Introduction
Aims
Methods
Search strategy
Study selection criteria
Data extraction and quality appraisal
Data analysis
Results
Key features
Gender | |
Male only | 4 |
Female only | 0 |
Male and female | 6 |
Setting | |
Military medical setting | 6 |
General military setting | 4 |
Region | |
North America | 8 |
Europe | 1 |
Middle East | 1 |
Mental disordera
| |
Posttraumatic stress disorder | 9 |
Depression | 5 |
Generalized anxiety disorder | 1 |
Common mental disorder | 1 |
Assessment of mental disordera
| |
Posttraumatic stress disorder diagnostic interview schedule | 2 |
Posttraumatic stress disorder screening instrument | 7 |
Depression screening instrument | 5 |
Generalized anxiety disorder screening instrument | 1 |
Common mental disorder screening instrument | 1 |
Type of domestic violencea
| |
Physical | 9 |
Psychological | 5 |
Mixed violence (physical, sexual, psychological and/or financial) | 1 |
Assessment of domestic violence | |
Validated instrument | 6 |
Adaptation of validated instrument | 1 |
Authors own measure | 3 |
References | Country | Sample size, type, and gender distribution | Method | Mental disorder | Prevalence of violence against a partner, with odds ratios | Quality appraisal score |
---|---|---|---|---|---|---|
Post-traumatic stress disorder (PTSD) | ||||||
Byrne and Riggs [15] | USA | 50 male veterans accessing a department of veteran affairs medical centre | Cross-sectional survey of male combat veterans who served in Vietnam between 1964 and 1975 Self-reported past year physical violence and psychological abuse perpetrated against a partner assessed using the Conflict Tactics Scale PTSD symptoms were assessed using the PTSD Checklist-Military (PCL-M) (cut off score ≥50 assigned for probable PTSD) | With PTSD: 26/50 (52 %) Without PTSD: 24/50 (48 %) | Physical violence With PTSD: 12/26 (46 %) Without PTSD: 4/24 (17 %) OR 4.29 (1.14–16.07) P = 0.0255 Psychological abuse With PTSD: 25/26 (96 %) Without PTSD: 21/24 (88 %) OR 3.57 (0.35–36.94) P = 0.2598 | Total score: 23/42 Selection score: 3/14 Measurement score: 10/14 |
Hundt et al. [41] | USA | 240 male and 24 female veterans attending an outpatient mental health veteran affairs hospital clinic (data not disaggregated by gender) | Case-file review of mixed-era veterans presenting for outpatient mental health treatment at a veterans hospital clinic Past year physical violence against a partner was assessed using the hospital clinics routine intake question: “Have you pushed, grabbed, slapped, or punched your partner in the past year?” Authors scored respondents positive for physical violence if they answered “yes” to this questions. PTSD symptoms were assessed using the PTSD Checklist Civilian (PCL-C) version (cut off score ≥50 assigned for probable PTSD) | With PTSD: 184/264 (70 %) Without PTSD: 80/264 (30 %) | Physical violence With PTSD: 34/184 (18 %) Without PTSD: 9/80 (11 %) OR 1.79 (0.81–3.93) P = 0.1438 | Total score: 27/42 Selection score: 5/14 Measurement score: 11/14 |
Owens et al. [42] | USA | 125 male and 8 female veterans attending a veteran affairs medical centre | Cross sectional survey of male and female veterans seeking treatment in either the Posttraumatic Stress Program or Substance Use Disorders Program at a Veterans Affairs Medical Center Past year physical violence and psychological abuse against a current partner assessed using sub-scales of the Conflict Tactics Scale PTSD symptoms were assessed using the PTSD Checklist-Military (PCL-M) (cut off score ≥50 assigned for probable PTSD) | Males With PTSD and Hazardous substance use: 86/125 (69 %) Without PTSD or Hazardous substance use: 3/125 (2 %) Females With PTSD and Hazardous substance use: 5/8 (63 %) Without PTSD or Hazardous substance use: 0/8 (0 %) | Males Physical violence With PTSD and Hazardous substance use: 19/86 (22 %) Without PTSD or Hazardous substance use: 1/3 (33 %) OR 0.57 (0.05–6.60) P = 0.6466 Psychological abuse With PTSD and Hazardous substance use: 69/86 (80 %) Without PTSD or Hazardous substance use: 3/3 (100 %) OR 0.57 (0.03–11.50) P = 0.3919 Females Physical violence With PTSD and Hazardous substance use: 1/5 (20 %) Without PTSD or Hazardous substance use: 0/0 (0 %) [OR not applicable] Psychological abuse With PTSD and Hazardous substance use: 5/5 (100 %) Without PTSD or Hazardous substance use: 0/0 (0 %) [OR not applicable] | Total score: 26/42 Selection score: 4/14 Measurement score: 11/14 |
Solomon et al. [47] | Israel | 202 male veterans who had previously sought treatment from rehabilitation medical centre | Cross sectional survey of male combat veterans who served in the 1973 Yom Kippur War Past year physical violence and psychological abuse perpetrated against a partner assessed using sub-scales of the Conflict Tactics Scale PTSD symptoms were assessed using the PTSD Inventory according to DSM-IV | With PTSD: 68/202 (34 %) Without PTSD: 134/202 (66 %) | Physical violence With PTSD: 14/68 (21 %) Without PTSD: 12/134 (9 %) OR 2.64 (1.14–6.07) P = 0.0196 Psychological abuse With PTSD: 62/68 (91 %) Without PTSD: 99/134 (74 %) OR 3.65 (1.45–9.19) P = 0.0039 | Total score: 27/42 Selection score: 10/14 Measurement score: 8/14 |
Taft et al. [44] | USA | 60 male veterans accessing a department of veteran affairs medical centre | Cross sectional survey of male combat veterans who served in Vietnam between 1964 and 1973 Physical violence and psychological abuse at any time against a current partner assessed using the Conflict Tactics Scale PTSD symptoms were assessed using the Clinician Administered PTSD Scale | With PTSD: 42/60 (70 %) Without PTSD: 16/60 (27 %) | Physical violence With PTSD: 13/42 (31 %) Without PTSD: 10/16 (63 %) OR 0.27 (0.08–0.90) P = 0.0282 Psychological abuse With PTSD: 35/42 (83 %) Without PTSD: 16/16 (100 %) OR 0.14 (0.01–2.66) P = 0.0816 | Total score: 26/42 Selection score: 5/14 Measurement score: 10/14 |
Taft et al. [23] | USA | 161 male veterans accessing a veteran affairs medical clinic | Cross sectional survey of male veterans attending a veteran healthcare service for PTSD between 2003 and 2008 Past year physical violence and psychological abuse against a partner assessed using the Conflict Tactics Scale-R PTSD symptoms were assessed using the Clinician Administered PTSD Scale | With PTSD: 126/161 (78 %) Without PTSD: 26/161 (16 %) | Physical violence With PTSD: 41/126 (33 %) Without PTSD: 8/26 (31 %) OR 1.09 (0.44–2.70) P = 0.8604 Psychological abuse With PTSD: 115/126 (91 %) Without PTSD: 22/26 (85 %) OR 1.90 (0.55–6.52) P = 0.3003 | Total score: 31/42 Selection score: 8/14 Measurement score: 11/14 |
Waliski et al. [45] | USA | 288 male and 24 female veterans from Operation Enduring Freedom/Operation Iraqi Freedom residing in 6 national guard units | Cross-sectional survey of veterans participating in a quasi-experimental evaluation of an acceptance and commitment therapy (ACT)-based educational workshop to promote healthy reintegration among returning Operation Enduring Freedom/Operation Iraqi Freedom troops Any physical violence perpetrated against a current partner was assessed using eight physical violence items from the Conflict Tactics Scale PTSD symptoms were assessed using the PTSD Checklist Civilian version (PCL-C) (cut off score ≥50 assigned for probable PTSD) | Males With PTSD: 38/288 (13 %) Without PTSD: 211/288 (73 %) Females With PTSD: 4/24 (17 %) Without PTSD: 13/24 (54 %) | Males With PTSD: 16/38 (42 %) Without PTSD: 34/211 (16 %) OR 3.79 (1.80–7.95) P = 0.0002 Females With PTSD: 2/4 (50 %) Without PTSD: 6/13 (46 %) OR 1.17 (0.12–10.99) P = 0.8928 | Total score: 26/42 Selection score: 6/14 Measurement score: 11/14 |
Zamorski et al. [46] | USA | 1745 active-duty Canadian Regular Forces Personnel (data not disaggregated by gender) | Cross-sectional survey of randomly selected sample of regular Canadian Armed Forces Personnel Self-reported partner violence perpetration over course of current relationship assessed using questions adapted from the Conflict Tactics Scale and its correlates were assessed in a stratified random sample PTSD symptoms were assessed using the 4 items primary care screen for PTSD with a cut off of 3 or more positive responses to the 4 items | With PTSD: 113/1741 (6 %) Without PTSD: 1628/1741 (94 %) | Physical+/or sexual violence With PTSD: 21/113 (19 %) Without PTSD: 104/1628 (6 %) OR 3.35 (2.00–5.59) P ≤ 0.0001 Emotional/financial violence With PTSD: 37/113 (33 %) Without PTSD: 242/1628 (15 %) OR 2.79 (1.84–4.23) P ≤ 0.0001 | Total score: 35/42 Selection score: 13/14 Measurement score: 11/14 |
Depression | ||||||
Hundt et al. [41] | USA | 240 male and 24 female veterans attending an outpatient mental health veteran affairs hospital clinic (data not disaggregated by gender) | Case-file review of mixed-era veterans presenting for outpatient mental health treatment at a veterans hospital clinic Past year physical violence against a partner was assessed using the hospital clinics routine intake question: “Have you pushed, grabbed, slapped, or punched your partner in the past year?” Authors scored respondents positive for physical violence if they answered “yes” to this questions Depression symptoms were assessed using the Beck Depression Inventory (cut off score ≥20 assigned for moderate depression) | With depression: 196/264 (74 %) Without depression: 68/264 (26 %) | With depression: 36/196 (18 %) Without depression: 7/68 (10 %) OR 1.96 (0.83–4.64)
P = 0.1203 | Total score: 27/42 Selection score: 5/14 Measurement score: 11/14 |
Owens et al. [42] | USA | 125 male and 8 female veterans attending a veteran affairs medical centre | Cross sectional survey of male and female veterans seeking treatment in either the Posttraumatic Stress Program or Substance Use Disorders Program at a Veterans Affairs Medical Center Past year physical violence and psychological abuse against a current partner assessed using sub-scales of the Conflict Tactics Scale Depression symptoms were assessed using the Center for Epidemiological Studies–Depression Scale (CES-D) (cut off score ≥16 assigned for probable depression) | Males With depression: 100/125 (80 %) Without depression: 3/125 (2 %) Females With depression: 5/8 (63 %) Without depression: 0/8 (0 %) | Males Physical violence With depression: 19/100 (19 %) Without depression: 1/3 (33 %) OR 0.47 (0.04–5.45) P = 0.5363 Psychological abuse With depression: 77/100 (77 %) Without depression: 3/3 (100 %) OR 0.47 (0.02–9.45) P = 0.3459 Females Physical violence With depression: 1/5 (20 %) Without depression: 0/0 (0 %) [OR not applicable] Psychological abuse With depression: 3/5 (60 %) Without depression: 0/0 (0 %) [OR not applicable] | Total score: 26/42 Selection score: 4/14 Measurement score: 11/14 |
Slep et al. [43] | USA | 35,391 male and female active-duty Air Force members: 28,758 males 6633 females | Cross sectional survey of active-duty Air Force members completing the 2006 Air Force Community Assessment, a biennial, anonymous survey conducted at 82 sites worldwide Past year physical violence against a partner assessed using a measure developed by the authors (constructs similar to the Revised Conflict Tactics Scale) Mental disorders assessed using the Centre for Epidemiological Studies Depression Scale (cut off score ≥16 assigned for probable depression) | Males With depression: 2348/28,758 (8 %) Without depression: 26,410/28,758 (92 %) Females With depression: 850/6633 (13 %) Without depression: 5783/6633 (87 %) | Males With depression: 79/2348 (3 %) Without depression: 231/26,410 (1 %) OR 3.95 (3.05–5.11) P ≤ 0.0001 Females With depression: 32/850 (4 %) Without depression: 61/5783 (1 %) OR 3.67 (2.38–5.66) P ≤ 0.0001 | Total score: 30/42 Selection score: 9/14 Measurement score: 13/14 |
Waliski et al. [45] | USA | 288 male and 24 female veterans from Operation Enduring Freedom/Operation Iraqi Freedom residing in 6 national guard units | Cross-sectional survey of veterans participating in a quasi-experimental evaluation of an acceptance and commitment therapy (ACT)-based educational workshop to promote healthy reintegration among returning Operation Enduring Freedom/Operation Iraqi Freedom troops Any physical violence perpetrated against a current partner was assessed using eight physical violence items from the Conflict Tactics Scale Depression was measured using the Patient Health Questionnaire (PHQ-9) (cut off score ≥10 assigned for probable depression) | Males With depression: 56/288 (19 %) Without depression: 194/288 (67 %) Females With depression: 6/24 (25 %) Without depression: 11/24 (46 %) | Males With depression: 21/56 (38 %) Without depression: 28/194 (14 %) OR 3.56 (1.81–6.97) P = 0.0001 Females With depression: 3/6 (50 %) Without depression: 5/11 (45 %) OR 1.20 (0.16–8.80) P = 0.8576 | Total score: 26/42 Selection score: 6/14 Measurement score: 11/14 |
Zamorski et al. [46] | USA | 1745 active-duty Canadian Regular Forces Personnel (data not disaggregated by gender) | Cross-sectional survey of randomly selected sample of regular Canadian Regular Forces Personnel Self-reported partner violence perpetration over course of current relationship assessed using questions adapted from the Conflict Tactics Scale and its correlates were assessed in a stratified random sample Depression measured using World Health Organization’s Composite International Diagnostic Interview: short form (CIDI-SF) | With depression: 123/1688 (7 %) Without depression: 1565/1688 (93 %) | Physical+/or sexual violence: With depression: 23/123 (19 %) Without depression: 95/1688 (6 %) OR 3.86 (2.34–6.35) P ≤ 0.0001 Emotional/financial violence With depression: 39/123 (32 %) Without depression: 226/1565 (14 %) OR 3.00 (2.00–4.50) P ≤ 0.0001 | Total score: 35/42 Selection score: 13/14 Measurement score: 11/14 |
Generalised anxiety disorder (GAD) | ||||||
Waliski et al. [45] | USA | 288 male and 24 female veterans from Operation Enduring Freedom/Operation Iraqi Freedom residing in 6 national guard units | Cross-sectional survey of veterans participating in a quasi-experimental evaluation of an acceptance and commitment therapy (ACT)-based educational workshop to promote healthy reintegration among returning Operation Enduring Freedom/Operation Iraqi Freedom troops Any physical violence perpetrated against a current partner was assessed using eight physical violence items from the Conflict Tactics Scale Generalized anxiety disorder was measured using the generalized anxiety disorder scale (GAD-7) (cut off score ≥10 assigned for probable anxiety) | Males With GAD: 60/288 (21 %) Without GAD: 190/288 (7 %) Females With GAD: 9/24 (38 %) Without GAD: 8/24 (33 %) | Males With GAD: 23/60 (38 %) Without GAD: 26/190 (14 %) OR 3.92 (2.02–7.62) P ≤ 0.0001 Females With GAD: 5/9 (56 %) Without GAD: 3/8 (38 %) OR 2.08 (0.30–14.55) P = 0.4566 | Total score: 26/42 Selection score: 6/14 Measurement score: 11/14 |
Main findings
References | Country | Sample size, type, and gender distribution | Method | Mental disorder | Prevalence of violence against a partner, with odds ratios | Quality appraisal score |
---|---|---|---|---|---|---|
Post-traumatic stress disorder (PTSD) | ||||||
MacManus et al. [65] | UK | 4038 male and 315 female regular deployed military personnel serving in March 2003 | Cross-sectional survey of personnel serving in the UK armed forces in March 2003 Physical violence against an adult family member in the weeks following return from deployment was assessed using the authors own developed question: “I was physically violent towards a family member” PTSD symptoms were assessed using the PTSD Checklist Civilian version (PCL-C) (cut off score ≥50 assigned for probable PTSD) | Males With PTSD: 154/4038 (4 %) Without PTSD: 3844/4038 (95 %) Females With PTSD: 12/315 (4 %) Without PTSD: 302/315 (96 %) | Males With PTSD: 35/154 (23 %) Without PTSD: 139/3844 (4 %) OR 7.84 (5.19–11.85) P ≤ 0.0001 Females With PTSD: 3/12 (25 %) Without PTSD: 4/302 (1 %) OR 24.83 (4.83–127.67) P ≤ 0.0001 | Total score: 37/42 Selection score:13/14 Measurement score: 13/14 |
Common mental disorder (CMD) | ||||||
MacManus et al. [65] | UK | 4038 male and 315 female regular deployed military personnel serving in March 2003 | Cross-sectional survey of personnel serving in the UK armed forces in March 2003 Physical violence against an adult family member in the weeks following return from deployment was assessed using the authors own developed question: “I was physically violent towards a family member” Common mental disorder was assessed using the General Health Questionnaire-12 (GHQ-12) (cut off score ≥4 assigned for probable CMD) | Males With CMD: 722/4038 (18 %) Without CMD: 3279/4038 (81 %) Females With CMD: 81/315 (26 %) Without CMD: 230/315 (73 %) | Males With CMD: 74/722 (10 %) Without CMD: 99/3279 (3 %) OR 3.29 (2.41-4.50) P ≤ 0.0001 Females With CMD: 5/81 (6 %) Without CMD: 1/230 (0.4 %) OR 15.20 (1.75–132.12) P = 0.0012 | Total score: 37/42 Selection score: 13/14 Measurement score: 13/14 |