I’ll be talking today about genetic and environmental factors an intimate partner violence perpetration and so before we start I want to take a second to recognize that in the ten seconds it took me to say those two sentences three people perpetrated intimate partner violence in the United States but what does that mean there’s a lot of different definitions for intimate partner violence and so for the purposes of this presentation i’ll be talking about physical emotional or sexual harm that occurs within the context of a current or former romantic relationship and so you may have noticed that i didn’t say anything about gender although you may normally think of intimate partner violence as a male perpetrator and a female victim what we know from community-based samples though is that about twenty eight percent of men will experience physical ipv in their lifetime and about thirty three percent of women well however when we look at the last 12 months about five percent of men report that they experienced physical ipv things like hitting kicking slapping by their partner and about four percent of women do in some there are over ten million victims of physical intimate partner violence each year in the United States and as if that catastrophic number wasn’t enough there are consequences of ipv4 victims for perpetrators and for the children who were exposed so when we think about physical ipb it makes a lot of sense to think that there are physical injuries there’s poor health there’s pain associated with that but we also now know that there are some chronic health conditions that tend to be associated with victimization things like high cholesterol arthritis sexually transmitted infections and along with those physical health consequences there are many psychological consequences things like depression anxiety substance abuse and suicide you may not have thought though that there are also economic consequences just for this little section I’m going to be talking about female victims because that’s the literature that’s been done so what we know is that female victims who experience I PV early in their life are less likely to graduate from high school they’re less likely to graduate from college and so just right at the early start of their life they’re already experiencing some difficulties they’re less likely to get high paying jobs without that education and in addition to that the actual experience of ipv can spill into their workplace when I worked in human resources at the University of Iowa I saw this fairly often where a partner would either be calling quite often the partner would be coming to work and so that caused a disruption in the industry Malc victims life and that was hard for her employer it was hard for the co-workers and it was especially hard for the victim to have that constant agitation that distraction that stress in the workplace and so thinking about that it’s not surprising that women who experience ipv tend to have unstable employment if you think about the distractions at work the partner may be preventing her from going to work it’s really hard to maintain employment under those conditions so not only is our women who experience ITV less likely to have good education or less likely to be able to maintain good employment they also have pretty significant health care costs associated with that victimization and so they’re really experiencing a wide range of economic issues you may be less likely to think about the consequences for the perpetrators and that’s not surprising because much of the literature focuses on the victims we know a fair amount about risk and protective factors for victims we know quite a lot about the consequences for victims and we know a reasonable amount about how to help those victims process their experience and potentially leave the relationship but what we know much less about is the perpetrators and what’s happening in their lives so I say consequences although the literature has been primarily cross-sectional and so it’s hard to say that these are true consequences for perpetrators it may be things that they’re experiencing that are actually causing the violence we don’t know at this point but what we do know is that perpetrators tend to be tend to experience higher level of depression anxiety and sub since abuse than their non perpetrating peers we also know and I think this is really interesting the perpetrators tend to report an unmet need for treatment and I think that whether that’s a cause of violence whether that’s a consequence of violence that’s a place that we can intervene if we get people the mental health treatment they need that may be a place that we can help perpetrators unsurprisingly there’s also economic consequences for perpetrators if you think about it again this is the male-to-female research that’s been done

if a man is at his partners work rep he’s calling her work if he’s thinking about what he’s going to do he’s less likely to be productive he’s distracted which leads to unstable employment he’s missing work and so many of the economic consequences experienced by victims are shared by perpetrators what I think is most tragic is the consequences for exposed children because intimate partner violence occurs within the context of an intimate partnership there are also children who are exposed to into my partner violence a good news is that there are a couple of positive consequences for infants and toddlers so as a result of the violence mothers tend to try to compensate for their exposure or their children’s exposure and so they tend to be more sensitive their their infants and their toddlers and as a result with children tend to be better at giving cues and receiving cues from their mothers however those positive consequences those positive results tend to disappear by the time the child reaches about school age we tend to see that kids who are exposed to ipv have a higher rate of developmental delays they have lower standardized test scores they have higher rates of externalizing and internalizing behaviors and ultimately increased aggression and unfortunately that pattern of increased aggression continues into adulthood or people who are exposed to ipv during childhood are much more likely to be victims and perpetrators in their own relationships and so given the high number of people who experience in compartment intimate partner violence each year and the significant quences for everyone involved it’s not surprising that people have tried to create theories and models that can be used both to predict intimate partner violence but also suggest how we may intervene on intimate partner violence the first theory is feminist theory if I had taken a poll and asked what do you think about when you think about intimate partner violence many of you would have probably said something along the lines of female victims male perpetrators and that’s because a lot of the literature a lot of the activism around intimate partner violence comes out of this feminist approach and so the feminist theory suggests that n perpetrators male perpetrators tend to use their power and control given to them by society to perpetrate violence against their partners there tends to be a focus on the intimidation the power and control the things that they’re using to control their partners and the goal then is to move them to a non violence or a quality circle where they’re sharing responsibility with their partners they’re treating the relationship like an equal economic partnership they’re not trying to use money to control the partner there’s more respect there’s more trust things that we think about when we think about a healthy relationship but unfortunately feminist theory is so embedded in the idea that male perpetrators and female victims are how intimate partner violence occurs that’s ignored the five percent of men who experience physical ipv in the last year which i think is a significant problem and so the rest of the theories that I’ll talk about today tend not to have that gender dynamic so social learning theory is one very broad urien public health and health behavior it’s been used for everything from cigarette smoking to HIV prevention to violence you may recognize the bubble doll if you had to take it intro to psychology classes I actually got to see the Bobo doll when I was at Iowa Albert bandura was at IO and he did the Bobo doll experiment and basically what he showed is that kids who saw adults hurting the bubble doll hitting it kicking it punching it we’re more likely than to engage aggressive play after the adult left and so what he thought and what other social learning theory and social cognitive theorists but was that there are really three things contributing to behavior you have your environment so in the case of the Bobo doll kids were exposed to that aggression they were taught that maybe being aggressive to the Bobo doll was okay they then in their own play experiences tended to engage in those aggressive behaviors and then the piece that is a little bit harder to visualize is cognition the way that they thought about those experiences then and so we know now that in a wide range of health behaviors those three things tend to interact and so it’s like I said it’s been used for a wide range of behaviors but for intimate partner violence I think there may be something more and so the background situational models suggest that that background learning that social learning theory is really important but it’s maybe not enough to determine if you’re going to perpetrate violence contextual characteristics

what’s happening near the time of violence is really important in whether it’s actually going to happen and finally one last theory I want to touch on briefly but I think is really important to the future of intimate partner violence is that may be what we call intimate partner violence isn’t just one thing maybe intimate partner violence is a range of behaviors and patterns of behaviors so for example the developmental model of battery are subtypes suggests that there are three types of intimate partner violence so there’s family only violence this may actually be mutual aggression we’re both the female and the male are perpetrating the violence there tends not to be a lot of disruption to their lives they tend not to be criminally justice involved they tend to keep their violence within the household and it tends not to be very high level very severe violence it may be occasional hitting it may be no arguing with emotional abuse which is bad we don’t want families to do that but it may not have the same level of consequences of some of the more severe types so the dysphoric borderline sub-type tends to be people who have maybe some anger-management issues there may be some violence that occurs without the house outside of the household but it tends to be much more severe violence within the household there may be that control and power dynamic to it and finally we have the violent or antisocial type and this it these are the people that tend to be very violent people in their general lives they probably have had some level of involvement with the criminal justice system they probably have perpetrated pretty severe violence within their own household and that’s probably spilled over into their daily lives and so if you think about the type of prevention and intervention efforts that are needed they probably look very different for these three types of perpetrators someone who is engaging in occasional lower-level violence may need some very different intervention or prevention activities than someone who is experiencing high level violence anger across their life but what I think is most important about theories and models is that they can be used to develop intervention and prevention efforts and so you will notice that there are three things here that I’m going to be talking about and unfortunately just like I mentioned with risk factors protective factors and consequences we have much more knowledge about how to intervene with victims so the first one is the Duluth model this follows fairly closely to the feminist theory which suggests that like I already mentioned their male perpetrators female victims and it tends to be related to the patriarchal ideas of society and so the focus then of these intervention activities is teaching men how to be nonviolent all of the things that I mentioned in the Equality nonviolent wheel teaching them how to negotiate with their partner how to respect their partner so part of it is just pure education on these types of things part of it is videos illustrating abusive behavior and it has a flair of confrontation to it you may have heard a better an eventual programs things that batterers are ordered to do as a part of their criminal justice involvement but Duluth model is one of the most common forms of batterer intervention programs however meta analysis suggests that overall the treatment effects are small which is pretty bad news given that were ordering people into this type of treatment what we know is that about thirty three percent of participants will perpetrate again within six months and unfortunately that’s not that different than the number who will perpetrate again without treatment and so cognitive behavioral therapy or CBT informed group programs was another aspect that people tried unfortunately fairly similar to the Duluth model in that it has group sessions teaching non violent responses there’s a focus on anger management and skills training it also has that flavor of patriarchal attitudes through it and unfortunately not surprisingly because of the overlap the treatment effects here are also small and so it’s somewhat controversially in the IPV world people have now started trying couples treatment and if you think about that its controversial because the victim didn’t necessarily do anything that probably didn’t do anything that resulted in the violence but we’re requiring him or her to participate and I say requiring loosely these programs are requiring both partners to be a part of this program even if one is completely blameless in the violence so the good thing about these though is

that they’re 12 gender separated sessions and so we’re not asking the perpetrator and the victim to be in the same group we’re just teaching them both skills about relationship skills emotional awareness parenting and what we’ve seen is that the results are fairly similar if either the male or the female partner attends the program similar to the Duluth model or the CBT informed group process but when both partners complete the program we see quite a bit more reduction and so that may suggest that it’s important to teach both partners how to be good partners both partners how to negotiate both partners how to do conflict resolution but unfortunately that’s a pretty small group of programs that I’ve talked about and so the reason that I focused on this for my dissertation is that I feel like we need to do a lot more around perpetration I think that we need to take the eye off of the victim and start looking at what we can do for perpetrators so I came out of community behavioral health which is really big on using theories and conceptual frameworks to inform your research and your prevention activities and so for that i use the catalyst model of aggression which suggests that family violence and genetics combine to create or to influence your personality and within your personality there are a range of behaviors that you’re likely to do so if you think about your driving down let’s call it 70 and someone cut you off and just it annoys you a lot what do you do there probably a range of things that you do and important to the catalyst model of aggression is that the environment plays a role in what you’re going to do so if you’re driving down 70 with your mother-in-law your father-in-law your boyfriend girlfriend’s parents you’re probably likely to do something different than if you’re in the car by yourself just jam out to your music but i think that there’s more than family violence and genetics that goes into that and so i overlaid the IPV contextual framework which i really like because there aren’t any theoretical relationships here what they say is that there’s a wide range of people doing intimate partner violence work from across disciplines from across a range of direct graphical locations and so we as intimate partner violence researchers and practitioners need to start developing a common language so when I is a public health person start talking about the environment I need to frame that in a way that people who are in medicine who are in psychology share that language and can tell what I’m talking about and so thinking about the different pieces of both the catalyst model of regression and the language used in the IPV conceptual model i created this conceptual framework which suggests that static antecedents these are things you have with you throughout your lifetime they may change a little bit but they’re unlikely to change without some sort of dramatic intervention so I chose to focus in on genetic risk factors the reason that I did that is that we have very little information about the role of genetics and intimate partner violence perpetration we know a lot more about the role of genetics in aggression in general and violence in general but if you think about that behavioral predisposition that way that you tend to respond to things it’s not just your genes it’s not just your personality there are other experiences that happen to you throughout your lifetime that we call distal antecedents there are things that happen much before perpetration they’re not directly related to perpetration but they may influence the probability that you’re going to perpetrate a change the way that your behavioral predisposition has developed and so I chose to focus in on exposure to violence and because I also like to look at protective factors high school climate and i’ll be going into these in more detail a little bit later finally i chose to look at proximal antecedents and those are the things that are happening near the time of violence there are things that may cause the violence they may be things that trigger the violence and so I think it’s really important that we understand more about what cuts or tuck’n textual what sort of environmental factors can we change that even if you’ve already developed that behavioral predisposition will help you de-escalate and so or this I use the ad health study does it is anyone familiar with the ad health study all right a couple of your so I’ll go into more depth there so the ad health study started as a in school sample of about 90,000 people which is a huge sample at

least in public health so there were 90,000 students who completed a fairly in-depth questionnaire of those 90,000 students about 21,000 were purposely selected to be nationally representative and were invited to participate in an in-home survey it’s obviously longitudinal where wave 2 happened about a year after wave 1 so kids were 8th grade to 12th grade but then they had already created this really amazing cohort of people it’s big it’s pretty in-depth and so they were able to secure funding for waves 34 and most recently wave 5 and so wave 3 is really that emerging adulthood period when kids are starting to become adults there still may be acting a little bit like kids brains are still developing but their emerging wave for was when they were pretty well into that young adult phase 24 to 32 and so the great thing about ahead health is that we have that data from the time period that it happened we’re not going back and asking thirty two year olds what happened when you were in eighth grade and so that’s a really great strength of the study and so it’ll be part of this analysis the participants had to be in a relationship in the 12 months prior to data collection it’s for two reasons one you can’t perpetrate intimate partner violence without an intimate partner and to the survey was set up to only ask about current partners so we don’t know they may still have been perpetrating against a former partner but that wasn’t captured in the survey there were some people who were incarcerated at the time of wave floor which means they probably wouldn’t have had that physical contact that’s necessary for physical into a partner violence and they also had to have complete information on exposures moderators and outcomes otherwise the model would automatically drop them out I’ll be talking about three different studies that I did but for all of them the outcome is the same it’s did you slap hit or kick your partner in the last 12 months at least once and the analysis is all the same so it’s multi variable and single variable logistic regressions it’s weighted and clustered the I’d health serv is almost beyond belief complex in their survey design and in their sampling design and so you have to account for that through waiting and clustering oh we’re now ready to dig into the good part of the presentation the results but before I do that does anyone have any questions about where we’ve come so far all right so I’m now going to take you back to your intro to biology back to your intro to psychology classes so bear with me for a second stated clearly presents what exactly is a gene each one of our cells contains 46 strands of DNA a single strand is made of millions of particles called nucleotides and these nucleotides come in four different types which scientists have labeled a see T&G a gene is a special stretch of DNA a sequence of a C’s T’s and G’s that code for something a gene contains information for a cell to read and use but what exactly does that information do you might have heard that there’s a blue-eyed Gina freckled gene possibly even in anger gene but single genes don’t literally make things like eyeballs or freckles or temper tantrums genes make proteins those proteins and interact with each other and all sorts of chemicals inside the body to build things like I pigments freckles and mood-altering hormones a single strand of deep alright so now that everybody has a little basic intro to what is a gene which believe me when I started this dissertation I needed that intro I really didn’t know much about genes but what I think is most important from that video that I want you to take away is that there’s no gene for IP be just like there’s no gene for blue eyes there’s no gene for temper tantrums there is no gene for intimate partner violence so in order to expand upon that idea you need to have a little understanding of what dopamine is and wide open Oh dopamine again back to your intro to psychology classes is a neurotransmitter it influences your motivation and it influences the way that you learn and from the literature we know that there are more than three dopamine genes but three that are specifically associated with aggression and those are dat 132 and drd4 and what we know from the

literature is that those risk genes tend to be associated with increased sensitivity to the environment which means and this is from a literature but people who have these higher risk genes tend to be more likely to perpetrate aggressive when they’re in adverse scenarios which makes sense they’re more sensitive to what’s happening around them so if it’s a bad environment they tend to react worse but what all does that mean so again back to that intro to psychology you may remember that you have axons and dendrites and lots and lots of other things in your brain it as your axons receive messages they move into the presynaptic neuron which tells the cell to release dopamine into the synaptic cleft this is how messages move between neurons so once the dopamine is in the synaptic cleft there are really two options for it it can be taken back by the presynaptic neuron or it can end up attached to one of the receptors on the postsynaptic neuron and if that happens the message continues into the dendrite which moves into the axon which then continues the message throughout your brain but what’s important about dat one drd2 and drd4 is that they influence that ability to move messages so dat one is called at rant dopamine transporter gene it changes the way that dopamine is reup we picked up took through the presynaptic neuron so basically if there’s a lot of dopamine in the synaptic cleft you may be more or less likely to have it taken back by the presynaptic neuron which means there’s less of that message available for the postsynaptic neuron brt two and brd4 on the other hand perform similar functions just on the dr d 2 receptor and the dr d 4 receptor of the postsynaptic neuron so how many dopamine receptors you have depends a little bit on how your drd4 drd2 and drd4 genes are expressed oh I mentioned that there were those three genes dat 132 and dirty for that one is what we call it vntr a variable number tandem repeat if you think back to the video it talked about a gene was a pattern of nucleotide base pairs and so a vntr is a situation where there’s a pattern say three or four specific new yuletide base pairs the repeat within that gene it maybe twice it may be 10 times and maybe 20 times but that repeat that variable number of repeats influences the function and the creation of the proteins and so with that 110 repeats of that pattern tends to infer increase sensitivity to the environment compared to the nine repeat however that’s only among people who have to you get one allele from your mom one from your dad you need to have both your ten repeat for dat one contrast drd2 is what’s called a snip a single nucleotide polymorphism in that case you only need to have one nucleotide base-pair different in this case the risk allele is an a and the non risk is a G however in contrast to dat one you only need to have one risk allele you can have an a in a G of 2 a’s but as long as you don’t have to geez you’re at a higher risk and your for increased sensitivity to your environment your d4 is similar to that one in that it’s a V in TR but it’s similar to drd2 in that you only need one risk allele so having 17 repeat or 18 repeat tends to make you more susceptible to the effects of your environment now let’s get into the really good stuff how is this associated with physical intimate partner violence so when we looked at the distribution of dat one dirty to and dirty for risk alleles we were forced to do it only among white men and women so I mentioned earlier that ad health is a nationally representative sample which means that it has non-white individuals in the sample but unfortunately when I started looking at the actual cell sizes and so we repair down okay dear t20 one or two alleles due to perpetrate violence yes or no and looked at those exposure and moderator interactions we ended up dealing with five six seven people in each of those cells and at that point one or two people can make a really big difference in your point estimates and in your confidence intervals and so I didn’t feel comfortable making meaningful inferences based on if one more person was in that group it would be a completely different result and so I focused in on white men and women just so that we can all feel comfortable that

adding a couple people to these groups isn’t going to dramatically change these results and so when we look at those distributions about fifty-five percent of people would be considered high risk or have a high risk allele for their dat one gene in contrast about a third of people would be considered high risk for drd2 or drd4 but again how is that related to intimate partner violence perpetration so in public health we tend to use odds ratios risk ratios that type of measurement to talk about the association between two things and so an odds ratio of one means that the odds between the two groups are pretty close to the same actually an odd ratio of one means are exactly the same so when we look here I think this is a great public health message your genes in the absence of consideration of the environment are not associated at all not even close with perpetrating ipv which is great there’s no just like I said a little bit earlier there’s no gene for ipv having one of these risk alleles doesn’t mean you’re going to go out and you have to perpetrate violence but unfortunately because this is a research study there are limitations that we have to consider when we are interpreting these results and one of the limitations is that it’s restricted to white men and women which means that these relationships may be very different among the non-white population but we don’t know that at this point we’re also unable to account for epigenetic differences and to dive even a little deeper into your intro to biology class or maybe your second biology class epigenetics is the way that your genes are turned on and off it tends to happen most during the prenatal period a little bit into the postnatal period and I’d actually just read a paper yesterday that suggests there’s still some changes that can happen into adulthood but your genes tend to be turned on or turned off fairly early in your life and so what we’re looking at is the actual genes that people have not the way that their environment has turned them on or turned them off and first the day didn’t have the epigenetics second was a really complicated to look at because unlike your gene that’s pretty consistent through your body your epigenetics can be totally different the way that your dat one gene is turned on in your brain can be very different than how it’s turned on or off in your liver your stomach anywhere that its present and so we haven’t fully we’re starting to we haven’t fully captured how to look at epigenetics in humans it’s much easier in animals when they tend to use mouse models the third limitation is that this is a candidate gene analysis that means I didn’t have access to the entire genome I just had little pieces of the genome that people thought were associated with a wide range of health behaviors so there may be other genes that they didn’t capture that are much more important to dopamine processing and finally I have to touch on the way that I pv was measured in this sample so I pv was measured self-reported by the perpetrator did you or did you not do one of those three behaviors in the last year and I think that you can imagine a lot of different ways outside of hitting kicking slapping that you can physically hurt your partner and on top of that if your self reporting your own experience your own perpetration there are a lot of things that go into whether you’re going to tell a researcher that however somebody has to go first and looking at dopamine genes any genes actually an intimate partner violence somebody had to go first and I decided it might as well be me even with those limitations Oh everybody on board with the very basic of the gene piece because we’re about to get much more complicated okay so what do you think is much more important for public health especially prevention and intervention research is how does that environment influence those jeans because at this point and ethically we shouldn’t be messing with people’s genes so what can we do with the environment that may prevent that gene from having any type of effect so in the general ipv literature and in the general aggression and violence literature there are a couple of things that popped out to me is really important and these are both distal antecedents which means that there are things that happen to you fairly early in your life that may shape your personality that may shape the way that you behave but they don’t directly contribute to each individual instance of violence but what I saw is that adolescent exposure to violence you’re

really important so whether its family of origin violence whether it’s violence that you’re exposed to or experienced in the community or whether it’s violence within your friend network those are really important as to how you develop I just as your behaviors develop and whether you’re likely to perpetrate violence later in life I also like to throw in something that’s positive you can’t always be looking at risk factors we need to know what’s working for people and what’s helping people so I chose to look at the school social environment there’s a lot less research on the school social environment and even less looking at how it impacts adulthood but we know that environment at school is read linked with reduced bullying which is linked with a whole range of other violence behaviors what we also know and this is why I was most important than it most interested in it is that you can live in a community that has a lot of violence you can be exposed to violence in the home but if you come to school and feel good about your school environment you feel like people care about you you feel like your teachers are invested in you that other violent exposure is much less important I unfortunately can’t say it completely ameliorates the effects of those other violent experiences but it does a lot to reduce the effects of that exposure and so for this I focused in on exposure to violence in the community which was measured as you experience this or you didn’t experience this for six different items I model this is the sum number meaning that zero indicates you didn’t experience any of these types of violence and six indicates that you experienced all of these types of violence and to go down a slightly funny story so as I was presenting this for my dissertation defense one of my commuting committee members raises her hand and says but that physical fight one I don’t know is that really violence because I used to fight in school and it was like I don’t know what to do with that information right now but I did include it so just note that that physical fighting may not be the same type of violence as the rest of them I also looked at school social environment and how did people feel like they connected with people in their school they feel close to people did they feel like they were happy were they safe and did they feel like their teachers were treating them fairly so they were asked each of those questions on a scale of one to five where one indicates they strongly agree with that statement five indicates they strongly disagree so this was modeled as the mean score on these five questions meaning that a mean score of 1 indicates they strongly agreed to all of these questions a 5 indicates that they strongly disagreed to each of these questions oh the good news when we look at the number of violent exposures during adolescence about sixty-five percent of people weren’t exposed to any of these types of violence about twenty percent were exposed to one so that may be our physical fighters like my dissertation committee member but about twenty percent or even a little less or exposed to two or more when we look at school connectedness remember a score of one indicates they felt really good about their environment they were strongly connected a score of five indicates that they were pretty strongly disconnected they didn’t feel good about their environment the median score here was about a 2.1 indicating the overall people felt pretty good about their school environment but there’s about twenty five percent of people here that we’re neutral strong disagreed or strongly disagreed and so what I thought it was so interesting when I started this analysis is that all of these exposures were 15 or so years before we asked about violence perpetration and so what you can see here looking at the odds ratio point estimate here and the ninety-five percent confidence level here for each additional type of violence you were exposed to an adolescence your odds of perpetrating increased by about forty five percent leave it for each additional unit so moving from strongly agree to agree agree to neutral etc increase your odds of perpetrating by about twenty-five percent and so we’re seeing that there are really long-lasting effects of these early adolescent experiences which i hypothesize meant that people who are really sensitive to the environment as a result of their genes and who have this long-lasting effect probably be most likely to perpetrate violence so any guesses as to what I found who do you think was it the highest odds of perpetrating violence

the highest odds between males and females or what do you uh so thinking about people who had no violent experience versus six violent experiences and who had high risk or low risk genes than the ones who had six which is what I thought ok so high risk genes high-risk environment that sounds like a done deal and I was absolutely wrong so there’s going to be several of these slides so I want to take you through and make sure that everybody’s on the same page as to what we’re looking at so the y-axis here is the probability of perpetrating ipb based on their set of characteristics for this instance it’s the number of violent experiences that they had so ranging from 0 they didn t weren’t exposed to any of those types 26 they experienced all of them it then coated the three genes by color so that one is red drd2 is green that four is purple and then the dotted lines indicate people that work based on the literature I promise I didn’t pull this out of nowhere based on the literature those were the people that had previously been found to have increased odds of aggression when they were faced with adverse experiences so what we find is actually the people that I conceptualized and that the literature conceptualized as high risk were not really impacted by the number of exposures they had you can see that their line pretty flat no significant differences as the number of violent experiences increases on the other hand people that in the literature were conceptualized to be at a greater risk of violence actually had much greater odds and probability as their number of violent exposures increased wish to me says okay did I code these right so believe me I have gone back probably 15 times I was like okay I’m am I sure that that’s coated right am I sure I read the literature right and unfortunately yes I did read the literature right and yes I did coat it right which means that there may be something different going on in this population there may be something different going on between general aggression and intimate partner violence aggression and unfortunately I was wrong about school social climate also although I’ll talk about this in a couple of different ways so when we think about the probability of perpetrating ipv among people who had a high risk or non risk that one gene it really doesn’t matter they are more likely to perpetrate as they become more disconnected from their school environment but again what’s really interesting is that this dr d 2 and d rt4 difference really pretty flat there’s really not much difference so if you’re someone that has a dr d for risk allele and you feel bad about your school environment you feel like you don’t care about you it’s really not that big a deal compared with someone that has those non risk alleles so you can see that their probability starts out at about a three percent and increases up to a twelve percent for people with a non risk drd2 allele which suggests to me that there’s something else going on because i thought okay i’m finding one instance where the genes are flipped maybe that’s just an artifact of the literature but if we’re seeing it in another analysis still population so there’s still maybe something a little funky with that population there just may be something different about intimate partner violence however again all these limitations that i already went through but there’s also a couple of additional limitations so one this is a secondary data analysis which means some of the things I really wanted to look at just weren’t there things like ipb exposure within the household child maltreatment it wasn’t there which unfortunately means I couldn’t look at it there’s also potentially problem with ms calcification so people were asked when they were in 7th to 12th grade in the last 12 months what was your experience so all we have is that little window however just because someone experienced violence in that window doesn’t mean it persisted through the to their experience the other hand if they didn’t experience it in that 12 month window it doesn’t mean that they didn’t so they may have had one really stellar here where they’re not exposed to violence and their teachers are great and then they move something changes and it all goes downhill so that’s something that needs to be teased apart a little bit more than we were able to do with this study and the last limitation really isn’t a limitation at all it’s just something I want you to think about is that a couple times there’s no gene

for intimate partner violence and I want you to keep that in your mind as you think through everything that I’m presenting even though people have an increased probability of perpetrating based on these constellation of factors it doesn’t mean that they’re destined to there’s no fairy godmother coming down and saying you will perpetrate intimate partner violence that’s just not the way these gene and environmental factors work but despite those limitations that doesn’t mean that we can’t get some really great implications out of it the first implication i think is that we really need a larger sample size as i was embarking on this i talked to someone with the national institute for drug abuse and they said we don’t like to fund genetic analysis because they keep complaining they need a larger sample size and i was like i have 20,000 people i want to be good and then I wasn’t so we really do need to look at these relationships either in a larger sample size or in a more diverse sample that would allow for examination of non-white individuals there are also many other genes and many other childhood or adolescence periences that may be really important but i think the practical implications here are four primary prevention we can help kids feel safer we can help kids feel better in their schools and that will raise all boats you may have noticed that nobody got better with these more adverse experiences and so even if they may not benefit to the same degree they at least won’t be harmed by being in a safer environment and so one final study that I did looked at proximal antecedents and these are the things that are happening near the time of violence they’ve been conceptualized as causing violence although I don’t like to go that far i like to say they’re associated with violence so very quickly you may throw around the term stress and stressor similarly a lot of people do inlay language I did before I started getting into this but they’re actually two different things when we start thinking about research stress is how you’re responding so it’s the interaction between you and your environment that makes you feel like you’re not sure you can handle this situation anymore it’s beyond the resources that you have and it’s compromising your well being a stressor on the other hand is that objective thing that happened to you and the really important point here is that stress is an individual response so I experienced a stressor for instance moving to Denver and that can be really stressful but someone else that moves may not experience that same stress that I did it depends a lot on your genes ah but also your social support network your coping mechanisms who’s around you at the time and so it’s really important when we start interpreting these results that we know which we’re talking about and for this we’re talking about stressors the reason i looked at financial stressors specifically the whole range of stressors that we could have looked at with it’s the most commonly reported antecedent to ipv in the literature as reported by female victims and i think that’s a really important point there because we know that economic abuse is fairly common in partnerships that have intimate partner violence and so the perception of the female victim first is her perception of stress rather than of the stressor and second may be completely different from that of the perpetrator we don’t know he may be giving her an allowance she may be giving him an allowance he or she may be lying about how much money they have and so we don’t know that the victims experience is representative of what’s happening to their perpetrators and so I focused in on six different things that may have happened in the last 12 months that were thought to be stressful stressors modeled it is the sum score so very similar to exposure to violence zero indicates you didn’t experience any of these types of financial stressors six indicates that you experienced all of them and so what we see is but overall about seventy eight percent of people experienced no financial stressors they were good they they weren’t evicted they didn’t have their phone turned off they didn’t have food insecurity about ten percent of people did have it did have one of those which leaves about twelve percent of people who experienced more than one and thinking about what we know from the literature already and we know about stressors it’s not surprising for everyone additional financial stress are you experienced your odds of perpetrating increased by about forty five percent I when we look at the interaction with jeans here first I get

to claim I was right about 11 jean one environmental exposure so I’ll talk again about that one separately from dr d 2 and d rd4 so what we see here is that the probability of perpetrating ipv significantly increased among people who had that high risk allele as their number of financial stressors increased yeah I was right once however what we see is that for dr d 2 and d r d for the slope that i saw with that one was actually more similar to the slope for the non risk alleles which suggests that they’re actually more influenced by that financial stressor than the people who had those high risk alleles but what I can say here is that everyone regardless of genetic risk inst significantly increased odds of perpetrating ipv as their financial stressors increased and so again limitations I think the main limitation of this is that I can tell you that these experiences and these exposures happen and in the last 12 months I can’t tell you how they happen in relationship to each other I don’t know if intimate partner violence happen in the first month and exposure to these financial stressors have been in the last month and for that reason I think it’s time that intimate partner violence researchers and practitioners stop treating into and partner violence as something that happens consistently it’s not like a disease that you get the disease and then you have the disease it’s an event it’s something that happens if ur frequencies it’s something that happens at different times and so it’s time to move to treating it as a discrete event rather than treating it as a checkbox once a year on a survey and so one way to do that is ecologic momentary assessment which is a way to randomly call text or email people throughout the week ask how’s your stress you can ask anything but tends to be things that change in the context means like how’s your stress what types of stressors are you experiencing how are you interacting with your partner and then at the end of the week you can go back and ask them did you have any intimate partner violence if so when did that happen and so you’re better able to map the context at the time I think it’s also important to think about the difference between stress stressors and biological stress they’ve kind of been lumped together in the literature as this is what stress is but that doesn’t really help when we’re thinking about how do we intervene and how do we prevent violence is it more important that you think you’re under stress is it more important that your objectively experiencing a stressor or is it more important how your body is processing that stressor and my practice implication here again is primary prevention I sound like a broken record and primary prevention but you saw all of it financial stressors increase the odds increase the probability for everyone and so again in reducing that exposure raises the boat for everyone and so I think that there are from this body of work a few important implications for public health research one I’m a researcher so i have to say more research but i think we need to focus in on really three areas one we need to start treating ITV as an event that happens not as a consistent exposure or outcome we need to focus in on is it more important about the perception or is it more important about the objective exposure and finally we need to become more rigorous in the way that we’re measuring perpetration whether it’s through dyad reports or through some other method of triangulation we know and actually just published a paper on this that female and male partners do not report the same experiences and so how we measure that do we talk to just victim perpetrator do we talked to both and try to combine that somehow makes a big difference in who we categorized as a victim or perpetrator and finally I think it’s important to think about the implications and as I said throughout these adverse experiences weren’t good for anybody and so preventing them across the board would among other things reduce the probability of perpetrating violence as an adult so as I wrap up I want you to think about one more thing we’ve been here for about an hour and in that time 1200 people perpetrated physical intimate partner violence right any questions

what do you take away from the that one finding you think that’s a real finding and if you do how do you interpret it in terms of what you just said and I pretend that it’s real finding and I was right once I actually think that it’s probably an artifact I like the data whenever you’re doing this type of analysis in this number of analysis you’re likely to find one result that you go hmm that seems a little different and so if i had to guess it’s probably not a real finding and that it probably tends to follow the patterns that we saw with the other genes and the other exposures but great plug for more research because i think we need to know more about the functional implications so is there actually something different about that one and that reuptake process that does make it different from drd2 and dirty for so if the prevention implications are all about changing the environment why even study the genes oh that’s a tricky question I have to say from a public health perspective I mean I’m many of my colleagues don’t agree with me that you know diving deep into the genetic factors I mean I’m just not sure that that’s the place to go and so I’m not just trying to trip you up I’m trying to understand in my own ad why do we go there if the interventions are environmental oh I think looking at the actual specific genes is really less important than what those jeans tell us so if I had in my perfect world found that those high risk alleles really do make a difference when they’re interacting with the environment that tells us something about the etiology of intimate partner violence there’s something about dopamine that changes and so if we can understand the implications of dopamine and what dopamine does in the brain I think we can then better tailor our interventions to know if it’s something if it is something dopamine related and we know its motivation and learning related obviously more complex than that then we can focus in on developing interventions that target motivation or learning so although I spent a lot of time focusing in almost three three genes I actually think that those three genes are much less important than what they tell us about dopamine processing and its association with ipv mean with another hard one I can take it sorry I like in this conversation I mean I do think that there are certain kinds of genetic findings are quite intriguing on sickle cell that’s an important thing to find out because it does have a real world application and it might have something to do with genetic counseling the idea that genes can be mutated by radiation just understanding the fact that it can happen has important policy implications and it does have to do with behavior why we avoid radiation for example and so part of me just says unless we find it sure I think we won’t know the answer to your question it’s a great question why it’s like but it is unfortunately like the existential question of why we do research whether you look for new knowledge and the problem is what we don’t know is what we don’t know and that’s why I think you go sip them through it even though that’s not my field it’s not where I go I can’t ignore the possibility what interested me was what your conclusion was about the implications of the interaction between the two and so I can’t really formulate this well what I go back to is the research on prevention in particularly prevention child abuse and David olds in the next building over telling us that the all the effects of his prevention with these women in need of extra services washed out when their self-efficacy was high enough now I quite understand what that means but it seems to me that what you could if it true the truth is not an artifact but a finding and what you’re really suggesting with that is certain individuals have such high dopamine levels in terms of the reaction to the environment that it is barter for them everything else being equal to deal with an environment that continues to be more and more stressful and so that would mean if you find such individuals you want to help them identify careers that they don’t want to go into you want to help them avoid high stress situations where as I can tell my own background that there are people out

there who yearn for this they love and are incentivized and activated by environments where the adrenaline is at levels that are much beyond what I’m comfortable with I mean I want go into emergency medicine yeah i mean i should enhance once with the Blue Angels and I came away concluding that not only am I not like them but I don’t think they’re like most people because they don’t really they get the impression they didn’t start to live until I was saying oh I hope I said my prayers yeah you know it just just interest me when you see those extreme variations and I think you dope do the research you don’t get hints of what the interactions might be the resilience is something we really do look for in violence among people because the environment is loaded with stressful things and so anything it touches on either a genetic or experiential difference in the way people react i think it’s important to understand I think genetics research is also an important step to doing Fe genetics research which I really think then we have more gene-specific so the University of Utah does a lot with epigenetics and they have this really great website where you can go and play around with experiences and see how it impacts the turning on and off of jeans and so there’s one that looks at rats and there’s a gene in rats that influences how well they’re able to come selves down after they’re stressed and that gene is turned on when mom’s room the pups so you can actually pretend to be a mommy read and go groom your pops and look at what that does to the gene and so I think that if we can figure out what genes may and be involved then we can figure out what we can do epigenetically to turn on the genes that we want turned on and turn off the genes that are maybe less advantageous well I’m having take kind of decided a little bit i’m much more in the behavioral camp with carol i really do think that behavior is a lot more what we the software is something we have a lot more access to right now but i am interested in what came out and sell that dick ruben picked up years ago about the knockout mice gene where the mothering gene was knocked out now if you can knock out the gene that is it possible that some women for whatever reason experience some deactivation so that their they don’t have the same response to oxytocin as other women would giving birth or caring for children and it was very clear from that particular study that there was a biological reward and incentive when you were in the process with giving birth and nursing your your offspring and so I mean those kinds of things are just you know it’s like we go to research we think about in ecology all the folks is set on the panel that I sit on said we’re not going to do oncology research anymore unless we have an oncologist so you just kind of have a concede your limits and I’m still open to the idea very open the idea we keep looking so that if you get what seems to be a completely extraneous finding you don’t necessarily reject possibility that it isn’t spurious I think we’re out of time Laura you willing to stay a few minutes now have it and be happy nastase so thank you again for presenting a provocative talk

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