Thesis (MSc)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Global estimates show that sub-Saharan Africa has the largest portion of HIV cases with South Africa having more people living with HIV than any other country in the world. Moreover, studies have shown a high incidence of intimate partner violence (IPV) among people living with HIV. IPV has been shown to be associated with mental health problems. Considerable empirical studies have demonstrated that HIV is a highly stigmatized disease. In addition, HIV-related stigma has also been shown to be a risk factor for mental health problems among persons living with HIV. However, no empirical studies have examined the combined effect of IPV and HIV-related stigma on mental health. This thesis builds on the existing body of research by examining to what extent the linear combination of IPV (timing and frequency) and HIV related stigma explained variation in symptoms of common mental health disorders in both men and women living with HIV. In addition, theoretical and empirical studies have suggested that social support may serve as a protective factor in the relationship between IPV, HIV-related stigma, and mental health. Yet, despite the increasing attention, no known studies have focused on the mediating or moderating role of social support in the relationship between IPV or HIV-related stigma, and mental health. This thesis examined the extent to which social support played a mediating or moderating role in these relationships. The study used a cross-sectional research design to study a convenience sample of 210 people living with HIV in three peri-urban areas in the Western Cape, South Africa. Participants completed a battery of self-report questionnaires that assessed IPV (timing and frequency), HIV-related stigma, social support, and symptoms of common mental health. The results from the hierarchical multiple regression analysis demonstrated that the linear combination of psychological aggression frequency and HIV related stigma explained a significant portion of the variance in symptoms of depression. Likewise, both physical assault timing and psychological aggression timing combined with HIV-related stigma explained a significant portion of variance in symptoms of depression. Psychological aggression timing combined with HIV-related stigma significantly explained variance in symptoms of posttraumatic stress disorder (PTSD). The results from the product-term regression analyses indicated that social support played a mediating role in the relationship between HIV-related stigma and symptoms of PTSD, but not depression. Social support did not moderate the relationship between HIV-related stigma and symptoms of common mental health disorders. In conclusion, the combination of IPV (physical assault and psychological aggression) and HIV-related stigma explained a significant portion of the variance in symptoms of common mental health disorders. Future research is needed for a better understanding of these relationships. A longitudinal experimental design is recommended in order to explore the direction of these relationships and to examine the context in which the IPV, HIV-related stigma, and social support is experienced. / AFRIKAANSE OPSOMMING: Wêreldwye beramings toon dat sub-Sahara Afrika die grootste gedeelte van HIV gevalle te wêreld het, terwyl Suid-Afrika meer mense het wat met MIV leef as enige ander land in die wêreld. Verder het studies getoon dat daar 'n hoë voorkoms van intiemepaargeweld (IPV) is onder mense wat met MIV leef. Daar is al getoon dat IPV verband hou met geestelike probleme. Aansienlike empiriese studies het getoon dat MIV 'n hoogs gestigmatiseer siekte is. Daarbenewens, is daar getoon dat MIV-verwante stigma 'n risiko faktor is vir geestelike probleme onder persone wat leef met MIV. Daar is egter geen empiriese studies wat die gekombineerde effek van IPV en MIV-verwante stigma op geestesgesondheid ondersoek nie. Hierdie tesis bou voort op die bestaande navorsing deur te ondersoek tot watter mate die lineêre kombinasie van IPV (tydsberekening en frekwensie) en MIV-verwante stigma variasie in die simptome van algemene geestesgesondheid afwykings verduidelik in beide mans en vroue wat met MIV leef. Daarbenewens, het teoretiese en empiriese studies voorgestel dat sosiale ondersteuning kan dien as 'n beskermende faktor in die verhouding tussen IPV, MIV-verwante stigma, en geestesgesondheid. Tog, ten spyte van die toenemende aandag, het daar al geen studies gefokus op die bemiddelende of modererende rol van sosiale ondersteuning in die verhouding tussen IPV of MIV-verwante stigma, en geestesgesondheid. Hierdie tesis ondersoek die mate waarin sosiale ondersteuning 'n bemiddelende of modererende rol speel in hierdie verhoudings. Die studie het 'n deursnee-navorsing ontwerp gebruik om 'n gerieflikheidsteekproef van 210 mense wat met MIV leef in drie peri-stedelike gebiede in die Wes-Kaap, Suid-Afrika te bestudeer. Deelnemers het 'n battery van self-verslag vraelyste voltooi wat IPV (tydsberekening en frekwensie), MIV-verwante stigma, sosiale ondersteuning, en simptome van algemene geestesgesondheid geassesseer het. Die resultate van die hiërargiese meervoudige regressie-analise het getoon dat die lineêre kombinasie van sielkundige aggressie frekwensie en MIV-verwante stigma 'n beduidende deel van die variansie in simptome van depressie verduidelik. Net so, het beide fisiese aanranding tydsberekening en sielkundige aggressie tydsberekening gekombineer met MIV-verwante stigma 'n beduidende deel van die variansie in simptome van depressie verduidelik. Sielkundige aggressie tydsberekening gekombineer met MIV-verwante stigma het „n beduidende variansie in simptome van post-traumatiese stresversteuring (PTSV) verduidelik. Die resultate van die produk-term regressie-analises het aangedui dat sosiale ondersteuning 'n bemiddelende rol speel in die verhouding tussen MIV-verwante stigma en simptome van PTSV, maar nie depressie nie. Sosiale ondersteuning het nie die verhouding tussen MIV-verwante stigma en simptome van algemene geestesgesondheid versteurings modereer nie. Ten slotte, die kombinasie van IPV (fisiese aanranding en sielkundige aggressie) en MIV-verwante stigma het 'n beduidende deel van die variansie in simptome van algemene geestesgesondheid versteurings verduidelik. Toekomstige navorsing is nodig vir 'n beter begrip van hierdie verhoudings. 'n Longitudinale eksperimentele ontwerp word aanbeveel om die rigting van hierdie verhoudings te verken en die konteks waarin die IPV, MIV-verwante stigma en sosiale ondersteuning ervaar is te ondersoek.

Les jeunes adultes sont plus susceptibles de subir de la violence conjugale que les adultes plus âgés. Toutefois, l'effet de se confier à propos de la violence subie sur la santé mentale est peu connu. L'objectif de cette étude est d'explorer les liens entre la violence conjugale, le soutien social et la détresse psychologique selon le sexe dans un échantillon de 233 jeunes couples. Les résultats indiquent que, pour les femmes, la fréquence de la violence psychologique subie, mais pas celle de la violence physique, était positivement associée à la détresse psychologique. Pour ces femmes, recourir à un plus grand nombre de confidents diminue la force de la relation entre la violence et de leur niveau de détresse psychologique. Pour les hommes, les fréquences de la violence physique et psychologique subies étaient positivement liées à la détresse psychologique, mais contrairement aux femmes, plus ils se sont confiés à propos de la violence qu'ils ont subi, plus leur niveau de détresse est élevé. / Young adults are more likely to experience intimate partner violence (IPV) than older adults but little is known about the effect of confiding to others about the sustained violence on their mental health. The objective of this study was to explore the links between IPV, help-seeking and psychological distress by gender in a sample of 233 young couples. Our findings indicate that for women, the frequency of sustained psychological violence, but not of physical violence, was positively associated to psychological distress and that for these women, seeking help from a greater number of confidents decreased the strength of the association between violence and their level of psychological distress. Secondly, for men, the frequency of physical and psychological violence were both positively linked to psychological distress but unlike women, the more people they talked to about the violence they have sustained, the greater their level of distress was.

Les jeunes adultes sont plus susceptibles de subir de la violence conjugale que les adultes plus âgés. Toutefois, l'effet de se confier à propos de la violence subie sur la santé mentale est peu connu. L'objectif de cette étude est d'explorer les liens entre la violence conjugale, le soutien social et la détresse psychologique selon le sexe dans un échantillon de 233 jeunes couples. Les résultats indiquent que, pour les femmes, la fréquence de la violence psychologique subie, mais pas celle de la violence physique, était positivement associée à la détresse psychologique. Pour ces femmes, recourir à un plus grand nombre de confidents diminue la force de la relation entre la violence et de leur niveau de détresse psychologique. Pour les hommes, les fréquences de la violence physique et psychologique subies étaient positivement liées à la détresse psychologique, mais contrairement aux femmes, plus ils se sont confiés à propos de la violence qu'ils ont subi, plus leur niveau de détresse est élevé. / Young adults are more likely to experience intimate partner violence (IPV) than older adults but little is known about the effect of confiding to others about the sustained violence on their mental health. The objective of this study was to explore the links between IPV, help-seeking and psychological distress by gender in a sample of 233 young couples. Our findings indicate that for women, the frequency of sustained psychological violence, but not of physical violence, was positively associated to psychological distress and that for these women, seeking help from a greater number of confidents decreased the strength of the association between violence and their level of psychological distress. Secondly, for men, the frequency of physical and psychological violence were both positively linked to psychological distress but unlike women, the more people they talked to about the violence they have sustained, the greater their level of distress was.

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To use standardized questionnaires for questions about domestic violence within the social services' elderly units Intimate partner violence (IPV)and the way women are  exposed to violence in close relationships has been recognized in recent decades as a problem at a societal level, both nationally and globally. As a result, work on IPV has  received new laws and regulations to strengthen women's right to protection in society, which has also led to work with these issues is being developed and prioritized at a  municipal level. While IPV has gained more visibility, IPV that affect older women also has received greater attention. IPV and aging can mean a special vulnerability as aging  can mean more isolation, greater need for care by or for a violent partner and that the violence may have lasted for a longer period of time. Research on the subject also shows that there is a knowledge gap about the elderly's exposure to violence and the work to discover it, and that there are no specific figures that show how widespread the problem is. Despite the increased focus on older women's exposure to IPV, interest in skills development regarding elderly is lower in comparison with other categories within the group  of women exposed to violence in Sweden's municipalities. At the same time, the development of welfare has moved in a direction towards an evidence-based practice and  developed standardized assessment instruments. Based on an attempt to combine work against violence in close relationships with evidence-based practice, the assessment  instrument FREDA was developed, which social workers and social service agents can use to detect and identify violence and make protection assessments, which is considered  an important part of violence prevention and violence protection work. Nevertheless, several studies and evaluations show that there are several obstacles to asking questions  about violence, such as insecurity and lack of knowledge. The purpose of our study has been to investigate how social workers at social agencies that works with elders ask  questions about violence in IPV and whether underlying factors such as knowledge, experience and supervision affect the tendency for social service agents to ask the question  about violence. The purpose is also to investigate the extent to which social service workers use standardized assessment instruments in matters of violence and whether  standardized assessment instruments is experienced as a support in their work. With a quantitative method and with a survey design to collect data, we have created a web survey with 49 statements and questions that we have sent via link to social service agents who work with development assistance and the elderly. The survey received a total of 79 respondents and the results have been processed in SPSS and to some extent in Excel. To present the results we have used SPSS to create graphs and crosstabs and through using Cramres V we report the strength of the relationships between the  variables. We have also developed a significance measure based on Cramers V. The results of the study shows that a significant proportion of the respondents do not agree that they ask questions about domestic violence to their clients and that there is a connection between not asking questions about domestic violence and not feeling that you have  enough knowledge of the subject. The results of the study cannot show where the knowledge about violence comes from, but it shows that within our sample there is a slight  tendency for the use of FREDA-short questions to have a positive impact on the experience of knowledge about IPV. The results of the study show that approximately one third  of the study respondents use FREDA-short questions at their workplace. The study also shows that of the respondents who stated that they fully or partially agree that they ask questions about violence in close proximity to a greater extent use FREDA-shortquestions. In conclusion, our study shows that there was a tendency for respondents who  stated that they did not agree that they ask questions about domestic violence also had the opinion that older people find it more intrusive to talk about IPV.

Problématique : La violence conjugale dans le couple lesbien est un phénomène très répandu et pourtant encore trop largement passé sous silence. On constate un manque d’intérêt pour cette question de la part des différentes communautés concernées, malgré plus récemment un regain d’attention pour le phénomène. Les tabous et les débats qui entourent la violence homoconjugale féminine continuent de l’exclure de la plupart des mouvements luttant contre les violences faites aux femmes. Pourtant, chaque année des femmes souffrent en silence de la violence de leurs conjointes; pourtant, chaque année ces victimes se perdent un peu plus dans l’invisibilité de leur condition. Le sujet de la violence conjugale dans le couple lesbien interpelle à plus d’un titre : à la fois sur la compréhension, mais aussi sur les solutions cliniques offertes. Comment dès lors apporter une réponse idoine à une catégorie de victimes méconnues et non reconnues, très souvent assaillies d’intolérance, de préjugés et d’ignorance de la part de celles et ceux censés les aider? Méthodologie : Des femmes victimes ainsi que des intervenantes de différentes disciplines des sciences humaines, familières avec la thématique de la violence homoconjugale féminine, ont été rencontrées. Avec un guide d’entrevue et des entretiens semi-dirigés, les répondantes ont raconté leur expérience. Selon la perspective sociologique wébérienne, elles ont ouvert sur le sens qu’elles donnaient à la violence vécue ou rapportée. L’analyse des données recueillies a ainsi été scrupuleusement effectuée selon une grille très précise afin de faire ressortir les thèmes et les sous-thèmes les plus emblématiques des discours en présence. La dimension interdisciplinaire a permis d’ouvrir sur une compréhension holistique plus aboutie de la thématique à étudier ainsi que d’être envisagée comme une piste de solution au niveau de l’intervention. Résultats : Il ressort que les formes de violence les plus utilisées par les abuseures sont les violences psychologiques, verbales, sexuelles et, dans une moindre mesure, physiques, dans le but d’assoir un pouvoir, une domination et un contrôle sur la victime. La présence du cycle de la violence conjugale a également été identifiée. Par comparaison avec les femmes victimes de leurs conjoints, les victimes homoconjugales féminines vivent un plus grand isolement et un plus grand stress, principalement en lien avec leur orientation sexuelle, couramment appelé : le stress des minorités sexuelles. De nouvelles formes de violence ont pu être identifiées, notamment la lesbophobie intériorisée. Entre deux femmes, la violence conjugale est banalisée et minimisée, réduite à un simple « crêpage de chignons ». Cette vision porte un tort considérable à la réalité de ce qui se passe dans l’alcôve lesbien, mais surtout constitue une atteinte supplémentaire à la victime. En dernier lieu, il s’avère que la relation d’aide pour les femmes, victimes de leurs conjointes demeure problématique et très insatisfaisante, principalement par le manque de structures adéquates, de formation des intervenantes, de publicisation sur le phénomène de la violence conjugale lesbienne. En outre, les préjugés des différents personnels socio-judiciaires sur le lesbianisme est encore très prégnant et constituent un frein à l’intervention. Conclusion : La violence conjugale dans le couple lesbien est engluée dans une toile d’araignée que tisse l’abuseure qui prend un pouvoir illicite sur sa partenaire avec la complicité du regard néfaste de la société à l’encontre du lesbianisme, du manque d’information et de formations des différents personnels sur cette thématique ainsi que du silence des communautés sur la lutte des violences faites aux femmes. Il y aurait tout lieu de privilégier la mobilisation, l’inclusion, l’éducation, l’information, la formation de tous. Car la violence conjugale lesbienne n’est pas une affaire privée. Elle est l’affaire de tous / Context. Domestic violence in lesbian couples is a widespread and largely ignored phenomenon. There is a lack of interest in this issue on the part of the various communities concerned, despite more recently renewed attention to the phenomenon. The taboos and debates surrounding female homoconjugal violence continue to exclude it from most of the movements fighting violence against women. However, each year, women suffer in silence from their partner's violence and each year these victims lose themselves a little more in the invisibility of their condition. The subject of conjugal violence in the lesbian couple raises many questions both on understanding and on the clinical solutions proposed. How to provide an appropriate response to this category of unrecognized victims who are very often confronted with intolerance, prejudice and ignorance from those who are supposed to help them? Methods. Women victims of domestic violence in a lesbian couple were met as well as practitioners from several disciplines of the humanities familiar with the theme of female homosexual violence. Using an interview guide and semi-structured interviews, we asked them to describe their experiences on this issue. The meaning they give to the violence experienced or reported has been gathered from a Weberian sociological perspective. The data analysis was scrupulously carried out according to a very precise grid in order to bring out the most emblematic themes and sub-themes of their narratives. The interdisciplinary perspective allows us for a more complete holistic understanding of the problem and can also be considered in itself as an avenue of intervention in the context of female homosexual violence Results. It appears that the type of violence abusers most commonly use to exert power, domination or control on the victim is psychological, verbal, sexual and, to a lesser degree, physical to exercise an authority, a domination, and a control on the victim. The conjugal violence cycle was also identified. In comparison to female victims of male partners, female homo-conjugal victims experience greater social isolation and stress, largely related to their sexual orientation, commonly referred to as stress of sexual minorities. New types of domestic violence have also been identified, such as internalized lesbophobia. Violence between two women is trivialized, minimized, and reduced to “cat fights.” This conception considerably detracts from the reality of what is happening in the lesbian alcove. Above all, it constitutes an additional attack on the victim. Finally, it appears that counseling support is very problematic and unsatisfactory for these women because of the lack of adequate support structures, training for practitioners and awareness of lesbian conjugal violence phenomenon. Furthermore, the prejudice from different personal socio-judiciary regarding lesbianism is still taking a stronger hold and can slow down the intervention process. Conclusion. Domestic violence in the lesbian couple is rooted in the spider web that the abuser weaves to take power over his partner with the complicity of society's harmful view of lesbianism, lack of information and professional training on the subject as well as the silence of the communities on violence against women. We must promote the mobilization, inclusion, education, information and training of all on this important issue. Domestic violence between lesbians is not a private matter. This is everyone's problem.

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Doctor of Philosophy / Department of Family Studies and Human Services / Sandra Stith / Farrell Webb / This study explored the impact of differentiation of self on Intimate Partner Violence (IPV). First, the study determined if differentiation of self in a relationship added to the variance accounted for by the known risk factors including relational satisfaction, marital conflict, romantic jealousy, depression, anxiety, and attitude about violence towards women. Second, it examined the moderating effect of gender on the relationship between differentiation of self and IPV. Results indicated that differentiation of self in a relationship is a predictor of perpetration of intimate partner violence in relationships even after controlling for other known risk factors. Results also indicated that gender did not moderate the relationship between differentiation of self and perpetration of violence.