Modeling Women's Need For Action in Violent Relationships.

We are beginning to understand that intimate partner violence (IPV) and women's decision-making about that violence are nonlinear phenomena. IPV and decision-making are influenced by variables feedforwarding upon themselves with multiple interconnected predictors and circularly causal relationships. Computer models can help us gain a systems perspective on these relationships and enable hypothesis-testing without engendering risk to women in these relationships.

He Said, She Said: Comparing Men's and Women's Descriptions of Men's Partner Violence.

More than one in three women and one in four men in the United States report victimization by intimate partner violence. Women and men often disagree about the frequency or severity of violent acts, and researchers have proposed various reasons for discordant reports. Using daily surveys and qualitative interviews, we compared men's and women's reports about men's partner aggression and examined language they used to describe their experiences.

Psychometrics of the Violence Nonlinear Dynamics Scale.

Objective: The trajectory of daily partner violence generally demonstrates nonlinear dynamics, and this nonlinearity is important to patient outcomes, as it is sometimes a stronger predictor of outcomes than violence frequency or severity. However, measurement of such dynamics is difficult, requiring complete time series data of sufficient length to yield stable measures. The purpose of this study was to develop a pencil-and-paper instrument to estimate violence nonlinearity and assess its psychometrics.

The Dynamics of Partner Violence and Alcohol Use in Couples: Research Methods.

Objective: This research team uses complexity science to gain a deeper understanding of daily dynamics of intimate partner violence (IPV). This report describes research methods for gathering daily information about patterns of partner violence and alcohol use from couples in near-real time, and addresses recruitment and retention, adherence to study protocol, data validity, and participant safety.

Methods: Researchers enrolled 20 heterosexual couples with violent relationships from a primary healthcare center.

Is Perceived Need for Action Among Women in Violent Relationships Nonlinear and, If So, Why?

Despite the prevalence and impact of partner violence, we understand little about women's action taking except that it seems an unpredictable, nonlinear process. This article determines the degree of nonlinearity in perceived need for help, legal action, or leaving among women in violent relationships. The participants included 143 women who experienced violence in the previous month, enrolled from six primary care clinics.

Is Readiness to Take Action Among Women in Violent Relationships a Catastrophic Phenomenon?

Taking action among women in violent relationships appears to involve sudden changes and reversals after periods of building stress, suggesting that decision making is a "catastrophic" phenomenon. This study sought to determine whether readiness-to-change is best modeled as a cusp catastrophic (CCM) phenomenon among women in violent relationships. A total of 143 women who experienced violence in the previous month completed baseline and end-of-study interviews assessing her hope, coping strategies, social network, and readiness-for-action (seeking help, taking legal action, and leaving) concerning the violence.

Research or intervention or both? Women's changes after participation in a longitudinal study about intimate partner violence.

Introduction: The tensions between risk and benefit in research are particularly evident in studies about intimate partner violence. Recalling and relating traumatic experiences may deepen posttraumatic stress or relieve the burden of terrible events long borne in secret. In this article, we examine the effects of study participation in a longitudinal investigation of intimate partner violence using both qualitative and quantitative data.

Predictors of Perceived Need for and Actual Action Taking Among Women in Violent Relationships.

Decision-making of women in violent relationships is poorly understood. The study seeks to identify predictors of need-for-action and actions taken by women in violent relationships. The participants were 143 women who experienced violence in previous month from 6 primary care clinics.

It is complicated! - misunderstanding the complexities of 'complex'.

Terminology matters - as Lakoff emphasised, words and phrases evoke powerful images and frames of understanding. It is for that reason that we need to discern and use appropriately the term complex/complexity in the health science/professional/policy domain. Complex is the fashionable term used when in reality one means 'complicated', 'difficult to understand' or 'multiple simultaneous actions'.

Using complexity science to examine three dynamic patterns of intimate partner violence.

Introduction: The partner violence literature describes 3 dominant models of dynamics of partner aggression: cycle of violence, family systems theory, and Duluth model (power and control wheel). Complexity science describes 3 patterns of system dynamics: periodic, chaotic, and random. Are these parallel patterns? In this analysis, investigators calculated dynamic patterns (periodic, chaotic, and random) using 84 daily reports of male-to-female aggression and assessed the "fit" between time-series-derived patterns of male partners' violent behaviors and literature-based models of violence dynamics.

Modeling Outcomes of Partner Violence Using Cusp Catastrophe Modeling.

Research suggests that intimate partner violence (IPV) is a complex, nonlinear phenomenon. In addition to the violence trajectory itself, IPV decision-making, help-seeking and leaving are nonlinear processes as well. The purpose of this study was to determine whether outcomes were best modeled as cusp catastrophic phenomena with measures of violence nonlinearity and wife-perpetrated violence serving as bifurcation variables.

Coping with intimate partner violence: Qualitative findings from the study of dynamics of husband to wife abuse.

Introduction: Coping can be defined as an individual's efforts to manage a problem. In Intimate Partner Violence (IPV), coping depends heavily on relationship context, circumstances, and resource availability. The range of coping strategies utilized by women experiencing violence are not fully understood.

Safely examining complex dynamics of intimate partner violence.

The overall goal of this study is to use complexity science to gain a deeper understanding of the nonlinear day-to-day dynamics of intimate partner violence, with implications for clinical interventions. This report describes research methods for gathering information about partner violence in real time and assesses recruitment and retention, adherence to study protocol, data validity, and participant safety. Research assistants enrolled 200 women in moderately violent intimate relationships and asked them to report about their relationships every day for 12 weeks.

Systems and complexity thinking in the general practice literature: an integrative, historical narrative review.

Purpose: Over the past 7 decades, theories in the systems and complexity sciences have had a major influence on academic thinking and research. We assessed the impact of complexity science on general practice/family medicine.

Methods: We performed a historical integrative review using the following systematic search strategy: medical subject heading [humans] combined in turn with the terms complex adaptive systems, nonlinear dynamics, systems biology, and systems theory, limited to general practice/family medicine and published before December 2010.

Association of knowledge, attitudes, and behaviors for colon cancer screening in Hispanic patients.

Purpose: The purpose of our cross-sectional study was to examine the association between sociodemographic, knowledge, attitude and behavior factors with colon cancer screening among low-income Hispanic patients from an urban family medicine clinic in San Antonio, Texas.

Methods: Using random stratified sampling, 804 patients were surveyed with 274 Hispanic patients meet the eligibility criteria for colon cancer screening (aged > or = 50 years). A 10-page self-administered questionnaire in Spanish or English completed in the clinic waiting room included self-reported colonoscopy, sociodemographic characteristics, health status, knowledge, attitudes, and behaviors toward colon cancer screening.

Chemical intolerance in primary care settings: prevalence, comorbidity, and outcomes.

Purpose: This study extends previous community-based studies on the prevalence and clinical characteristics of chemical intolerance in a sample of primary care clinic patients. We evaluated comorbid medical and psychiatric disorders, functional status, and rates of health care use.

Methods: A total of 400 patients were recruited from 2 family medicine clinic waiting rooms in San Antonio, Texas.

Understanding intimate partner violence dynamics using mixed methods.

Trauma research has employed both quantitative and qualitative methods, but only recently, have mixed method studies begun to appear in the trauma literature. The purpose of this case series was to demonstrate the value of mixed method approaches to studying dynamics among cases involving intimate partner violence (IPV). Of the 16 women in abusive relationships who completed daily reports of the household violence and environment over an 8-week period, three cases were chosen for discussion because they provided near complete quantitative data, rich qualitative data, and a "clear" dynamic pattern.

The research mentoring relationship in family medicine: findings from the grant generating project.

Background And Objectives: Mentoring has been acknowledged as a critical factor in the development of family medicine academicians. Specific aims were to describe the research mentoring in family medicine from the experience of both mentors and protégés and identify characteristics that mentors and protégés associated with a successful mentoring relationship. The Grant Generating Project (GGP) Fellowship, a training and mentoring program for family medicine researchers, provided a natural opportunity to study these issues and better understand what is successful in research mentoring.

Issues important to the research mentoring relationship.

Background And Objectives: Family medicine lacks a critical mass of experienced, federally funded researchers to serve as research mentors for young investigators. The purpose of this study was to identify issues important when mentoring junior investigators.

Methods: Eight experienced primary care investigators, known for their excellence in mentorship, were recruited from the Primary Care Research Methods and Statistics Conference.

Complex dynamics in intimate partner violence: a time series study of 16 women.

Objective: Three theories attempt to explain the dynamics of intimate partner violence, each representing a different dynamic pattern of violence: periodic, chaotic, and random. But few studies assess violence and its potential predictors in real time or permit assessment of the dynamics of violence. The purpose of this exploratory study was to estimate the degree of complexity in patterns of violence and identify predictors of violent events.

A method for estimating relative complexity of ambulatory care.

Purpose: We wanted to demonstrate a method for calculating the relative complexity of ambulatory clinical encounters.

Methods: Measures of complexity should reflect the complexity of the typical encounter and across encounters. If inputs represent the information transferred from the patient to the physician, then inputs include history, physical examination, testing, diagnoses, and patient demographics.

Psychosocial effects of physical and verbal abuse in postmenopausal women.

Purpose: The purpose of this study was to examine the psychological effects of physical and verbal abuse in a cohort of older women.

Methods: This observational cohort study was conducted at 40 clinical sites nationwide that are part of the Women's Health Initiative (WHI) Observational Study. We surveyed 93,676 women aged 50 to 79 years using the mental health subscales and the combined mental component summary (MCS) score of the RAND Medical Outcomes Study 36-item instrument.

Lessons from Jurassic Park: patients as complex adaptive systems.

Rationale: With realization that non-linearity is generally the rule rather than the exception in nature, viewing patients and families as complex adaptive systems may lead to a better understanding of health and illness. Doctors who successfully practise the 'art' of medicine may recognize non-linear principles at work without having the jargon needed to label them.

Methods: Complex adaptive systems are systems composed of multiple components that display complexity and adaptation to input.

Culture-bound syndromes in Hispanic primary care patients.

Introduction: We sought to document Hispanic primary care patients' knowledge and experience of five culture-bound syndromes (CBS), as well as the basic socio-cultural correlates of these disorders.

Methods: A convenience sample of 100 adult Hispanic patients presenting in an urban South Texas primary care clinic was recruited to complete a brief cross-sectional survey, presented in an oral format. Interviews sought information concerning five culture-bound syndromes--susto, empacho, nervios, mal de ojo, and ataques de nervios.

Power laws in covariability of anxiety and depression among newly diagnosed patients with major depressive episode, panic disorder and controls.

Context: Although symptoms of anxiety and depression correlate, they may covary in irregular and unpredictable ways. This non-linear covariation may be important to psychiatric diagnosis, treatment and relapse. This non-linear anxiety-depression interaction suggests that power laws may be observed.