title: The differential effects of intimate terrorism and situational couple violence on mental health outcomes among abused Chinese women: a mixed-method study.
abstract: BACKGROUND
  Distinctions have been made between the two main forms of intimate partner violence: intimate terrorism (IT) and situational couple violence (SCV), depending on whether the violence is part of a general pattern of control. Differential effects also exist between IT and SCV. However, the IT/SCV distinction and their differential effects have yet to be demonstrated in violent intimate relationships in China. We aimed to identify IT and SCV among Chinese women who reported partner violence in Hong Kong and to differentiate the effects of IT and SCV on their mental health outcomes.
  
  
  METHODS
  A mixed-method design was used in a cross-sectional study to collect quantitative and qualitative data from women 18 years of age or older who had been victims of intimate partner violence in the past year. Six hundred and thirteen women were recruited from 18 districts in Hong Kong. Quantitative instruments were administered to assess intimate partner violence, control by an intimate partner, and mental health outcomes. Individual face-to-face interviews were conducted with 200 of the women to capture their experiences of intimate partner violence and the context in which it occurred.
  
  
  RESULTS
  Of the 613 women, 215 (35.1%) were identified as victims of IT and 324 (52.9%) as victims of SCV. Compared to SCV victims, IT victims reported significantly more violence-related physical injury (p < 0.001), higher use of medical services (p < 0.001), and more symptoms of depression (p < 0.001) and posttraumatic stress disorder (p < 0.001). The interviews revealed two broadly different pictures with IT victims describing their relationship problems as serious and life-threatening, and physical violence was part of the controlling behaviors used by their partners. Such details were not reported by those in the SCV group.
  
  
  CONCLUSIONS
  Our findings indicate that violence in intimate relationships in China is not a unitary phenomenon, and it has at least two forms, IT and SCV, which were shown to have differential effects on Chinese women. The findings regarding the IT/SCV distinction and their differential effects on mental health outcomes have implications for policy, research and practice.
  
  
  BACKGROUND
  Trial registration: ClinicalTrials.gov NCT01206192.
authors.affiliation: School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William M.W. Mong Block , 21 Sassoon Road, Pokfulam, Hong Kong, China. afytiwar@hku.hk.
authors.forename: Agnes
authors.initials: A
authors.lastname: Tiwari
authors.affiliation: Department of Social Work and Social Administration, The University of Hong Kong, Room 534, Jockey Club Tower, The Centennial Campus, Pok Fu Lam, Hong Kong, China. eklchan@hku.hk.
authors.forename: Ko Ling
authors.initials: KL
authors.lastname: Chan
authors.affiliation: School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William M.W. Mong Block , 21 Sassoon Road, Pokfulam, Hong Kong, China. denisest@hku.hk.
authors.forename: Denise Shuk Ting
authors.initials: DS
authors.lastname: Cheung
authors.affiliation: School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William M.W. Mong Block , 21 Sassoon Road, Pokfulam, Hong Kong, China. dytfong@hku.hk.
authors.forename: Daniel Yee Tak
authors.initials: DY
authors.lastname: Fong
authors.affiliation: Department of Social Work and Social Administration, The University of Hong Kong, Room 534, Jockey Club Tower, The Centennial Campus, Pok Fu Lam, Hong Kong, China. elsieyan@hku.hk.
authors.forename: Elsie Chau Wai
authors.initials: EC
authors.lastname: Yan
authors.affiliation: Po Leung Kuk, 66 Leighton Road, Leigton Hill, Hong Kong, China. debbie.tang@poleungkuk.org.hk.
authors.forename: Debbie Hoi Ming
authors.initials: DH
authors.lastname: Tang
mesh_terms: D000328:Adult; D000374:Aggression / Q000523:psychology; D018585:Battered Women / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006723:Hong Kong; D006801:Humans; D007407:Interviews as Topic; D001523:Mental Disorders / Q000523:psychology*; D008875:Middle Aged; D012747:Sexual Partners / Q000523:psychology*; D013179:Spouse Abuse / Q000523:psychology*; D055815:Young Adult