Research On Intimate Partner Violence Assignment
Research On Intimate Partner Violence Assignment
Background : Intimate partner violence (IPV) against women is a major global health issue, particularly in low- and middle-income countries (LMICs), that is associated with poor physical and mental health, but its association with breastfeeding practices is understudied. Both the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) recommend that children initiate breastfeeding within the first hour of birth and be exclusively breastfed for the first 6 months of life. Breastfeeding within the first hour of birth is critical to newborn survival, and exclusive breastfeeding for 6 months is recognised to offer significant health benefits to mothers and their infants. We examined the association of maternal exposure to IPV with early initiation of breastfeeding (within 1 hour of birth) and exclusive breastfeeding in the first 6 months. Methods and findings : We assessed population-based cross-sectional Demographic and Health Surveys (DHS) from 51 LMICs. Data from the most recent DHS in each country (conducted between January 2000 and January 2019) with data available on IPV and breastfeeding practices were used. By WHO region, 52.9% (27/51) were from Africa, 11.8% (6/51) from the Americas, 7.8% (4/51) from the Eastern Mediterranean, 11.8% (6/51) from Europe, 11.8% (6/51) from South-East Asia, and 3.9% (2/51) from the Western Pacific. We estimated multilevel logistic regression models for any IPV and each type of IPV separately (physical violence, sexual violence, and emotional violence), accounting for demographic and socioeconomic factors.
Depending on specification, the sample size varied between 95,320 and 102,318 mother–infant dyads. The mean age of mothers was 27.5 years, and the prevalence of any lifetime exposure to IPV among mothers was 33.3% (27.6% for physical violence, 8.4% for sexual violence, and 16.4% for emotional violence). Mothers exposed to any IPV were less likely to initiate breastfeeding early (adjusted odds ratio [AOR]: 0.88 [95% CI 0.85–0.97], p < 0.001) and breastfeed exclusively in the first 6 months (AOR: 0.87 [95% CI 0.82–0.92], p < 0.001). The associations were similar for each type of IPV and were overall consistent across infant’s sex and WHO regions. After simultaneously adjusting for all 3 types of IPV, all 3 types of IPV were independently associated with decreased likelihood of early breastfeeding initiation, but only exposure to physical violence was independently associated with a decreased likelihood of exclusively breastfeeding in the first 6 months. The main limitations of this study included the use of cross-sectional datasets, the possibility of residual confounding of the observed associations by household wealth, and the possibility of underreporting of IPV experiences attenuating the magnitude of observed associations. Conclusions : Our study indicates that mothers exposed to any form of IPV (physical, sexual, or emotional violence) were less likely to initiate breastfeeding early and breastfeed exclusively in the first 6 months. These findings may inform the argument for antenatal screening for IPV in LMICs and the provision of services to not only improve mothers’ safety and well-being, but also support them in adopting recommended breastfeeding practices.
Respond to the following questions in 500 words each
Dr. Daniela Yeung, a community psychologist, has been conducting a federally funded ethnographic study of men’s attitudes toward intimate partner violence following conviction and release from prison for spousal abuse. Over the course of a year, she has had individual monthly interviews with 25 participants while they were in jail and following their release. Aiden, a 35-year-old male parolee convicted of seriously injuring his wife, has been interviewed by Dr. Yeung on eight occasions. The interviews have covered a range of personal topics including Aiden’s problem drinking, which is marked by blackouts and threatening phone calls made to his parents and girlfriend when he becomes drunk, usually in the evening. To her knowledge, Aiden has never followed through on these threats. It is clear that Aiden feels very comfortable discussing his life with Dr. Yeung. One evening Dr. Yeung checks her answering machine and finds a message from Aiden. His words are slurred and angry: “Now that you know the truth about what I am you know that there is nothing you can do to help the evil inside me. The bottle is my savior and I will end this with them tonight.” Each time she calls Aiden’s home phone she gets a busy signal.
Ethical Dilemma
Dr. Yeung has Aiden’s address, and after 2 hours, she is considering whether or not to contact emergency services to go to Aiden’s home or to the homes of his parents and girlfriend.
Discussion Questions
Why is this an ethical dilemma? Which APA Ethical Principles help frame the nature of the dilemma?
Does this situation meet the standards set by the Tarasoff decision’s “duty to protect” statute? How might whether or not Dr. Yeung’s state includes researchers under such a statute influence Dr. Yeung’s ethical decision making? How might the fact that Dr. Yeung is a research psychologist without training or licensure in clinical practice influence the ethical decision?
How are APA Ethical Standards 2.01f, 3.04, 3.06, 4.01, 4.02, 4.05, and 8.01 relevant to this case? Which other standards might apply?
What are Dr. Yeung’s ethical alternatives for resolving this dilemma? Which alternative best reflects the Ethics Code aspirational principles and enforceable standards, legal standards, and obligations to stakeholders?
What steps should Dr. Yeung take to implement her decision and monitor its effect?