Low Rates of Screening for Intimate Partner Violence among Veterans with PTSD
In recent years, healthcare providers have been encouraged to screen male patients for intimate partner violence (IPV) perpetration, as well as victimization. Veterans returning from Iraq and Afghanistan have high rates of PTSD, and, historically, Veterans with PTSD have been found to have a higher incidence of IPV perpetration than Veterans without PTSD. This retrospective cohort study sought to determine how many Veterans' records showed documentation of screening for IPV perpetration - and to assess the total number of screenings, and whether an initial screening affected future screenings. Investigators identified a random sample of 507 male Veterans enrolled in PTSD treatment at one VA healthcare facility over a 5-year period (11/02-11/07). For this study, IPV was defined as physical or sexual violence against an intimate partner or behaviors that establish a threat of such violence, in addition to a pattern of psychologically abusive and coercive behaviors toward an intimate partner.
Findings show a low rate of screening and assessment for IPV perpetration in male, treatment-seeking Veterans with PTSD - a population believed to have high rates of relationship conflict. Of the 507 patient records that were examined, 120 (24%) showed documentation of IPV screening. Of those, 73 (61%) showed positive results for IPV perpetration, and 61 (51%) showed more than one screening. Documentation of screening most often occurred at the Veteran's initial appointment (71%), and in an outpatient mental health setting (72%). While most patient records did not show documentation of a screening or assessment for IPV perpetration, many provided rich descriptions of relationships, indicating that Veterans gave VA staff opportunities to ask about IPV.
Authors suggest that documenting IPV screening and perpetration can alert other providers, offering an opportunity for further assessment of its impact on the Veteran and his family members.
Gerlock A, Grimesey J, Pisciotta A, and Harel O. Documentation of screening for perpetration of intimate partner violence in male Veterans with PTSD. American Journal of Nursing November 2011;111(11):26-32.
This study was funded by HSR&D (NRI 04-040). Dr. Gerlock is part of HSR&D's Northwest Center for Outcomes Research in Older Adults, Seattle, WA, and the VA Puget Sound Healthcare System.