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Psychologists can help create a world free of interpersonal violence, said Wanda Jones, DPH, director of the U.S. Department of Health and Human Services Office on Women's Health, opening the two-day "Summit on Violence and Abuse in Relationships: Connecting Agendas and Forging New Directions."

Jones said the first step is believing it can be achieved: "As long as we say it's not possible, we will fail to see the opportunities right in front of us," said Jones.

More than 450 psychologists, advocates and students, including representatives from 19 APA divisions, APA's four directorates and other organizations, attended the summit, held Feb. 28-29 in Bethesda, Md.

The summit is a first step in what should be an enduring effort by psychologists to reduce interpersonal violence, both within American society and the world as a whole, said APA President Alan E. Kazdin, PhD, whose presidential initiatives include integrating the contributions of psychology in research, practice and public policy to reduce interpersonal violence.

What isn't needed is a task force report that no one remembers a few years after it's complete, Kazdin said.

"It matters if we have an impact on the public," he said.

Jones cited grim statistics on the toll inflicted by interpersonal violence, including:

  • Sexual assault. One in four women report rape or sexual assault by an intimate partner in their lifetimes, compared with fewer than one in 10 men.

  • Child maltreatment. While the rate of child maltreatment cases reported to child welfare agencies declined slightly from 12.5 cases per 1,000 children to 12.1 in the past five years, the real number of cases might be three times as high.

  • Special populations and at-risk groups. Prevalence rates of partner violence in gay, lesbian, bisexual and transgender communities, or in older people and people with disabilities, are not known.

Robert Geffner, PhD, president of Div. 56 (Trauma), who coordinated the conference with Jacquelyn White, PhD, president of Div. 35 (Society for the Psychology of Women), said that the conference has already been successful in bringing people together who can reduce interpersonal violence.

"It's time that these issues were changed and that we have a national priority and a national movement to do so," he said.

Summit participants also heard from keynote speaker Jacki McKinney, a consumer advocate who fights for the rights and recovery of people with mental illnesses and co-occurring disorders. Looking back at her own life, McKinney said psychologists who listened to her experiences and believed she could get better helped her recover from mental illness, trauma, addiction and homelessness--giving her a chance to help her great-grandchildren overcome a history of dysfunction and thrive.

"We can't pull it together if you can't remember the silent partner," she said.

Violence in the community context

"What does it mean when loving is dangerous ... when it can cost you your very life?" asked Thema Bryant-Davis, PhD, assistant professor at Pepperdine University's Graduate School of Education and Psychology.

That's a question many African-American women confront in their personal lives, Bryant-Davis said at a session on the challenges faced by special populations during the antiviolence summit.

Research on African-American women shows, for example, that they have higher rates of intimate partner violence, including homicide, she said. That fact needs to be considered in a larger context of social trauma and racial and sexual oppression, an environment that traditionally devalues the personal suffering of women of African descent. This group of women is particularly vulnerable to intimate-partner violence because their lack of economic and social resources prevents many from being able to move away from abusive partners.

That's why it's critical for psychologists who want to reduce interpersonal violence to explore its effects on the communities of people who are disproportionately affected by violence, said Priscilla Dass-Brailsford, EdD, who also spoke at the session. Dass-Brailsford described a group intervention she developed for middle-school teens who live in a chronically violent Boston neighborhood with a murder rate twice the national average.

She tried measuring their exposure to trauma but found that the standard measurement scales did not appear to capture the teens'experiences. So her research team asked each teen to keep a journal. One teen wrote about wanting to grow up to become a football player or a doctor, but also listed "and not getting shot" as a personal goal, Dass-Brailsford said.

Many of the teens were also worried about getting shot because of mistaken identity.

The tentative results show that psychologists need to develop culturally appropriate assessment strategies and interventions for urban youth whose chances for educational success and functional adulthood are jeopardized by their exposure to violence, she said.

By not having access to measurement scales that are culturally attentive, "There's a whole group of people left out of the conversation," she said.

Another population at risk for interpersonal violence is the families of service members who are suffering from post-traumatic stress disorder (PTSD), said Casey Taft, PhD, a Department of Veterans Affairs psychologist with the National Center for PTSD in Boston.

Historically, studies of Vietnam veterans show that one-third of those with PTSD were violent with their partners over the previous year--a rate two to three times higher than veterans without PTSD, he said. A string of domestic homicides involving soldiers from Fort Bragg, N.C., in 2002, and the number of Iraq and Afghanistan veterans coming home experiencing PTSD, have drawn media interest to the risk of violence faced by military families, Taft said.

More resources are needed to study the best approaches to preventing violence within these families, he said.

Who is watching the children?

An increasing number of U.S. children live in violent homes, says Southern Methodist University's Ernest N. Jouriles, PhD. An estimated 15.5 million children live in homes in which there's been at least one incident of physical intimate partner violence this year, including pushing, shoving and threats. Seven million children have likely seen more severe aggression, such as beatings or gun violence, according to Jouriles. These estimates are based on data he's collected on 1,635 families and U.S. Census Bureau statistics.

The numbers are increasing: Previous estimates indicated that between 3 million and 10 million children witnessed such horrors in the home.

Yet research is lacking on how to best help these children stave off the anxiety, depression and other psychosocial effects that accompany these traumas, added Jouriles. More longitudinal research is needed as well to shed light on how witnessing such abuse plays out later in these children's lives, he said. What's more, only three intervention programs aimed at helping these young bystanders--Project Support, Kids Club and Child-Parent Psychotherapy--have proven effective, noted Jouriles.

"This is sad compared with other areas of psychology," he said.

In number and scope, these interventions are just the start of what's needed for these children, added Kids Club founder Sandra Graham-Bermann, PhD, of the University of Michigan. She recommended researchers take an ecological approach to violence exposure research and look at how a child's socioeconomic status, age, birth order, community, parenting and ethnicity operate as potential risk or protective factors.

"We need more complex research," said Graham-Bermann. "We need to know what contributes to it so we can target our interventions. We also need more money to use what we know and get it out to the communities."

Researchers also need to consider children's brain development and neural chemistry, added presenter Robert Geffner, PhD, of the Institute on Violence, Abuse and Trauma at Alliant International University. His research shows that the chronic stress of repeated exposure to violence can cause structural changes to a child's frontal temporal lobe, potentially undermining the children's ability to organize thoughts and solve problems. And as this key brain area loses ground, the sensory and motor cortexes become overdeveloped, causing these children to be hypervigilant about gestures and sounds as potential violence indicators.

"This part of the brain becomes survival," said Geffner. "There's a whole other realm here we need to start paying attention to."

No escape route

Encouraging a more holistic view that considers the differing contexts of violence may help at-risk populations find the support they need, according to University of Manitoba women's and gender studies professor Janice Ristock, PhD. Along with research neuropsychologist Martha E. Banks, PhD, and Wayne State University professor of gerontology and nursing Olivia G.M. Washington, PhD, Ristock explored how psychologists can better understand and respond to domestic abuse among the elderly, those with disabilities and lesbian, gay, bisexual, transgender and queer (LGBTQ) people, at a session moderated by Div. 45 (Society for the Psychological Study of Ethnic Minority Issues) membership committee chair Brian Ragsdale, PhD.

Abuse of women with physical and psychological disabilities comes in many forms--emotional, physical, sexual and financial. Yet to date, little information exists as to who is most at risk, Banks said. What is clear, however, is that family members--particularly intimate partners--are the biggest perpetrators of violence among this population, and their abuse can lead to the women's early deaths.

Few women with disabilities are able to leave abusive homes and find support elsewhere. Yet even women--with or without disabilities--who do leave often face a new challenge, Washington said: homelessness. According to the National Coalition for the Homeless and the National Coalition Against Domestic Violence, nearly half of homeless women are fleeing from domestic abuse. African-American women approaching age 50 are more vulnerable to the triple threats of race, poverty and abuse, Washington added, and often don't qualify for public aid because they no longer have minor children and are too young for Social Security assistance.

Similarly, victims of abuse in the LGBTQ population face stigma and barriers in many mainstream services responding to violence, as well as limited housing and shelter opportunities if they leave a violent relationship, Ristock said. Presenters emphasized the need for more targeted research and increased resources for these vulnerable populations.

"We have to understand what the real 'meat and bones'issues and barriers are in order to develop targeted interventions to overcome them," Washington said.

-J. Chamberlin, C. Munsey, A. Novotney and E. Packard