In lower- and middle-income countries (LMICs), studies of interventions to reduce intimate partner violence (IPV) are expanding, yet measurement equivalence of the IPV construct—the primary outcome in these investigations—has not been established. We assessed the measurement equivalence of physical and sexual IPV item sets used in recent trials in LMICs and tested the impact of noninvariance on study inference. With data from four intervention trials (N = 3,545) completed before 2020, we used multiple-group confirmatory factor analysis to assess invariance across arms, over time, and across studies. We also calculated average treatment effects adjusting for covariate imbalance to assess concordance with published results. Most items functioned equivalently within studies at baseline and end line. Some evidence of longitudinal noninvariance was observed in at least one study arm in three studies, but did not meaningfully affect latent means or effect-size estimates. Evidence of partial invariance across studies at baseline and strict invariance over time was observed. Common measures of physical and sexual IPV were valid for measuring intervention impact in these samples. The study highlights the need for harmonized use of the tested scale, content validity assessments, and routine measurement equivalence testing to ensure valid inferences about intervention effectiveness.

Objectives: Growing evidence of the effectiveness of mindfulness-based interventions for posttraumatic stress disorder (PTSD) warrants greater understanding of factors relevant to the relation between trait mindfulness and PTSD, such as emotion dysregulation (ED). The goal of this study was to examine associations between trait mindfulness, ED, and PTSD symptoms across two samples of trauma-exposed adults. Methods: Participants for Sample 1 (n = 39, 90% women, 100% Black) and Sample 2 (n = 60, 100% women, 87% Black) were recruited from an urban hospital in the South. Trait mindfulness, ED, and PTSD were assessed. Results: Across both samples, mindfulness and ED were significantly associated with overall PTSD severity (r = −.49 and r = −.42, ps =.001; r =.53 and r =.51, ps <.001, respectively) in the expected direction. In Sample 1, mindful nonjudgment and difficulty with emotion regulation strategies showed the strongest associations with overall PTSD severity as well as symptom clusters. In Sample 2, mindful acceptance and all ED dimensions (except non-awareness) showed strong associations with overall PTSD severity and particularly with negative cognitions and mood symptoms. In both samples, ED mediated the association between mindfulness and overall PTSD severity (Sample 1: ab = −.15, 95% CI [−.35, −.02]; Sample 2: ab = −.11, 95% CI [−.22, −.04]). Conclusions: These findings demonstrate the important role of ED in the relation between trait mindfulness and PTSD symptoms among trauma-exposed adults. They highlight the value of examining ED as a mechanism of change in mindfulness-based interventions for PTSD. Clinical Trials Registration: Sample 1: NCT03922581, April 22, 2019; NCT03938350, May 6, 2019; Sample 2: NCT02754557, April 28, 2016.

Intimate partner violence (IPV), a significant public health problem among low-income African American women, often has negative sequelae. Despite this, many women in abusive partnerships report having meaningful lives. To advance our understanding of factors that promote resilience in this traumatized population, this investigation aimed to elucidate the potential mediating role of one culturally-salient factor, Africultural coping, in the relation between IPV (physical, non-physical) and existential well-being (i.e., meaning in life). The sample included 213 low-income African American women with a suicide attempt and IPV exposure in the prior year. Results from mediational analyses with bootstrapping partially support the study hypotheses. We found that (1) one form of IPV (nonphysical) was inversely related to existential well-being; (2) one form of IPV (physical IPV) was positively correlated with two of the four dimensions of this culturally-salient form of coping (spiritual-centered, ritual-centered); (3) four dimensions of Africultural coping, as well as the total score, correlated with existential well-being; and (4) Africultural coping as reflected in spiritual- and ritual-centered coping mediated the relation between IPV (physical, but not nonphysical) and existential well-being. The findings suggest that culturally responsive interventions that bolster Africultual coping behaviors may optimize the existing capacity of low-income African American women to manage stressful situations, such as IPV, in a manner that enhances the sense of meaning in their lives.

The study explored associations among childhood abuse, post-traumatic stress symptoms (PTSS), and alcohol misuse in a sample of low-income African-American women (N = 172). Using bootstrapping techniques, a mediation effect was found of childhood physical and emotional abuse on alcohol misuse via PTSS symptom severity, avoidance, and hyperarousal, as well as for childhood sexual abuse on alcohol misuse via PTSS symptom severity and hyperarousal. Our results suggest that PTSS indicators, particularly symptom severity and hyperarousal, may be important mechanisms underlying the association of experiences of abuse during childhood and alcohol misuse in adulthood.

Objectives: The COVID-19 pandemic has negatively affected wellbeing. However, the impact on the mental health status of Chinese psychiatrists and their relationship with quality of life (QOL) has not been examined. Methods: This was a national cross-sectional survey performed between January 11 and March 15, 2021. Demographic and work-related data were collected anonymously using an online questionnaire. Common mental health symptoms and QOL were assessed using the Depression Anxiety Stress Scale-Chinese version and the World Health Organization Quality of Life Schedule-Brief, respectively. Results: A total of 3,783 psychiatrists completed this questionnaire. The prevalence of depressive, anxious, and stress symptoms were 26.7% (95%CI = 25.3–28.1%), 24.1% (95%CI = 22.8–25.5%), and 11.6% (95%CI = 10–12%), respectively. Moreover, 11.1% of the participants endorsed both depressive and anxious symptoms, and 8% endorsed symptoms in all three domains. Binary logistic regression showed that aged 30–39 years (OR = 1.5, P = 0.03), male gender (OR = 1.2, P = 0.04), single (OR = 1.44, P = 0.01), and having a negative perception of the COVID-19 on healthcare (OR = 2.34, P <0.001) were factors associated with higher levels of depressive symptoms. Participants who were divorced and widowed (OR = 1.56, P = 0.03), worked more than 4 night shifts/month (OR = 1.33, P<0.001) and/or longer working years (OR = 1.71, P < 0.001), and had a negative perceived impact of the COVID-19 on healthcare (OR = 2.05, P < 0.001) were more inclined to experience anxious symptoms. In addition, psychiatrists with high QOL scores had lower odds of experiencing depressive, anxious, and stress symptoms (all P < 0.001). Multivariate analysis showed that the presence of each of the three types of mental health symptoms was independently associated with lower QOL (all P < 0.05). In addition, the depression × anxious × stress interaction was significantly correlated with lower QOL (P < 0.05). Conclusion: Approximately one-fourth of psychiatrists in China experienced depressive and anxious symptoms during the COVID-19 pandemic, and more than one-tenth reported stress. Mental health symptoms were significant contributors to lower QOL. The psychological wellbeing of psychiatrists during the pandemic requires more attention, and interventions are needed to improve the psychological wellbeing and QOL of physicians who care for individuals with mental disorders.

Spiritual well-being has been shown to reduce suicidal behavior, depressive symptoms, and hopelessness. Thwarted interpersonal needs have been shown to increase risk of suicidal behavior. This paper aims to explore the interrelationships among spiritual well-being, thwarted interpersonal needs, and negative outcomes including suicidal ideation, hopelessness, and depressive symptoms among African American women. Sixty-six African American women (M = 36.18; SD = 11.70), from a larger study of women who had experienced interpersonal violence within the past year, completed self-report questionnaires. Mediation analyses revealed that thwarted belongingness, but not perceived burdensomeness, significantly mediated the relations between spiritual well-being and the three outcomes. This study provides the first examination of the role of thwarted interpersonal needs on the link between spiritual well-being and negative psychological outcomes. Spiritual well-being serves a protective role against feelings of social isolation, which may reduce one’s risk of negative psychological outcomes. Treatments that bolster a sense of spirituality and social connectedness may reduce suicidal ideation, hopelessness, and depressive symptoms.

Parenting behavior is key to understanding transmission of intergenerational trauma-related risk. Emotion dysregulation (ED) and psychological symptoms are associated with negative parenting behaviors, although their unique roles remain unclear. The current study examined associations of ED dimensions, depression, PTSD, and substance use with parenting behaviors in African American mothers. Participants included 98 mother-child dyads recruited from an urban hospital setting. Trauma exposure, ED, depression, substance use, and parenting behaviors (overreactivity, laxness, demandingness, warmth, corporal punishment) were assessed using self-report measures. PTSD was assessed using a semi-structured interview. Correlational results showed significant positive associations between ED and dysfunctional parenting behavior (p <.001), overreactivity (p <.001), and laxness (p <.01) and negative associations with warmth (p <.01). These associations varied across the dimensions of ED examined. Regression analyses were run to examine the unique effects of ED (separate models for overall and specific dimensions) and psychological symptoms; overall ED and its dimensions accounted for significant variance in parental behaviors (R2 =.10–.24, p’s <.01), while additional model steps including psychological symptoms were not significant except for the association between depression and lower warmth. In efforts to reduce the intergenerational effects of trauma, parenting interventions that include a direct focus on certain dimensions of ED may be critical.

Background The persistence and impacts of violence against women motivated Sustainable Development Goal (SDG) 5.2 to end such violence. Global psychometric assessment of cross-country, cross-time invariance of items measuring intimate partner violence (IPV) is needed to confirm their utility for comparing and monitoring national trends. Methods Analyses of seven physical-IPV items included 377,500 ever-partnered women across 20 countries (44 Demographic and Health Surveys (DHS)). Analyses of five controlling-behaviors items included 371,846 women across 19 countries (42 DHS). We performed multiplegroup confirmatory factor analysis (MGCFA) to assess within-country, cross-time invariance of each item set. Pooled analyses tested cross-country, cross-time invariance using DHSs that showed configural invariance in country-level multiple-group confirmatory factor analysis (MGCFAs). Alignment optimization tested approximate invariance of each item set in the pooled sample of all datasets, and in the subset of countries showing metric invariance over at least two repeated cross-sectional surveys in country-level MGCFAs. Results In country-level MGCFAs, physical-IPV items and controlling-behaviors items functioned equivalently in repeated survey administrations in 12 and 11 countries, respectively. In MGCFA testing cross-country, cross-time invariance in pooled samples, neither item set was strictly equivalent; however, the physical-IPV items were approximately invariant. Controlling- behaviors items did not show approximate cross-country and cross-time invariance in the full sample or the sub-sample showing country-level metric invariance. Conclusion Physical-IPV items approached approximate invariance across 20 countries and were approximately invariant in 11 countries with repeated cross-sectional surveys. Controllingbehaviors items were cross-time invariant within 11 countries but did not show cross-country, cross-time approximate invariance. Currently, the physical-IPV item set is more robust for monitoring progress toward SDG5.2.1, to end IPV against women.

Background: One third of women experience intimate partner violence (IPV) and potential sequelae. Sustainable Development Goal (SDG) 5.2—to eliminate violence against women, including IPV—compels states to monitor such violence. We conducted the first global measurement-invariance assessment of standardised item sets for IPV. Methods: Demographic and Health Surveys (DHS) from 36 Lower−/Middle-Income Countries (LMICs) administering 18 IPV items during 2012–2018 were included. Analyses were performed separately for two items sets: lifetime physical IPV (seven items) and controlling behaviours (five items). We performed country-specific exploratory and confirmatory factor analyses (EFA/CFA). Datasets meeting benchmarks for acceptable item loadings and model-fit statistics were included in multiple-group CFA (MGCFA) to test for exact measurement invariance. Based on findings, alignment optimization (AO) was performed to assess approximate measurement invariance (< 25% of model parameters non-invariant). For each item set, national rankings based on AO-derived scores and on prevalence estimates were compared. AO-derived scores were correlated with type-specific IPV prevalences to assess correspondence. Results: National rates of physical IPV (5.6–50.5%) and controlling behavior (25.9–84.7%) varied. For each item set, item loadings and model-fit statistics were adequate in country-specific, unidimensional EFAs and CFAs. Both unidimensional constructs lacked exact invariance in MGCFA but achieved approximate invariance in AO analysis (12.3% of model parameters for physical IPV and 6.7% for controlling behaviour non-invariant). For both item sets, national rankings based on AO-derived scores were distributed similarly to rankings based on prevalence. However, estimates often were not significantly different cross-nationally, precluding national-level comparisons regardless of estimation strategy. Three physical-IPV items (slap, twist, choke) and two controlling-behaviour items (meet female friends; contact with family) warrant cognitive testing to improve their psychometric properties. Correlations of AO-derived scores for physical IPV (0.48–0.66) and controlling behaviours (0.49–0.87) with prevalences of lifetime physical, sexual, psychological IPV as well as controlling behaviour varied. Conclusions: Seven DHS lifetime physical-IPV items and five DHS controlling-behaviour items were approximately invariant across 36 LMICs spanning five world regions, such that cross-national comparisons of factor means are reasonable. Measurement-invariance testing over time will inform their utility to monitor SDG5.2.1; cross-national, cross-time measurement-invariance testing of improved sexual and psychological IPV item-sets is needed.

Intimate partner violence (IPV) against women, particularly those living in poverty who have multiple marginalized identities, is a significant public health issue. IPV is associated with numerous mental health concerns including depression, hopelessness, and suicidal behavior. The present study examined the ecological determinants of these mental health outcomes in a high-risk sample of 67 low-income, African American women survivors of IPV. Based on an ecological framework that conceptualizes individuals as nested in multiple, interactive systems, we examined, longitudinally, the main and interactive effects of self-reported neighborhood disorder and social support from family members and friends on participants’ mental health (i.e., self-reported depressive symptoms, hopelessness, and suicide intent). In multiple regression analyses, neighborhood disorder interacted with social support from family members to predict depressive symptoms and hopelessness over time. Neighborhood disorder also interacted with social support from friends to predict hopelessness and suicide intent over time. High levels of social support buffered against the dangerous effects of neighborhood disorder on depressive symptoms, hopelessness, and suicide intent; at low levels of social support, there was no significant association between neighborhood disorder and those mental health outcomes. Neighborhood disorder and social support did not yield significant main effects. These findings underscore the importance of interventions that target individuals, families, and communities (e.g., community empowerment programs). Group interventions may also be important for low-income, African American women survivors of IPV, as they can help survivors establish and strengthen relationships and social support.