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The impact of parental intimate partner abuse on young adult relationships

    Intimate partner violence and abuse (IPVA) has the potential to be physically and psychologically damaging across generations. Childhood exposure to IPVA may place young people at greater risk of IPVA within their own relationships. It is estimated that a quarter of UK adults have grown up in a household where parental IPVA has taken place.

    The research team, including VISION Director Professor Gene Feder and led by Dr Annie Herbert (University of Bristol), aimed to provide estimates for the relationship between IPVA among mothers, and IPVA in their children’s own relationships as young adults.

    They studied the intergenerational effects of prospectively-reported IPVA in a UK general population birth cohort and examined effects according to different subtypes of maternal IPVA victimisation (psychological [and to an extent, controlling behaviours], and physical) and young adult IPVA victimisation and perpetration (psychological [including controlling behaviours], physical, and sexual). This is the first prospective longitudinal study on intergenerational effects of IPVA in the UK.

    The researchers found a modest association between maternal IPVA (partner-to-mother victimisation) and IPVA victimisation among their children as young adult women, and between maternal IPVA and IPVA perpetration in young adult men.  After adjusting for potential confounding factors, the association for victimisation among women lessened, but a weak positive association for perpetration among young men remained. This finding was consistent with some previous reviews of studies on intergenerational effects of IPVA. The strongest association was for perpetration by men growing up around physical IPVA victimisation.

    The findings showed that maternal IPVA victimisation is responsible for up to 10% of cases of IPVA in young adult relationships, largely concentrated amongst young people who experienced complex adversity including child maltreatment. Services supporting domestic violence cases in families should consider wider trauma, including history of child maltreatment.

    To download: The impact of parental intimate partner violence and abuse (IPVA) on young adult relationships: a UK general population cohort study – The Lancet Regional Health – Europe

    To cite: The impact of parental intimate partner violence and abuse (IPVA) on young adult relationships: a UK general population cohort study. Herbert, Annie et al. The Lancet Regional Health – Europe, Volume 0, Issue 0, 101278

    For further information, please contact Annie at annie.herbert@bristol.ac.uk

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    Start for Life Outcomes Framework: Identifying candidate indicators

      In 2021, the Government in England recognised the importance of supporting parents to give their babies and young children under two years of age the best start in life. There was a public commitment to publish a Start for Life Outcomes Framework. The Department of Health and Social Care in England then commissioned the NIHR Children and Families Policy Research Unit to undertake a five-month rapid responsive study to identify and provide a commentary on candidate indicators for this framework.

      The research team, including VISION Deputy Director and Senior Lecturer at University of Bristol, Dr Estela Capelas Barbosa, identified candidate indicators to monitor population health of babies, young children, and their families. The project’s secondary focus generated principles for a framework to monitor service performance for this population. 

      They conducted two rapid reviews with systematic searches to identify existing outcomes frameworks and core outcome sets that recommended relevant indicators for monitoring both population health and service performance.

      Forty-seven candidate indicators were identified, of which 36 met the priority criteria. Many indicators featured in existing frameworks and had some relevant data already collected at scale in England. However, data were often not reported/available separately for adults or households with children and/or by age of child.

      Significant further work is needed to develop frameworks to monitor population-level outcomes for babies or assess the quality of services. Frameworks require a clear purpose and consideration of unintended consequences from focusing on some indicators and not others.

      The Public Health Outcomes Framework is already a rich resource with 24 (66%) of the 36 priority
      indicators already featuring in some form.

      To download the summary and / or report: Start for Life Outcomes Framework: Identifying candidate indicators

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      A Scoping Review: Black and Minoritized Women’s Experiences of Specialist Domestic Violence Services in the UK

        Domestic violence and abuse (DVA) harms individuals from all backgrounds, yet the experiences and needs of different communities vary significantly. The Crime Survey for England and Wales (CSEW) estimated that over 1.4 million women and 751,000 men experienced DVA in the year ending March 2023. Black and minoritized women may face heightened vulnerability to DVA due to factors such as socio-economic deprivation, racism, and exposure to specific forms of violence such as so-called honor-based abuse, female genital mutilation or forced marriage.

        In addition, minoritized “survivor–victims” of DVA may face intersecting challenges within their socio-political and community context that impede their ability to disclose DVA and may experience social stigma and fears of racism from service providers for example.

        This scoping review maps the existing available literature on Black and minoritized women’s experiences with specialist DVA services in the UK to summarize current understanding and identify knowledge gaps.

        The research team, comprised of Penelope E. Lowe from University of Roehampton, VISION researchers Sally McManus, Ravi K. Thiara, Estela Capelas Barbosa and Ladan Hashemi, and Pardis Asadi Zeidabadi from City St George’s UoL, and Sumanta Roy of Imkaan and a VISION Advisory Board member, conducted a comprehensive search across multiple databases and gray literature sources. 

        Thematic analysis of the findings revealed three main themes: additional service needs, barriers to accessing support, and the pivotal role of “by and for” services. The team concluded that “by and for” services—provided by and for minoritized women—which adopt an intersectional approach are crucial in addressing the unique needs of Black and minoritized “survivor–victims”, particularly in terms of language support, practical assistance, and community-related support. There is a need for more peer-reviewed literature to recognize the role of “by and for” services, using diverse methodologies to support Black and minoritized communities better.

        To download the article: Black and Minoritized Women’s Experiences of Specialist Domestic Violence Service in the United Kingdom (UK): A Scoping Review

        To cite: Lowe, P. E., McManus, S., Asadi Zeidabadi, P., Thiara, R. K., Roy, S., Capelas Barbosa, E., & Hashemi, L. (2025). Black and Minoritized Women’s Experiences of Specialist Domestic Violence Services in the United Kingdom (UK): A Scoping Review. Trauma, Violence, & Abuse, 0(0).  https://doi.org/10.1177/15248380251335038

        For further information, please contact Penelope at penelope.lowe@rutgers.edu

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        The economic burden of child maltreatment and co-occurring parental domestic violence and abuse in the UK

          Child maltreatment (CM) and parental domestic violence and abuse (pDVA) impose considerable lifelong adverse outcomes on those affected. Approximately 8.5 million adults in England and Wales are estimated to have been exposed to CM (physical, sexual or emotional abuse or emotional or physical neglect of a child by a parent or caregiver) before their 16th birthday. Despite sharing multiple family and environmental risk factors, the economic burden of child exposure where they co-occur has not previously been estimated in detail.

          VISION researcher Professor Gene Feder estimated average lifetime societal costs resulting from CM or childhood exposure to pDVA, and incremental costs for scenarios where they co-occur with lead researcher Dr Kevin Gilbert at the University of Cambridge and others.

          The findings showed that lifetime costs for childhood exposure to CM and/or pDVA, were £71,309 per child (non-fatal exposure), and £1,292,377 per CM fatality, with £27.8 billion projected costs (2013 UK birth cohort).

          Total costs for exposure to pDVA alone was £1.0 billion (£16,639 per child exposed), rising to £2.0 billion (£71,037 per exposed child) for children reporting awareness of pDVA. Co-occurring CM and pDVA imposed greater costs than either alone, including costs from child perpetration of intimate partner violence.

          As a result of the research the team concluded that CM and/or pDVA exposure incurs large personal and societal economic burdens. Costs from both pDVA exposure and intergenerational transmission of IPV perpetration highlight the importance for policies to address both CM and domestic violence and abuse in affected households.

          Given the scale of burden accrued over the life course after CM and/or pDVA exposure, this model can provide a framework upon which policy makers can identify the best use of resources to maximise the societal benefits from the effective interventions needed to tackle a complex social issue.

          To download the article: The economic burden of child maltreatment and co-occurring parental domestic violence and abuse in the UK

          To cite: Herbert K, Feder G, Gilbert R, Powell C, Howarth E, Morris S. The economic burden of child maltreatment and co-occurring parental domestic violence and abuse in the UK. Child Abuse Negl. 2025 Mar 31;163:107435. doi: 10.1016/j.chiabu.2025.107435. Epub ahead of print. PMID: 40168916.

          For further information, please contact Kevin at kch28@medschl.cam.ac.uk

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          Evaluation of a domestic violence training and support intervention in Palestinian primary care clinics in the west bank: a mixed method study

            Domestic violence (DV) is a violation of human rights and a major public health problem that damages the health of women and their families. In the occupied Palestinian territories, 29% of women have a lifetime exposure to intimate partner violence, the most prevalent form of DV.

            Despite the existence of national policies to prevent and respond to DV, implementation within the Palestinian primary health care system has been weak. The research team, including VISION researcher Professor Gene Feder, developed, piloted, and evaluated a system-level intervention, including training for health care providers and care pathways for women patients. The aim of the evaluation was to determine the feasibility and acceptability of the HEalthcare Responding to violence and Abuse (HERA) intervention.

            The adaptation of a previous (HERA) intervention was implemented in primary health care
            settings in Palestine, informed by stakeholder meetings, interviews with clinic managers and health care providers (HCP), facility-level readiness data, and findings of a previous pilot study. The training component of the intervention, delivered by the Palestinian Counseling Centre, included a train-the-trainer session, two clinic-based training sessions, and reinforcement sessions for front-line healthcare providers in four clinics.

            Healthcare providers were trained to ask about DV, give immediate support, and offer a referral to a nurse case manager. The care pathway beyond the case manager was either referral to a primary-care based psychologist or social worker or to a gender-based violence focal point external to the clinic that coordinated referrals to appropriate external services (e.g. police, safe house, psychologist, social worker).

            For the evaluation, the researchers employed a thematic analysis of post-intervention semi-structured interviews with HCP and trainers, and observations of training sessions and field notes. Provider Intervention Measure (PIM) data on changes in HCP attitudes and practice were analysed with descriptive statistics. Identification and referral rates for women disclosing DV 12 months before and 12 months after the intervention were obtained from clinic registries. The research team also developed a theory of change to triangulate the qualitative and quantitative data.

            Results showed that the training proved acceptable to HCPs and there was evidence of positive change in attitudes and readiness to engage with women patients experiencing DV. Compared to the year before the intervention, there was a reduction in the number of patients disclosing DV during the intervention and of referrals in three of the four clinics. This reduction may be explained by the impact of the Covid 19 pandemic on clinic priorities, lack of time, persisting HCP fear about engaging with DV, and HCP rotation between clinics.

            The delivery of the training component of the HERA intervention within the Palestinian primary
            healthcare system proved partly feasible and was acceptable to HCPs, but contextual factors limited HCP implementation of the training in practice.

            To download the article: Evaluation of a domestic violence training and support intervention in Palestinian primary care clinics in the west bank: a mixed method study

            For further information, please contact Nagham at naghamjoudeh@gmail.com

            Multiple adverse childhood experiences and mental and physical health outcomes in adulthood: New systematic review protocol assessing causality

              Research suggests that adverse childhood experiences can have a lasting influence on children’s development that result in poorer health outcomes in adulthood. Like other exposure-outcome relationships, however, there is uncertainty about the extent to which the relationship between adverse childhood experiences and health is causal or attributable to other factors.

              The aim of this systematic review is to better understand the nature and extent of the evidence available to infer a causal relationship between adverse childhood experiences and health outcomes in adulthood.

              A comprehensive search for articles will be conducted in four databases (Medline, CINAHL, PsycInfo and Web of Science) and Google Scholar. The team, led by Dr Lisa Jones of Liverpool John Moores University, and includes VISION researchers Professor Mark Bellis and Professor Sally McManus, will review studies published since 2014:

              • of adults aged 16 years or over with exposure to adverse childhood experiences before age 16 years from general population samples;
              • that report measures across multiple categories of childhood adversity, including both direct and indirect types; and
              • report outcomes related to disease morbidity and mortality.

              To download the protocol: Interpreting evidence on the association between multiple adverse childhood experiences and mental and physical health outcomes in adulthood: protocol for a systematic review assessing causality

              To cite: Jones L, Bellis MA, Butler N, et al. Interpreting evidence on the association between multiple adverse childhood experiences and mental and physical health outcomes in adulthood: protocol for a systematic review assessing causality. BMJ Open 2025;15:e091865.  doi: 10.1136/bmjopen-2024-091865

              For further information, please contact Lisa at l.jones1@ljmu.ac.uk

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              Systematic review: Effectiveness of UK-based adult domestic and sexual violence support interventions and services

                Recommendations

                • Further high-quality research into the effectiveness of domestic and sexual violence and abuse (DVSA) interventions and evaluations of perpetrator programmes are required, including randomised controlled studies where appropriate and ethical, to improve certainty regarding the effect estimates generated from evidence syntheses. Published protocols, adherence to reporting guidelines, such as CONSORT, STROBE and SQUIRE 2.0, and considering and accounting for confounding factors where randomisation is not feasible, will strengthen the research.
                • Developing a core outcome set via co-production with survivors, practitioners and service providers, commissioners, policy makers and researchers will increase consistency in reported outcomes and create the cohesion necessary to develop a robust evidence base to aid understanding of how effective various support services are.

                In the United Kingdom, there are a range of support services and interventions for people who have experienced domestic and sexual violence and abuse (DSVA), including refuges, advocacy such as Independent Domestic Violence Advisors (IDVAs), referral, outreach, and helplines. These are often provided by the Voluntary and Community Sector (VCS), although may also be located in the public or private sector. Due to the lack of consensus on outcomes used to assess effectiveness, evidence syntheses in this field have been limited.

                Dr Sophie Carlisle led a team of VISION researchers, Dr Annie Bunce, Prof Sally McManus, Dr Estela Capelas Barbosa, Prof Gene Feder, and Dr Natalia V Lewis, and Prof Matthew Prina from Kings College London. They used findings from their scoping review to identify the common reported outcomes, to direct and inform an evidence synthesis on the effectiveness of UK-based interventions and services for DSVA.

                The team conducted a systematic review and, where possible, meta-analysis. They searched relevant peer reviewed and grey literature sources. The following were included: randomised controlled trials, non-randomised comparative studies, pre-post studies, and service evaluations of support interventions or services for adults who had experienced or perpetrated DSVA. The intervention typology and selection of outcomes was determined based on co-production with stakeholders from specialist DSVA organisations. The quality of the studies was assessed independently by two reviewers. Where meta-analysis was not possible, the researchers synthesized studies with vote counting based on the direction of effect.

                The review demonstrates that there appear to be benefits of UK-based advocacy and outreach services, psychological support interventions, and perpetrator programmes. However, risk of bias and methodological heterogeneity means that there is uncertainty regarding the estimated effects.

                A co-produced core-outcome set is needed to develop a more robust evidence base and facilitate future research in this field. Research practices such as publishing of study protocols, following reporting guidelines and, for research where randomisation is not feasible, considering and accounting for potential confounding factors, would greatly improve the quality of research.

                To download the paper: Effectiveness of UK-based support interventions and services aimed at adults who have experienced or used domestic and sexual violence and abuse: a systematic review and meta-analysis – PMC

                To cite: Carlisle S, Bunce A, Prina M, McManus S, Barbosa E, Feder G, Lewis NV. Effectiveness of UK-based support interventions and services aimed at adults who have experienced or used domestic and sexual violence and abuse: a systematic review and meta-analysis. BMC Public Health. 2025 Mar 14;25(1):1003. doi: 10.1186/s12889-025-21891-5. PMID: 40087589; PMCID: PMC11908015.

                For further information, please contact Sophie at sophie.carlisle4@nhs.net

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                Physical health conditions and intimate partner violence: A gendered issue

                  Intimate partner violence (IPV) is a widespread global public health issue with serious and long-lasting consequences. While much research has focused on the mental health consequences of IPV, such as depression and PTSD, there is limited evidence on its association with physical health.

                  This study explored how different types and number of types of IPV are linked to specific physical health conditions, and whether these associations differ between men and women. VISION researchers Dr Ladan Hashemi, Dr Anastasia Fadeeva and Professor Sally McManus, with Nadia Khan, City St George’s UoL, examined this using data from the 2014 Adult Psychiatric Morbidity Survey.

                  Key findings include:

                  • Women were more likely to experience IPV and a higher number of IPV types than men.
                  • Women’s experience of lifetime and 12-month IPV were significantly associated with 12 and 11 different physical health conditions, respectively, while men’s experience of lifetime and 12-month IPV were significantly associated with 4 and 1 conditions, respectively.
                  • Different types of IPV types were associated with different types of physical health condition, particularly among women.
                  • A cumulative association between experiencing a greater number of IPV types and an increased risk of physical health conditions was evident for women but not for men.

                  The research concludes that IPV is a gendered issue, with stronger associations between IPV and physical health evident in this data for women than for men. This may be because women are more likely to experience more and multiple types of IPV, more frequently, and more often with injury. Healthcare systems must recognise IPV as a priority issue, ensuring support is tailored to those affected.

                  Recommendation

                  • Healthcare systems need to address IPV as a priority health issue for the female population. Gender-informed approaches in IPV intervention strategies and healthcare provision are required. This means emphasising the development of IPV-responsive healthcare systems and comprehensive IPV curricula in medical and health training.

                  To download the paper: Intimate partner violence and physical health in England: Gender stratified analyses of a probability sample survey – Ladan Hashemi, Anastasia Fadeeva, Nadia Khan, Sally McManus, 2025

                  To cite: Hashemi L, Fadeeva A, Khan N, McManus S. Intimate partner violence and physical health in England: Gender stratified analyses of a probability sample survey. Women’s Health. 2025;21. doi:10.1177/17455057251326419

                  For further information, please contact Ladan at ladan.hashemi@citystgeorges.ac.uk

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                  Synthetic datasets enable linkage and a longitudinal understanding of experiences of violence and health impacts and consequences

                    Violence is a complex social problem and a public health issue, with implications for the health and social care systems, police and justice systems, as well as significant productivity losses for those who experience it. Analysing data collected by these systems can aid understanding of the problem of violence and how to respond to it. In social research, analysing administrative records together with survey data has already enabled better measurements of violence and its costs, capturing experiences of both victim-survivors and perpetrators across multiple points in time and social and economic domains.

                    Ideally, data from the same individuals would enable linkage and a longitudinal understanding of experiences of violence and their (health) impacts and consequences. However, most studies in violence-related research analyse data in silo due to difficulties in accessing data and concerns for the safety of those exposed. This is particularly the case for data from third sector specialist support services for victims or perpetrators of violence which has, to VISION’s knowledge, not been linked or combined with other datasets. Because these services provide person-centred trauma-informed care and there is a risk that information on their service users may be used against them in courts or by immigration authorities, direct data linkage is not possible and alternatives are needed.

                    With this research, VISION researchers Dr Estela Capelas Barbosa, Dr Niels Blom, and Dr Annie Bunce provide a proof-of-concept synthetic dataset by combining data from the Crime Survey for England and Wales (CSEW) and administrative data from Rape Crisis England and Wales (RCEW), pertaining to victim-survivors of sexual violence in adulthood. Intuitively, the idea was to impute missing information from one dataset by borrowing the distribution from the other.

                    The researchers borrowed information from CSEW to impute missing data in the RCEW administrative dataset, creating a combined synthetic RCEW-CSEW dataset. Using look-alike modelling principles, they provide an innovative and cost-effective approach to exploring patterns and associations in violence-related research in a multi-sectorial setting.

                    Methodologically, they approached data integration as a missing data problem to create a synthetic combined dataset. Multiple imputation with chained equations were employed to collate/impute data from the two different sources. To test whether this procedure was effective, they compared regression analyses for the individual and combined synthetic datasets for a variety of variables.

                    Results show that the effect sizes for the combined dataset reflect those from the dataset used for imputation. The variance is higher, resulting in fewer statistically significant estimates. VISION’s approach reinforces the possibility of combining administrative with survey datasets using look-alike methods to overcome existing barriers to data linkage.

                    Recommendations

                    • Imputing missing information from one dataset by borrowing the distribution from the other should be applicable for costing exercises as it permits micro-costing. 
                    • Compared to traditional research, VISION’s proposed approach to data integration offers a cost-effective solution to breaking (data-related) silos in research.

                    To download the paper: Look-alike modelling in violence-related research: A missing data approach | PLOS One

                    To cite: Barbosa EC, Blom N, Bunce A (2025) Look-alike modelling in violence-related research: A missing data approach. PLoS ONE 20(1): e0301155. https://doi.org/10.1371/journal.pone.0301155

                    For further information, please contact Estela at e.capelasbarbosa@bristol.ac.uk

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                    The impact and risk factors of adolescent domestic abuse: A rapid systematic review

                      As a phenomenon, abusive behavior between adolescents in intimate relationships remains relatively invisible, due in part to the persistent yet unfounded assumption that domestic abuse is something that occurs between adults. There is an emerging body of evidence indicating that both victimization and perpetration in intimate partner relationships can and do occur well before adulthood.

                      This review seeks to improve understandings of intimate partner abuse between adolescents, focusing in particular on younger adolescents below the age of 16 and the impacts and risk and protective factors.

                      VISION researchers Dr Ruth Weir, Dr Olumide Adisa and Dr Niels Blom, with their collaborators, conducted a rapid systematic review by searching three electronic databases (PsycInfo, Embase, and Social Sciences Citation Index). The team utilized pre-existing systematic reviews to identify relevant primary studies. Findings of the included studies were described and summarized using narrative synthesis.

                      Seventy-nine studies were identified for inclusion. Synthesis of the findings of these studies identified five categories of risk and protective factors, including bullying and parental intimate partner violence, social and cultural factors, school and neighborhood environment and health and wellbeing. However, the review also identified a gap of qualitative research and a lack of attention to how ADA intersects with cultural factors, gender differences, criminalization, and poor mental health. Many of the studies report on school-based settings, limiting understanding of the role of neighborhood factors in prevention, protection and recovery. Participatory research on help-seeking behaviors of adolescents is rare.

                      The review synthesized risk and protective factors associated with ADA, especially those occurring between younger adolescents. It highlighted the complex interplay and overlap between using and experiencing violence and abuse and the need for systematic research to inform the development of advocacy, interventions and prevention that is right for young people.

                      Highlights from the VISION ADA rapid review: Gaps, limitations & considerations for future research

                      • Little recent academic interest on ADA in the UK
                      • Focus in existing global literature on physical or sexual violence but less so on coercive control or emotional / psychological abuse
                      • Lack of systematic examination of long-term consequences of ADA on wellbeing
                      • Lack of intersectional analysis (ethnicity, sexual orientation, socioeconomic status, etc)
                      • Little exploration of adolescents’ help-seeking behaviours and attitudes to different kinds of possible support
                      • Research design limitations

                      To download the paper: Adolescent Domestic Abuse and Its Consequences: A Rapid Systematic Review | Journal of Family Violence

                      To cite: Weir, R., Adisa, O., Blom, N. et al. Adolescent Domestic Abuse and Its Consequences: A Rapid Systematic Review. J Fam Viol (2025). https://doi.org/10.1007/s10896-025-00813-4

                      For more information on this rapid review, please contact Ruth at ruth.weir@city.ac.uk

                      To view and / or download the list of systematic reviews included in this paper:

                      SRs included in Weir ADA journal articleDownload

                      Further ADA research across the VISION consortium:

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