Labeling dating abuse: Undetected abuse among Spanish adolescents and young adults

Int J Clin Health Psychol, Vol. 12. Nº 1 SÁNCHEZ et al. Polysomnographic parameters in fibromyalgia patients 55 Labeling dating abuse: Undetected abuse among Spanish adolescents and young adults1 Luis Rodríguez-Franco (Universidad de Sevilla, Spain), Javier López-Cepero Borrego (Universidad de Sevilla, Spain), Francisco J. Rodríguez-Díaz2 (Universidad de Oviedo, Spain), Carolina Bringas Molleda (Universidad de Oviedo, Spain), Cristina Estrada Pineda (Universidad de Guadalajara, México), M. Ángeles Antuña Bellerín (Universidad de Sevilla, Spain), and Raúl Quevedo-Blasco (Universidad de Granada, Spain) ABSTRACT. The Instituto de la Mujer in Spain highlights the existence of adult women being abused both with and without self-labeling as victims (situations of perceived abuse and technically abuse, respectively). The aims of this ex post facto study are assessing the existence of both types of abuse, and developing an alternative evaluation instrument for young couples, mixing behavioral items and a question on abuse perception (atomic and molecular evaluations). Using questions included in the Cuestionario de Violencia de Novios (CUVINO) we carried out two studies with different samples of adolescent and young women in school. The first one (N = 709; M = 18.5 years) replied the study conducted by the Instituto de la Mujer, finding 6.2% of women self-labeled as abused and 71% being technically abused. The second study (N = 1,327; M = 18.5) evaluated the relationship among different general perceptions (feeling abused, afraid and trapped in dating relationships), finding 5.8% of self-labeled abused women, 11.9% of afraid women, and 26.8% of women trapped in their relationships. Implications that these inconsistencies may have on prevention efforts are discussed. KEYWORDS. Labeling. Abuse. Dating violence. Spanish adolescent and young couples. Ex post facto study. 1This research was supported by grants from a research project financed by the University of Oviedo (Reference UNOV-07-MB-2005). 2 Correspondence: Facultad de Psicología. Universidad de Oviedo. Plaza Feijoo s/n. 33003 Oviedo (Spain). E-mail: [email protected] © International Journal of Clinical and Health Psychology ISSN 1697-2600 print ISSN 2174-0852 online 2012, Vol. 12, Nº 1, pp. 55-67 © International Journal of Clinical and Health Psychology Int J Clin Health Psychol, Vol. 12. Nº 1 56 RODRÍGUEZ-FRANCO et al. Undetected abuse among Spanish adolescents and young adults RESUMEN. El Instituto de la Mujer en España matiza la existencia de mujeres adultas autopercibidas como maltratadas y técnicamente maltratadas (la víctima soporta algún tipo de violencia sin atribuirle la etiqueta de maltrato). El objetivo del presente estudio ex post facto es verificar ambos tipos de maltrato y desarrollar alternativas de evaluación en parejas jóvenes. Para ello, se utilizó una combinación de 13 ítems conductuales y de una pregunta sobre percepción de maltrato (evaluaciones atómica y molecular, respectivamente). A través de las preguntas contenidas en el Cuestionario de Violencia de Novios (CUVINO), se realizaron dos estudios diferenciados con muestra de mujeres adolescentes y jóvenes escolarizadas. El primero de ellos (N = 709; M = 18,5 años) replicó la evaluación de maltrato técnico llevada a cabo por el Instituto de la Mujer, encontrando un 6,2% de maltrato percibido y un 71% de maltrato técnico. En un segundo estudio (N = 1.327; M = 18,5), se evaluó la concordancia entre percepciones generales (sentirse maltratada, sentir miedo y sentirse atrapada en la relación), encontrando un 5,8% de mujeres maltratadas, un 11,9% de atemorizadas y un 26,8% atrapadas en sus relaciones. Se discuten las implicaciones que las inconsistencias encontradas en ambos estudios pueden tener sobre los esfuerzos preventivos. PALABRAS CLAVE. Violencia de novios. Maltrato percibido. Maltrato técnico. Parejas de adolescentes y jóvenes. Estudio ex post facto. Interpersonal partner violence has evolved in a short time from being considered a domestic problem, of private nature, to getting a prominent position at community policies (Fariña, Arce, and Buela-Casal, 2009; Ulla et al., 2009). As a result of these changes, many countries have introduced specific programs covering different areas (mental health, legal, community policies, mass media, etc.) in order to deal with these abuses (e.g., Echeburúa and Fernández-Montalvo, 2009; Echeburúa, Sarasua, Zubizarreta, Amor, and de Corral, 2010; Echeburúa, Sarasua, Zubizarreta, and de Corral, 2009). At the same time, the amount of research devoted to this subject has increased during the past decade (Fernández Fuertes, Fuertes, and Pulido, 2006; Rodríguez-Franco, López-Cepero, and Rodríguez-Díaz, 2009; Zych and Quevedo-Blasco, 2011). Among these studies, the violent acts carried out in dating relationships between teenagers or youths remain relatively unexplored. Thus, domestic violence continues to be the subject of most publications, of which only .68% use samples of exclusively young people (Rodríguez-Franco et al., 2009). Nevertheless, in recent years, terms like dating violence have become themes for studies focused on these age ranges (Ortega, Ortega Rivera, and Sánchez, 2008; Ortega, Sánchez, Ortega Rivera, Nocentini, and Menesini 2010), and studies at the Spanish level have also appeared (e.g., Ruiz, Expósito, and Bonache, 2010). Thanks to specific studies there is data available showing the presence and high frequency of victimization at these ages, in both males and females (Buelga, Musitu, and Murgui, 2009; Estévez and Emler, 2011). The available results vary widely, but together they signal a widespread presence of these phenomena. Citing studies in which these aggressions were evaluated on modified versions of the Strauts´ Conflict Tactics Scale (1979), results point to approximate figure of 30% for mild or moderate physical aggressions (US sample - Katz, Kuffel, and Coblentz, 2002; Sears, Byers, and Price, 2007; Spanish Int J Clin Health Psychol, Vol. 12. Nº 1 RODRÍGUEZ-FRANCO et al. Undetected abuse among Spanish adolescents and young adults 57 sample - Muñoz-Rivas, Graña, O´Leary, and González, 2007) and more than 50% for psychological and emotional aggressions (US sample - Sears et al., 2007; UK sample - Hird, 2000; Spanish sample - Muñoz-Rivas et al., 2007). Categories used to describe and analyze abusive behavior constitute one of classic themes of research on partner violence, and play a central role in prevention (Amor, Echeburúa, and Loinaz, 2009; Loinaz, Ortiz-Tallo, Sánchez, and Ferragut, 2011), since it is hard to prevent against something we cannot label and recognize (Rodríguez Franco, Antuña, and Rodríguez Díaz, 2001). Several proposals for categorizing partner violence are available: the broadest classification as regards behavior forms (topography) is to distinguish between physical, psychological (or emotional) and sexual violence (Labrador, Rincón, de Luis, and Fernández-Velasco, 2004; Muñoz-Rivas, 2006). Cascardi, AveryLeaf, O´Leary, and Smith-Slep (1999) subdivide physical violence into two degrees (mildmoderate and severe), based on factoring CTS results, to create a fourth category. European Council proposed a six-factor classification: physical, sexual, psychological, economic, structural and spiritual violence (Instituto de la Mujer, 2006). Finally, a classification is available based on eight factors, obtained through the CUVINO (Cuestionario de Violencia de Novios/Dating Violence Questionnaire), which makes distinctions among violence which is coercive, sexual, gender-based, instrumental, physical, by detachment, by humiliation, and by emotional punishment (Rodríguez-Franco, Antuña, Rodríguez-Díaz, Herrero, and Nieves, 2007). However, besides subtypes of violence considered in any prevention program, we must be aware that spreading messages through the mass media (press, radio, television,…), does not necessarily lead to improve our sensibility to partner abuse (Goodman, Dutton, Weinfurt, and Cook, 2003). It is empirically difficult to prove the effectiveness of these programs (Wekerle and Wolfe, 1999; Wolfe et al., 2003), since the degree of exposure and the impact on the target population are quite hard to assess. The Instituto de la Mujer (2006) published a research report based on the III MacroSurvey on Domestic Violence, carried out on adult female population, which proposed an alternative classification. In addition to victimization behaviors suffered, a question on maltreatment perception (labeling) was included. Through this combined evaluation, the report provides an estimation of both number of woman who are aware of abuses (perceived maltreatment: 3.6% of the sample) and those who do not (non perceived abuse: 9.6% of the sample). Thus, number of women suffering aggressive behaviors without labeling them like abuse was far higher than these aware of their situation. The concept of unlabeled abuse, is of great interest when it comes to planning intervention with the victim, since the victim’s motivation and receptiveness might vary in function of her perception of the problem (Tjaden and Thoennes, 2000; O’Keefe and Treister, 1998). Moreover, the concept highlights the disconnection between the label maltreatment and the underlying content, representing an proof of inefficiency in prevention programs - it is possible that the potential victims declare themselves intolerant with maltreatment as a term, while their ability to detect such abusive behaviors may be defective (Adelman and Hea Kil, 2007). This becomes even more relevant if we consider that most of the available resources are directed towards abuse victims (such as, e.g., the 016 helpline in Spain). Int J Clin Health Psychol, Vol. 12. Nº 1 58 RODRÍGUEZ-FRANCO et al. Undetected abuse among Spanish adolescents and young adults In light of the above, we consider the study of technical maltreatment in adolescent and young population to be of maximum interest. Therefore, this ex post facto study (Montero and León, 2007), has a double objective: first, to replicate the study of the Instituto de la Mujer through a selection of items from the Cuestionario de Violencia de Novios (CUVINO) in order to estimate levels of perceived and technical maltreatment among Spanish young female school-goers; second, to determine the degree of coherence shown by young Spanish females between different perceptions (labels) of maltreatment. Method (STUDY 1) Sample 709 school-going females from both private and public schools from several places around Spain (provinces of A Coruña, Asturias, Huelva, Ourense and Sevilla) were included. Ages were comprended from 16 to 21 years old (M = 18.53 years; SD = 1.55 years.) Only people who had been in a dating relationship above one month long were considered for participate in this study. All participants were volunteers. Instruments 13 items from the 62 original CUVINO set (Rodríguez-Franco et al., 2007) were selected. These questions had similar wording to Instituto de la Mujer instrument (2006) (equivalences are shown in Table 1). In addition, the question Do you feel or have you ever felt abused? was included, in order to assess subjects general perception of abuse. The CUVINO gathers answers on a five level Likert type scale, similar to the one used in the replicated study. Following the proposal of the Instituto de la Mujer, only those items with a response of frequently or higher frequency were considered as positive responses. The question «Do you feel or have you ever felt affraid?» had only two possible answers in the CUVINO (yes/no), so affirmative answers were remarked as positive. Procedure Schools were contacted by mail to ask for their cooperation. They were selected randomly from the census of high schools of each participating province. Once they were selected, one classroom from each of four levels - 3rd and 4th years of Basic Secondary Education (Educación Secundaria Obligatoria) and 1st and 2nd years of Upper Level Secondary Education (Bachillerato) - was chosen. Data was collected by one of the members of the research team during class hours with a teacher present in the classroom. SPSS v15 software was selected to process data. Three researchers matched equivalent questions from CUVINO and Instituto de la Mujer survey independently. Proposals were compared, and disagreements discussed and voted, in order to decide the final 13 questions set. Prior to evaluation, participants were told information gathered in the study would be analyzed as a whole to keep confidenciality. A request was made not to add personal information to the sheet in order to preserve the anonymity of the participants Int J Clin Health Psychol, Vol. 12. Nº 1 RODRÍGUEZ-FRANCO et al. Undetected abuse among Spanish adolescents and young adults 59 TABLE 1. Equivalence between items of the Instituto de la Mujer survey and CUVINO questionnaire. Instituto de la Mujer Survey Original CUVINO item (extract) He prevents you from seeing your family or having relations with friends and neighbors He isolates you from your friends and family He takes away the money you have earned or doesn´t give you enough money to live by your own He controls your money He insults or threatens you He criticizes, insults or shouts at you He decides what you can or cannot do He imposes rules at his convenience He insists on having sex even when he knows you don’t feel like it He doesn’t take into account your feelings about sex He doesn’t take into account your needs (the worst food is for you, the worst space in the home, etc) He doesn’t take into account your feelings You are sometimes scared by him Do you feel or have you felt scared? He can hit or push you when he’s angry He has slapped, pushed or shaken you He tells you that you are not able to do things on your own (you would be nothing without him) He insults or ridicules you for your ideas He tells you that you do nothing properly, that you are clumsy He criticizes, undermines or humiliates you He ridicules your ideas (religious or political beliefs, organizations to which you belong…) He ridicules your own beliefs, social class or religion He doesn’t value your work He doesn’t approve of or encourage your qualities He undermines you in front of your children He insults you in the presence of family and friends Note. CUVINO = Cuestionario de Violencia de Novios. Results From a holistic point of view, 6.2% of the sample (N = 44) responded affirmatively to the question Do you feel or have you ever felt abused? Analyzing the behavioral indicators, it was found that 22.8% of the sample (N = 162) reported not having experienced any of these situations during their relationships, while the remaining 77.2% reported having experienced one or more of these situations. 56.8% (N = 403) experienced at least two of them and 40.8% (N = 429) experienced three or more. All the woman who reported had felt abused, except for two, scored in at least one of the items. The distribution by positive items is detailed in Figure 1, and the percentages of technical maltreatment, by cut-off point, in Table 2. Int J Clin Health Psychol, Vol. 12. Nº 1 60 RODRÍGUEZ-FRANCO et al. Undetected abuse among Spanish adolescents and young adults FIGURE 1. Number of women and number of behaviors suffered (N = 709). 144 114 100 50 53 28 23 11 88602 162 0 20 40 60 80 100 120 140 160 180 012345678910111213 TABLE 2. Percentage of technical maltreatment by cut-off point (1, 2 or 3 behaviors). Frequency % % Technical Maltreatment 1 or more behavior 547 (77.2%) 71 % 2 or more behaviors 403 (56.8%) 50.6% 3 or more behaviors 289 (40.8%) 34.6% Perceived maltreatment = 6.2% (N = 44) Additionally, it was calculated the percentage of women who felt abused according to the number of behaviors suffered. Less than 10% of the young women who suffered 6 or less abusive behaviors labeled themselves as abused, while under 20% of those who suffered 7 or 8 abusive behaviors did. Of the 24 women who indicated they suffered 9 or more behaviors, the percentage of perceived maltreatment was 54.17% (N = 13). The results are illustrated in Figure 2. A disaggregated analysis by items showed that the most frequent behavior among the 13 selected was He does not take into account your feelings, with positive responses counting for 43.86%, following by He imposes rules at his convenience, with 29.2 % of responses being positive, and He isolates you from your friends and family, with 28.77%. The complete distribution is presented in Table 3. Int J Clin Health Psychol, Vol. 12. Nº 1 RODRÍGUEZ-FRANCO et al. Undetected abuse among Spanish adolescents and young adults 61 FIGURE 2. Percentage of women indicating whether they have felt maltreated or not by number of behaviors suffered. % No 98.77 96.50 97.37 92.86 98 90.57 92.86 82.61 81.82 37.5 62.5 33.33 50 93.77 %Ye s 1.23 3.5 2.63 7.14 2 9.43 7.14 17.39 18.18 62.5 37.5 66.67 50 6.23 0123456789 10 11 13 ? TABLE 3. Frequency and percentage of positive responses for the 13 CUVINO items. Conclusions Data shown above exceed Instituto de la Mujer estimates for adult population. Compared to the 3.6% of adult women who felt abused, the perceived maltreatment in the sample of this study was 6.2%. Whereas 9.6% of the adult sample suffered some kind of victimization frequently, up to 71% of adolescent and young women did (it is, they were technically abused). The percentage of women who perceived themselves to be abused was low even when the number of abusive behaviors suffered was high (less than 20% of perceive maltreatment for women who suffered up to 8 abusive behaviors. Positives % Total He doesn’t take into account your feelings 311 43.86% He imposes rules at his convenience 207 29.20% He isolates you from your friends and family 204 28.77% He criticizes, insults or shouts at you 198 27.93% He doesn’t approve of or encourage your qualities 149 21.02% He insults or ridicules you for your ideas 144 20.31% He criticizes, undermines or humiliates you 126 17.77% He doesn’t take into account your feelings about sex 118 16.64% Do you feel or have you ever felt affraid? 84 11.85% He has slapped, pushed or shaken you 77 10.86% He ridicules your own beliefs, social class or religion 76 10.72% He controls your money 52 7.33% He insults you in the presence of family and friends 52 7.33% Int J Clin Health Psychol, Vol. 12. Nº 1 62 RODRÍGUEZ-FRANCO et al. Undetected abuse among Spanish adolescents and young adults Method (STUDY 2) Sample 1,327 school-aged women from private and public schools from the provinces of A Coruña, Asturias, Huelva, Ourense, and Sevilla were selected. Ages were between 16 and 21 years (M = 18.56; SD = 1.52). All subjects took part in the study voluntarily. Instruments Three questions were used from the CUVINO´s second version (Rodríguez-Franco et al., 2007; Rodríguez-Franco et al., 2010). This instrument has 42 behavioral items, selected through a factor analysis carried out on of the original version and the inclusion of some new items, for which two pieces of information are requested: frequency of victimization, and bothering associated with each. The instrument also gathers information about general perception (relationship labeling): Do you feel or have you ever felt abused in your relationship?, Do you feel or have you ever felt fear?, and Do you feel or have you ever felt trapped in your relationship? These three questions were used to meet the objectives of the second study. Procedure Schools were recruited in the same way described for first study. All the women participating in the study reported having had at least one dating relationship lasting more than one month and all agreed to participate voluntarily. SPSS, v.15 was used for statistical analysis. Results The frequencies and percentages of positive answers obtained for each question are shown in Table 4. TABLE 4. Frequency and percentage of positives for holistic perception questions. Positives (freq.) % Total Abused? 77 5.8% Affraid? 159 11.9% Trapped? 358 26.8% An analysis of the distribution of these responses using a table of 2x2x2 = 8 combinations was carried out. The most frequent was the combination no perception of abuse-no fear-not trapped, with 920 appearances (69.33% of cases), while the combination perception of abuse-fear-trapped appeared on 50 occasions (3.77% of the total). Remaining cases (N = 357; 26.9% of the total) were combinations of positives and negatives. Full results are reported in Table 5. Int J Clin Health Psychol, Vol. 12. Nº 1 RODRÍGUEZ-FRANCO et al. Undetected abuse among Spanish adolescents and young adults 63 TABLE 5. Combined results for the three holistic questions (N = 1,327). Abused? Yes No 77 (5.8%) 1,250 (94.2%) Affraid? Yes No Yes No 56 (4.22%) 21 (1.58%) 103 (7.76%) 1147 (86.44%) Trapped? Yes No Yes No Yes No Yes No 50 (3.77%) 6 ( .45%) 17 (1.28%) 4 ( .3%) 64 (4.82%) 39 (2.94%) 227 (17.11%) 920 (69.33%) Conclusions In this second study we found differences between the percentages of women who perceive themselves as abused, felt afraid or are trapped in their relationships. Compared to the 5.8% of young females who felt abused, nearly twice that number (11.9%) claimed to have felt afraid, while percentage of women who had considered themselves trapped in their relationship was four times higher (26.8%). Contingency analysis of the three conditions shows that more than a quarter of the sample (26.9% of the cases) indicate mixed situations; of these, just over 17% are women who solely felt trapped, while the second most frequent group (4.8% of the total) corresponds to feeling afraid and being trapped but not feeling maltreated. Discussion of both studies Both studies provide information of great significance for research on violence in young couples: one set of conclusions is drawn from the comparison between our study and the one conducted by Instituto de la Mujer in 2006, and the other is directly drawn from the results of our two studies. Regarding the replication of Instituto de la Mujer study, percentage of females self labeled as abused was higher for adolescent and young samples (6.2% and 5.8%, depending on the study) than estimated in adult population (3.6%). Comparing the levels of technical maltreatment, we also found higher percentages among young people, with more than 70% when the cut-off point was a single positive indicator, and just over 34% if we count only cases in which at least three behaviors were frequently suffered (compared with 9.6% in the initial study). In addition, percentage of perceived abuse was low even among women who showed 9 or more indicators (barely 54%, slightly more than half). Of course, these conclusions must be taken into account cautiously: using a non-validated instrument to assess abuse constitutes a clear weakness of the first study, and selected cut-off point (which could be named as zero tolerance) may lead to a high percentage of false positives. But, on the other hand, these evidences strongly suggest that the capacity of young females to detect and label abuse is far from the desirable level.