substances were recruited from the community. Micro-longitudinal data were collected four times per day for 14 days using automated telephone-based data collection. Analyses included latent class analysis (LCA) and multilevel analysis (interval-, day-, and person-level), complimented by novel data visualization tool (EventFlow). We identified three classes that significantly differed in the prevalence of and patterns among IPV types, PTSD, and substance use. Based on examination of LCA results and visualization of the latent classes in EventFlow. Different patterns of associations among IPV types, PTSD symptoms, and substance use were identified within classes at the interval-, day-, and person-level. Results from this study provide greater insight into the heterogeneity of women’s lived experiences than do studies solely relying on cross-sectional survey data. Findings with this type of data collection can inform the development of interventions to increase the precision in clinical practice, identify new avenues for future research, and have important policy implications.

Keywords

alcohol and drugs domestic violence PTSD

Get full access to this article

View all access options for this article.

References

Akaike

(1974). A new look at the statistical model identification. IEEE Transactions on Automatic Control, 19(6), 716–723. https://doi.org/10.1109/tac.1974.1100705

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ., text revision ed.).

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

Blasdell

(2021). The co-occurrence of physical and sexual intimate partner violence among US college females. International Journal of Criminal Justice Sciences, 169(1), 97–109. https://doi.org/10.5281/zenodo.4762461

Bolger

Davis

Rafaeli

(2003). Diary methods: Capturing life as it is lived. Annual Review of Psychology, 54(1), 579–616. https://doi.org/10.1146/annurev.psych.54.101601.145030

Bolger

Laurenceau

J.-P.

(2013). Intensive longitudinal methods: An introduction to diary and experience sampling research. Guilford Press.

Bonomi

A. E.

Anderson

M. L.

Rivara

F. P.

Thompson

R. S.

(2007). Health outcomes in women with physical and sexual intimate partner violence exposure. Journal of Women's Health, 16(7), 987–997. https://doi.org/10.1089/jwh.2006.0239

Cafferky

B. M.

Mendez

Anderson

J. R.

Stith

S. M.

(2018). Substance use and intimate partner violence: A meta-analytic review. Psychology of Violence, 8(1), 110–131. https://doi.org/10.1037/vio0000074

Cattaneo

L. B.

Stylianou

A. M.

Hargrove

Goodman

L. A.

Gebhard

K. T.

Curby

T. W.

(2021). Survivor-centered practice and survivor empowerment: Evidence from A research-practitioner partnership. Violence Against Women, 27(9), 1252–1272.

10.

De Dios

M. A.

Anderson

B. J.

Caviness

C. M.

Stein

. (2014). Intimate partner violence among individuals in methadone maintenance treatment. Substance Abuse, 35(2), 190–193. https://doi.org/10.1080/08897077.2013.835764

11.

Easteal

Holland

Judd

(2015). Enduring themes and silences in media portrayals of violence against women. Women's Studies International Forum, 48, 103–113. https://doi.org/10.1016/j.wsif.2014.10.015

12.

Enders

Bandalos

(2001). The relative performance of full information maximum likelihood estimation for missing data in structural equation models. Structural Equation Modeling A Multidisciplinary Journal, 8(3), 430–457.

13.

First

M. B.

Sptizer

R. L.

Miriam

Williams

J. B. W.

(2002). Structured clinical interview for DSM-IV-TR axis I disorders, research version. Biometrics Research, New York State Psychiatric Institute.

14.

Foa

E. B.

Cashman

Jaycox

Perry

(1997). The validation of a self-report measure of posttraumatic stress disorder: The posttraumatic diagnostic scale. Psychological Assessment, 9(4), 445–451. https://doi.org/10.1037//1040-3590.9.4.445

15.

Golding

J. M.

(1999). Intimate partner violence as a risk factor for mental disorders: A meta-analysis. Journal of Family Violence, 14(2), 99–132. https://doi.org/10.1023/a:1022079418229

16.

Grest

C. V.

Lee

J. O.

Gilreath

Unger

J. B.

(2018). Latent class analysis of intimate partner violence perpetration and victimization among Latino emerging adults. Journal of Youth and Adolescence, 47(3), 575–585. https://doi.org/10.1007/s10964-017-0807-0

17.

Guyon-Harris

K. L.

Madigan

Bronfman

Romero

Huth-Bocks

A. C.

(2021). Prenatal identification of risk for later disrupted parenting behavior using latent profiles of childhood maltreatment. Journal of interpersonal violence, 36(23–24), 13517–13540. https://doi.org/10.1177/0886260520906175

18.

Harvard Medical School. (2007). National Comorbidity Survey (NCS). www.hcp.med.harvard.edu/ncs/ftpdir/table_ncsr_12monthprevgenderxage.pdf

19.

Hebenstreit

C. L.

Maguen

Koo

K. H.

DePrince

A. P.

(2015). Latent profiles of ptsd symptoms in women exposed to intimate partner violence. Journal of Affective Disorders, 180, 122–128. https://doi.org/10.1016/j.jad.2015.03.047

20.

Hellmuth

J. C.

Jaquier

Swan

S. C.

Sullivan

T. P.

(2014). Elucidating posttraumatic stress symptom profiles and their correlates among women experiencing bidirectional intimate partner violence. Journal of Clinical Psychology, 70(10), 1008–1021.

21.

Howard

M. C.

Hoffman

M. E.

(2018). Variable-centered, person-centered, and person-specific approaches: Where theory meets the method. Organizational Research Methods, 21(4), 846–876. https://doi.org/10.1177/1094428117744021

22.

Human-Computer Interaction Lab. (2012). EventFlow: Exploring point and interval event temporal patterns. http://www.cs.umd.edu/hcil/eventflow

23.

Jumarali

S. N.

Nnawulezi

Royson

Lippy

Rivera

A. N.

Toopet

(2021). Participatory research engagement of vulnerable populations: Employing survivor-centered, trauma-informed approaches. Journal of Participatory Research Methods, 2(2), 1–21.

24.

Kiefer

Schick

M. R.

Newberger

N. G.

Ferguson

J. J.

Raudales

A. M.

Sullivan

T. P.

Weiss

N. H.

(2024). Concordance of posttraumatic stress disorder symptoms assessed via retrospective report versus experience sampling methods in community women experiencing intimate partner violence. Journal of Interpersonal Violence, 39(3–4), 605–630. https://doi.org/10.1177/08862605231197737

25.

Kopak

A. M.

Combs

Goodman

Hoffmann

N. G.

(2019). Exposure to violence and substance use treatment outcomes among female patients. Substance Use & Misuse, 54(3), 362–372. https://doi.org/10.1080/10826084.2018.1491050

26.

Koss

M. P.

Oros

C. J.

(1982). Sexual experiences survey: A research instrument investigating sexual aggression and victimization. Journal of Consulting and Clinical Psychology, 50(3), 455–457. https://doi.org/10.1037/0022-006X.50.3.455

27.

Krebs

Breiding

M. J.

Browne

Warner

(2011). The association between different types of intimate partner violence experienced by women. Journal of Family Violence, 26(6), 487–500. https://doi.org/10.1007/s10896-011-9383-3

28.

Lagdon

Armour

Stringer

(2014). Adult experience of mental health outcomes as a result of intimate partner violence victimisation: A systematic review. European Journal of Psychotraumatology, 5(1), 24794. https://doi.org/10.3402/ejpt.v5.24794

29.

Lawrence

Yoon

Langer

(2009). Is psychological aggression as detrimental as physical aggression? The independent effects of psychological aggression on depression and anxiety symptoms. Violence and Victims, 24(1), 20–35. https://doi.org/10.1891/0886-6708.24.1.20

30.

Magnussen

Shoultz

Oneha

M. F.

Hla

M. M.

Brees-Saunders

Akamine

Talisayan

Wong

(2004). Intimate-partner violence: A retrospective review of records in primary care settings. Journal of the American Academy of Nurse Practitioners, 16(11), 502–512. https://doi.org/10.1111/j.1745-7599.2004.tb00430.x

31.

Mahalanobis

P. C.

(1930). On tests and measures of group divergence, theoretical formulae. International Journal of the Asiatic Society of Bengal, 26(2), 541–588.

32.

Masyn

(2013). Latent class analysis and finite mixture modeling. In Little

T. D.

(Ed.), The Oxford handbook of quantitative methods: Statistical analysis (pp. 551–611). Oxford University Press.

33.

Miller

(2006). A specification of the types of intimate partner violence experienced by women in the general population. Violence Against Women, 12(12), 1105–1131. https://doi.org/10.1177/1077801206293501

34.

Modrowski

C. A.

Rizzo

C. J.

Collibee

Houck

C. D.

Schneider

(2021). Victimization profiles in girls involved in the juvenile justice system: A latent class analysis. Child Abuse & Neglect, 111, 1041074. https://doi.org/10.1016/j.chiabu.2020.104774

35.

Monroe

Plaisant

Shneiderman

Plaisant

Shneiderman

(2013). Temporal event sequence simplification. IEEE Transactions on Visualization and Computer Graphics, 19(12), 2227–2236. https://doi.org/10.1109/tvcg.2013.200

36.

Muthén

L. K.

Muthén

B. O.

(1998). Mplus: The comprehensive modeling program for applied researchers: User’s guide. Muthén & Muthén.

37.

Okuda

Olfson

Hasin

Grant

B. F.

Lin

K. H.

Blanco

(2011). Mental health of victims of intimate partner violence: Results from a national epidemiologic survey. Psychiatric Services, 62(8), 959–962. https://doi.org/10.1176/ps.62.8.pss6208_0959

38.

Ørke

E. C.

Vatnar

S. K. B.

Bjørkly

(2018). Risk for revictimization of intimate partner violence by multiple partners: A systematic review. Journal of Family Violence, 33(5), 325–339. https://doi.org/10.1007/s10896-018-9952-9

39.

Overstreet

N. M.

Willie

T. C.

Hellmuth

J. C.

Sullivan

T. P.

(2015). Psychological intimate partner violence and sexual risk behavior: Examining the role of distinct posttraumatic stress disorder symptoms in the partner violence-sexual risk link. Women's Health Issues, 25(1), 73–78. https://doi.org/10.1016/j.whi.2014.10.005

40.

Peterson

Kearns

M. C.

McIntosh

W. L.

Estefan

L. F.

Nicolaidis

McCollister

K. E.

Gordon

Florence

(2018). Lifetime economic burden of intimate partner violence among US adults. American Journal of Preventive Medicine, 55(4), 433–444. https://doi.org/10.1016/j.amepre.2018.04.049

41.

Rind

Wang

T. D.

Aigner

Miksch

Wongsuphasawat

Plaisant

Shneiderman

(2013). Interactive information visualization to explore and query electronic health records. Foundations and Trends^® in Human-Computer Interaction, 5(3), 207–298. https://doi.org/10.1561/1100000039

42.

Rosay

A. B.

(2016). Violence against American Indian and Alaska Native women and men: 2010 findings from the National Intimate Partner and Sexual Violence Survey. https://www.ncjrs.gov/pdffiles1/nij/249736.pdf

43.

Schwarz

(1978). Estimating the dimension of a model. The Annals of Statistics, 6(2), 461–464.

44.

Sclove

S. L.

(1987). Application of model-selection criteria to some problems in multivariate analysis. Psychometrika, 52(3), 333–343. https://doi.org/10.1007/BF02294360

45.

Sessarego

S. N.

Siller

Edwards

K. M.

(2021). Patterns of violence victimization and perpetration among adolescents using latent class analysis. Journal of Interpersonal Violence, 36(19–20), 9167–9186. https://doi.org/10.1177/0886260519862272

46.

Sinha

Calfee

C. S.

Delucchi

K. L.

(2021). Practitioner’s guide to latent class analysis: Methodological considerations and common pitfalls. Critical Care Medicine, 49(1), e63–e79. https://doi.org/10.1097/ccm.0000000000004710

47.

Snijders

Bosker

(2011) Multilevel analysis: An introduction to basic and advanced multilevel modeling (2nd ed.). Sage Publications,.

48.

Spencer

Mallory

A. B.

Cafferky

B. M.

Kimmes

J. G.

Beck

A. R.

Stith

S. M.

(2019). Mental health factors and intimate partner violence perpetration and victimization: A meta-analysis. Psychology of Violence, 9(1), 1–17. https://doi.org/10.1037/vio0000156

49.

Spillane

N. S.

Schick

M. R.

Kirk-Provencher

K. T.

Nalven

Goldstein

S. C.

Crawford

M. C.

Weiss

N. H.

(2022). Trauma and substance use among Indigenous peoples of the United States and Canada: A scoping review. Trauma Violence & Abuse, 24(5), 3297–3312. https://doi.org/10.1177/15248380221126184

50.

Stockman

J. K.

Hayashi

Campbell

J. C.

(2015). Intimate partner violence and its health impact on ethnic minority women. Journal of Women's Health, 24(1), 62–79. https://doi.org/10.1089/jwh.2014.4879

51.

Straus

M. A.

Hamby

S. L.

Warren

W. L.

(2003). The conflicts tactics scales handbook. Western Psychological Services.

52.

Stubbs

Szoeke

(2022). The effect of intimate partner violence on the physical health and health-related behaviors of women: A systematic review of the literature. Trauma Violence & Abuse, 23(4), 1157–1172. https://doi.org/10.1177/1524838020985541

53.

Sullivan

T. P.

Armeli

Tennen

Weiss

N. H.

Hansen

N. B.

(2020). Fluctuations in daily PTSD symptoms are related to proximal alcohol use: A micro-longitudinal study of women victims of intimate partner violence. American Journal of Drug and Alcohol Abuse, 46(1), 98–108. https://doi.org/10.1080/00952990.2019.1624765

54.

Sullivan

T. P.

Cavanaugh

C. E.

Buckner

J. D.

Edmondson

(2009). Testing posttraumatic stress as a mediator of physical, sexual, and psychological intimate partner violence and substance problems among women. Journal of Traumatic Stress, 22(6), 575–584. https://doi.org/10.1002/jts.20474

55.

Sullivan

T. P.

Khondkaryan

Dos Santos

N. P.

Peters

E. N.

(2011). Applying experience sampling methods to partner violence research: Safety and feasibility in a 90-day study of community women. Violence Against Women, 17(2), 251–266. https://doi.org/10.1177/1077801210397756

56.

Sullivan

T. P.

McPartland

T. S.

Armeli

Jaquier

Tennen

(2012). Is it the exception or the rule? Daily co-occurrence of physical, sexual, and psychological partner violence in a 90-day study of substance-using, community women. Psychology of Violence, 2(2), 154–164. https://doi.org/10.1037/a0027106

57.

Sullivan

T. P.

Weiss

N. H.

Flanagan

J. C.

Willie

T. C.

Armeli

Tennen

(2016). PTSD and daily co-occurrence of drug and alcohol use among women experiencing intimate partner violence. Journal of Dual Diagnosis, 12(1), 36–42. https://doi.org/10.1080/15504263.2016.1146516

58.

Sutherland

McCormack

Pirkis

Easteal

Holland

(2015). Media representations of violence against women and their children: State of knowledge paper. Australia’s National Research Organization for Women’s Safety. https://anrows.intersearch.com.au/anrowsjspui/bitstream/1/19851/1/FINAL-Co-branded-Media-Representations_WEB.pdf

59.

Sutter

M. E.

Rabinovitch

A. E.

Trujillo

M. A.

Perrin

P. B.

Goldberg

L. D.

Coston

B. M.

Calton

J. M.

(2019). Patterns of intimate partner violence victimization and perpetration among sexual minority women: A latent class analysis. Violence Against Women, 25(5), 572–592. https://doi.org/10.1177/1077801218794307

60.

Tabachnick

B. G.

Fidell

L. S.

(Eds.). (2013). Using multivariate statistics (6th ed.). Pearson.

61.

Tolman

R. M.

(1999). The validation of the psychological maltreatment of women inventory. Violence and Victims, 14(1), 25–37.

62.

Tukey

J. W.

McLaughlin

D. H.

(1963). Less vulnerable confidence and significance procedures for location based on a single sample: Trimming/winsorization 1. Sankhyã: The Indian Journal of Statistics, Series A, 25(3), 331–352.

63.

Van der Heijden

P. G. M.

HitHart

Dessens

J. A. G

. (1997). A parametric bootstrap procedure to perform statistical tests in latent class análisis. In Rost

Langeheine

(Eds.), Applications of latent trait and latent class models in the social sciences (pp. 190–202). Waxman Muenster.

64.

Weiss

N. H.

Brick

L. A.

Schick

M. R.

Forkus

S. R.

Raudales

A. M.

Contractor

A. A.

Sullivan

T. P.

(2022). Posttraumatic stress disorder strengthens the momentary associations between emotion dysregulation and substance use: A micro-longitudinal study of community women experiencing intimate partner violence. Addiction, 117(12), 3150–3169. https://doi.org/10.1111/add.15992

65.

Wright

N. M.

Dmitrieva

DePrince

A. P.

(2021). Dependence in adult relationships: Latent classes of relational dependence and associated outcomes in women exposed to intimate partner abuse. Psychological Trauma Theory Research Practice and Policy, 13(3), 359–367. https://doi.org/10.1037/tra0000661

66.

Yoshihama

Gillespie

Hammock

A. C.

Belli

R. F.

Tolman

R. M.

(2005). Does the life history calendar method facilitate the recall of intimate partner violence? Comparison of two methods of data collection. Social Work Research, 29(3), 151–163. https://doi.org/10.1093/swr/29.3.151

67.

Young-Wolff

K. C.

McCaw

(2019). Intimate partner violence and psychological distress: Opportunities for prevention and early intervention among emerging adult women. Journal of Women's Health, 28(8), 1013–1014. https://doi.org/10.1089/jwh.2019.7918