Acessibilidade / Reportar erro

Lesbian Intimate Partner Violence and Perceived Social Support

Violência entre Parceiras Íntimas e Percepção de Suporte Social

Violencia entre Parejas Íntimas y Percepción de Apoyo Social

Abstract

Intimate partner violence is recurrent in the daily lives of many Brazilian women, but its characteristics are little studied in same-sex relationships. This article aims to characterize the manifestation of violence in homosexual relationships among women based on its typology and frequency and to analyze the possible associations between violence and social support. The sample consisted of 634 Brazilian lesbians adults aged 18 to 58 years who answered three online instruments: Brazil Socioeconomic Classification Criteria, Conflict Tactics Scales (Brief version), and Perception of Social Support Scale. Based on latent class analysis, we identified four significantly different classes in terms of patterns of violence suffered and perceived social support. The findings reinforce the finding that relationship intimate partner violence and social support is a heterogeneous phenomenon, in which the variables are not always directly associated.

Keywords:
violence; social networks; homosexuality; violence against women

Resumo

A violência entre parceiros íntimos é recorrente no cotidiano de muitas mulheres brasileiras, mas suas características são pouco estudadas em relacionamentos homossexuais. O objetivo deste estudo foi caracterizar a manifestação da violência em relacionamentos homossexuais de mulheres a partir de sua tipologia e frequência, e analisar as possíveis associações entre violência e percepção de suporte social. A amostra foi composta por 634 adultas brasileiras, lésbicas, com idades entre 18 e 58 anos. As participantes responderam a três instrumentos online: Critério de Classificação Socioeconômica Brasil, Escala Tática de Conflitos e Escala de Percepção do Suporte Social. Por meio da análise de classes latentes, identificou-se quatro classes significativamente distintas em temos de padrões de violência sofrida e suporte social percebido. Os achados reforçam que a relação entre violência entre parceiras e o suporte social consiste em um fenômeno heterogêneo, cujas variáveis nem sempre se relacionam diretamente.

Palavras-chave:
violência; redes sociais; homossexualidade; violência contra mulher

Resumen

La violencia entre parejas íntimas es recurrente en la vida diaria de muchas mujeres brasileñas, pero sus características son poco estudiadas en las relaciones homosexuales. El objetivo de este artículo fue caracterizar la manifestación de violencia en las relaciones homosexuales entre mujeres con relación a tipo y frecuencia, y analizar las posibles asociaciones entre violencia y apoyo social. Participaron 634 adultas brasileñas lesbianas, de 18 a 58 años de edad. Las participantes respondieron a tres instrumentos en línea: Criterio de Clasificación Socioeconómica de Brasil, Escala Resumida de Conflicto Táctico y Escala de Percepción de Apoyo Social. Del análisis de clases latentes, se identificaron cuatro clases significativamente diferentes en términos de patrones de violencia sufrida y apoyo social percibido. Los hallazgos refuerzan que la relación entre violencia entre parejas y apoyo social es un fenómeno heterogéneo, en el que las variables no siempre están directamente relacionadas.

Palabras clave:
violencia; redes sociales; homosexualidad; violencia contra la mujer

Violence is a global public health problem that directly or indirectly affects the lives of millions of people (World Health Organization [WHO], 2021World Health Organization. (2021). Violence against women prevalence estimates, 2018: Global, regional and national prevalence estimates for intimate partner violence against women and global and regional prevalence estimates for non-partner sexual violence against women. Geneva, Switzerland: Author. Retrieved from https://www.who.int/publications/i/item/9789240022256
https://www.who.int/publications/i/item/...
). Although there is no single, consensual definition of violence, the World Health Organization presents a definition widely accepted by academics and scientists, characterizing it as the threat or practice of physical force against oneself or another person, group or community, with harmful consequences, such as suffering, death, deprivation, and psychological or developmental damage (Krug, Dahlberg, Mercy, Zwi, & Lozano, 2002Krug, E. G., Dahlberg, L. L., Mercy, J. A., Zwi, A. B., & Lozano, R. (2002). World report on violence and health. Geneva, Switzerland: WHO. Retrieved from https://who.int/iris/bitstream/handle/10665/42495/9241545615_eng.pdf
https://who.int/iris/bitstream/handle/10...
). In addition, this definition includes neglect and various types of abuse, whether physical, sexual or psychological, as well as other actions against oneself, such as suicide and self-inflicted acts.

Intimate Partner Violence (IPV) is a subtype of interpersonal violence, behavior that causes physical, psychological or sexual harm and may involve controlling actions aimed at the part considered to be the most vulnerable in the relationship (Messinger, 2011Messinger, A. M. (2011). Invisible victims: Same-sex IPV in the national violence against women survey. Journal of Interpersonal Violence, 26(11), 2228-2243. doi: 10.1177/0886260510383023
https://doi.org/10.1177/0886260510383023...
). Notably, IPV is more recurrent against women (WHO, 2021World Health Organization. (2021). Violence against women prevalence estimates, 2018: Global, regional and national prevalence estimates for intimate partner violence against women and global and regional prevalence estimates for non-partner sexual violence against women. Geneva, Switzerland: Author. Retrieved from https://www.who.int/publications/i/item/9789240022256
https://www.who.int/publications/i/item/...
). Violence against women is defined by the United Nations as acts of gender-based violence against women in which the result is any type of harm or suffering, whether physical, sexual or mental, which thus includes acts of threat, coercion or deprivation of liberty, whether in the public or private life of the victim (Pan American Health Organization [PAHO], 2017Pan American Health Organization. (2017). Fact sheet - violence Against women. Washington, DC: Author. Retrieved from https://www.paho.org/en/topics/violence-against-women
https://www.paho.org/en/topics/violence-...
).

The Information Sheet on Violence Against Women (PAHO, 2017Pan American Health Organization. (2017). Fact sheet - violence Against women. Washington, DC: Author. Retrieved from https://www.paho.org/en/topics/violence-against-women
https://www.paho.org/en/topics/violence-...
) explained that there are numerous consequences for women victims of violence by intimate partners. The effects are seen in a wide spectrum, but they affect physical, psychological, sexual and reproductive health, both in the long and short term (Miller & Irvin, 2017Miller, B., & Irvin, J. (2017). Invisible scars: Comparing the mental health of LGB and heterosexual intimate partner violence survivors. Journal of Homosexuality, 64(9), 1180-1195. doi: 10.1080/00918369.2016.1242334
https://doi.org/10.1080/00918369.2016.12...
; PAHO, 2017Pan American Health Organization. (2017). Fact sheet - violence Against women. Washington, DC: Author. Retrieved from https://www.paho.org/en/topics/violence-against-women
https://www.paho.org/en/topics/violence-...
). Furthermore, the prevalence of psychopathological symptoms in women victims of violence has been widely debated in the literature (Spencer et al., 2019Spencer, C., Mallory, A. B., Cafferky, B. M., Kimmes, J. G., Beck, A. R., & Stith, S. M. (2019). Mental health factors and intimate partner violence perpetration and victimization: A meta-analysis. Psychology of Violence, 9(1), 1-17. doi: 10.1037/vio0000156
https://doi.org/10.1037/vio0000156...
). For example, indicators of anxiety and depression in women victims of violence are alarming, as are physical damage, psychological damage and low self-esteem (Gerino, Caldarera, Curti, Brustia & Rollè, 2018Gerino, E., Caldarera, A. M., Curti, L., Brustia, P., & Rollè, L. (2018). Intimate partner violence in the golden age: Systematic review of risk and protective factors. Frontiers in Psychology, 9, 1595. doi: 10.3389/fpsyg.2018.01595
https://doi.org/10.3389/fpsyg.2018.01595...
; Ogbe, Harmon, Van den Bergh, & Degomme, 2020Ogbe, E., Harmon, S., Van den Bergh, R., & Degomme, O. (2020). A systematic review of intimate partner violence interventions focused on improving social support and/mental health outcomes of survivors. PLoS One, 15(6), e0235177. doi: 10.1371/journal.pone.0235177
https://doi.org/10.1371/journal.pone.023...
). It is important to emphasize that the manifestation of IPV is heterogeneous. Cases occur regardless of the victims’ economic class, age, ethnicity, education and sexual orientation (Dias et al., 2019Dias, N. G., Costa, D., Soares, J., Hatzidimitriadou, E., Ioannidi-Kapolou, E., Lindert, J., ... Fraga, S. (2019). Social support and the intimate partner violence victimization among adults from six European countries. Family Practice, 36(2), 117-124. doi: 10.1093/fampra/cmy042
https://doi.org/10.1093/fampra/cmy042...
; Santos, Freitas, & Ceara-Silva, 2019Santos, N. C. R., Freitas, R., & Ceara-Silva, G. L. (2019). Violência conjugal lésbica: Relatos de assistentes sociais que atendem mulheres na cidade de Niterói [Lesbian marital violence: Reports of social workers attending women in the city of Niterói]. Serviço Social & Sociedade, (134), 124-141. doi: 10.1590/0101-6628.169
https://doi.org/10.1590/0101-6628.169...
; Luz & Gonçalves, 2014Luz, R. R., & Gonçalves, H. S. (2014). Violência doméstica entre casais homossexuais: A violência invisível [Domestic violence among homosexual couples: The invisible violence]. Bagoas-Estudos Gays: Gêneros e Sexualidades, 8(11), 79-99. Retrieved from https://periodicos.ufrn.br/bagoas/article/view/6544
https://periodicos.ufrn.br/bagoas/articl...
; Steele, Everett, & Hughes, 2020Steele, S. M., Everett, B. G., & Hughes, T. L. (2020). Influence of perceived femininity, masculinity, race/ethnicity, and socioeconomic status on intimate partner violence among sexual-minority women. Journal of Interpersonal Violence, 35(1-2), 453-475. doi: 10.1177/0886260516683176
https://doi.org/10.1177/0886260516683176...
). Still, studies on IPV in same-sex relationships are scarce.

A systematic literature review carried out by Edwards, Sylaska and Neal (2015Edwards, K. M., Sylaska, K. M., & Neal, A. M. (2015). Intimate partner violence among sexual minority populations: A critical review of the literature and agenda for future research. Psychology of Violence, 5(2), 112-121. doi: 10.1037/a0038656
https://doi.org/10.1037/a0038656...
) showed that only 3% of the available bibliography on IPV involved the Lesbian, Gay and Bisexual (LGB) population. In addition, some areas of knowledge, such as psychology and psychiatry, contributed to the pathologization and marginalization of this community (Gonçalves & Carvalho, 2019Gonçalves, J. A., & Carvalho, A. R. R. F. (2019). Lesbianidade e psicologia na contemporaneidade: Uma revisão sistemática [Lesbianity and psychology in contemporianity: A systematic review]. Revista Gênero, 20(1), 135-156. doi: 10.22409/rg.v20i1.38495
https://doi.org/10.22409/rg.v20i1.38495...
). The term “homosexualism”, for example, whose suffix indicates illness, remained for over a century in the classification manuals of mental disorders at the American Psychiatric Association, being withdrawn only in 1973 (Gonçalves & Carvalho, 2019Gonçalves, J. A., & Carvalho, A. R. R. F. (2019). Lesbianidade e psicologia na contemporaneidade: Uma revisão sistemática [Lesbianity and psychology in contemporianity: A systematic review]. Revista Gênero, 20(1), 135-156. doi: 10.22409/rg.v20i1.38495
https://doi.org/10.22409/rg.v20i1.38495...
).

The struggle and the achievement of visibility by the LGB community enabled the recognition of some vulnerabilities faced by this group and the creation of public policies. Such achievements directly influence actions in the field of health, education and, certainly, the safety of this population (Gonçalves & Carvalho, 2019Gonçalves, J. A., & Carvalho, A. R. R. F. (2019). Lesbianidade e psicologia na contemporaneidade: Uma revisão sistemática [Lesbianity and psychology in contemporianity: A systematic review]. Revista Gênero, 20(1), 135-156. doi: 10.22409/rg.v20i1.38495
https://doi.org/10.22409/rg.v20i1.38495...
). In this sense, it is advocated that the various sciences, including the psychological one, should focus on understanding the psychological and social phenomena concerning this population, including the phenomenon of violence that permeates homosexual relationships.

Despite the recognition of IPV impacts, as well as the existence of homosexual relationships among women in countless cultures, there are few studies that focused on the experiences of violence experienced in these relationships, especially in the national context. The absence of investigations aimed at this segment hides the epidemiological data and masks this disastrous reality. Steele et al. (2020Steele, S. M., Everett, B. G., & Hughes, T. L. (2020). Influence of perceived femininity, masculinity, race/ethnicity, and socioeconomic status on intimate partner violence among sexual-minority women. Journal of Interpersonal Violence, 35(1-2), 453-475. doi: 10.1177/0886260516683176
https://doi.org/10.1177/0886260516683176...
) highlight that IPV of sexual minorities can be as harmful as that of heterosexual relationships. Furthermore, Edwards et al. (2015Edwards, K. M., Sylaska, K. M., & Neal, A. M. (2015). Intimate partner violence among sexual minority populations: A critical review of the literature and agenda for future research. Psychology of Violence, 5(2), 112-121. doi: 10.1037/a0038656
https://doi.org/10.1037/a0038656...
) argue that domestic violence is seen from a heteronormative point of view, that is, as if “real couples” were essentially heterosexual, making the violence that occurs between same-sex couples invisible.

Although in recent decades the topic of IPV has started to be more discussed, there are studies that show that cases are underreported in Brazil, evidencing flaws in the strategies adopted for referring cases to the public authorities (Ferreira & Moraes, 2020Ferreira, I. A., & Moraes, S. S. (2020). Subnotificação e Lei Maria da Penha: O registro como instrumento para o enfrentamento dos casos de violência doméstica contra mulher considerando o anuário brasileiro de segurança pública [Under-notification and the Maria da Penha Law: Registration as an instrument for dealing with cases of domestic violence against women considering the Brazilian yearbook of public safety]. O Público e o Privado, 18(37), 259-280. doi: 10.52521/18.4108
https://doi.org/10.52521/18.4108...
). It is reasonable to assume that this scenario is similar or even more worrisome in same-sex relationships. The lack of dialogue about violence within the LGB community itself is also reinforced by the fear of reinforcing negative stereotypes about the community (Luz & Gonçalves, 2014Luz, R. R., & Gonçalves, H. S. (2014). Violência doméstica entre casais homossexuais: A violência invisível [Domestic violence among homosexual couples: The invisible violence]. Bagoas-Estudos Gays: Gêneros e Sexualidades, 8(11), 79-99. Retrieved from https://periodicos.ufrn.br/bagoas/article/view/6544
https://periodicos.ufrn.br/bagoas/articl...
). Studies carried out on the subject show that the rate of violence in same-sex relationships can be as high as in heterosexual ones (Luz & Gonçalves, 2014Luz, R. R., & Gonçalves, H. S. (2014). Violência doméstica entre casais homossexuais: A violência invisível [Domestic violence among homosexual couples: The invisible violence]. Bagoas-Estudos Gays: Gêneros e Sexualidades, 8(11), 79-99. Retrieved from https://periodicos.ufrn.br/bagoas/article/view/6544
https://periodicos.ufrn.br/bagoas/articl...
; Messinger, 2011Messinger, A. M. (2011). Invisible victims: Same-sex IPV in the national violence against women survey. Journal of Interpersonal Violence, 26(11), 2228-2243. doi: 10.1177/0886260510383023
https://doi.org/10.1177/0886260510383023...
).

In Messinger’s (2011Messinger, A. M. (2011). Invisible victims: Same-sex IPV in the national violence against women survey. Journal of Interpersonal Violence, 26(11), 2228-2243. doi: 10.1177/0886260510383023
https://doi.org/10.1177/0886260510383023...
) research involving 14,182 North American participants, it was found that IPV in same-sex couples was higher when compared to heterosexual ones. The author described that one of the hypotheses about the high percentage of violence could be the influence of stressors that this minority experiences, such as situations of prejudice, stigma and social exclusion. He also highlighted the need for more detailed investigations into the specificities of violence that occur in same-sex relationships.

According to Topa (2010Topa, H. (2010). No arco-íris também há roxo: Violência conjugal nas relações lésbicas [Rainbow also has purple: Marital violence in lesbian relationships]. LES Online, 2(1), 13-21. Retrieved from https://lesonlinesite.files.wordpress.com/2017/03/violenciaconjugal.pdf
https://lesonlinesite.files.wordpress.co...
), IPV in same-sex relationships has a particular aspect which is its double discrimination. In the case of lesbians, in addition to suffering prejudice for relating affectively with other women, they suffer from the impact of the phenomenon called “double closet” (Topa, 2010Topa, H. (2010). No arco-íris também há roxo: Violência conjugal nas relações lésbicas [Rainbow also has purple: Marital violence in lesbian relationships]. LES Online, 2(1), 13-21. Retrieved from https://lesonlinesite.files.wordpress.com/2017/03/violenciaconjugal.pdf
https://lesonlinesite.files.wordpress.co...
). The first closet refers to the popular term known as “being in the closet” when lesbians or anyone in the LGB community hides or denies their sexual orientation for fear of reprisal. The “second closet”, on the other hand, would be this woman’s behavior of hiding the violence suffered in the intimate relationship from her social group. For Santos et al. (2019Santos, N. C. R., Freitas, R., & Ceara-Silva, G. L. (2019). Violência conjugal lésbica: Relatos de assistentes sociais que atendem mulheres na cidade de Niterói [Lesbian marital violence: Reports of social workers attending women in the city of Niterói]. Serviço Social & Sociedade, (134), 124-141. doi: 10.1590/0101-6628.169
https://doi.org/10.1590/0101-6628.169...
) this is one of the reasons for these women to remain in these relationships, as the fear of suffering some kind of prejudice or reprisal silences them and prevents them from being activated in social support networks. The authors also mention the culture present in Brazil of blaming women when they are IPV victims.

Social support is seen as a protective factor in situations of violence, which can influence the perception of belonging, validation and how much the victim feels welcomed and protected in their support network (Dias et al., 2019Dias, N. G., Costa, D., Soares, J., Hatzidimitriadou, E., Ioannidi-Kapolou, E., Lindert, J., ... Fraga, S. (2019). Social support and the intimate partner violence victimization among adults from six European countries. Family Practice, 36(2), 117-124. doi: 10.1093/fampra/cmy042
https://doi.org/10.1093/fampra/cmy042...
). Perceived Social Support (PSS) is directly related to the processes of resilience in women victims of violence and the reduction of psychological symptoms (Machisa, Christofides, & Jewkes, 2018Machisa, M. T., Christofides, N., & Jewkes, R. (2018). Social support factors associated with psychological resilience among women survivors of intimate partner violence in Gauteng, South Africa. Global Health Action, 11(Suppl. 3), 1491114. doi: 10.1080/16549716.2018.1491114
https://doi.org/10.1080/16549716.2018.14...
). Miller and Irvin (2017Miller, B., & Irvin, J. (2017). Invisible scars: Comparing the mental health of LGB and heterosexual intimate partner violence survivors. Journal of Homosexuality, 64(9), 1180-1195. doi: 10.1080/00918369.2016.1242334
https://doi.org/10.1080/00918369.2016.12...
) suggest that the perceived social support also affects the mental health of LGB victims of IPV. Thus, it was observed that emotional support from friends, family and access to community services, such as shelters for victims of violence, are important factors for the protection and promotion of mental health in victims (Miller & Irvin, 2017Miller, B., & Irvin, J. (2017). Invisible scars: Comparing the mental health of LGB and heterosexual intimate partner violence survivors. Journal of Homosexuality, 64(9), 1180-1195. doi: 10.1080/00918369.2016.1242334
https://doi.org/10.1080/00918369.2016.12...
).

Based on these findings, it is hypothesized that lesbians who are isolated and without support networks can suffer more drastically when they are exposed to Intimate Partner Violence (IPV), as well as having more difficulties in breaking away from the aggressor partner. Because they have particularities, especially due to the imposed patriarchal model, women’s same-sex relationships need a differentiated and detailed analysis. Analyzing and comparing these cases of IPV with reference to heterosexual relationships is a simplistic and reductionist way of understanding a complex phenomenon such as violence (Santos et al., 2019Santos, N. C. R., Freitas, R., & Ceara-Silva, G. L. (2019). Violência conjugal lésbica: Relatos de assistentes sociais que atendem mulheres na cidade de Niterói [Lesbian marital violence: Reports of social workers attending women in the city of Niterói]. Serviço Social & Sociedade, (134), 124-141. doi: 10.1590/0101-6628.169
https://doi.org/10.1590/0101-6628.169...
).

Based on the above arguments, it is understood as extremely relevant, scientific and social, to conduct research on IPV, since studies with this approach are practically non-existent in Brazil. Thus, the aim of this study was to characterize the manifestation of violence in homosexual relationships among women based on its typology and frequency, and to analyze the possible associations between violence and the perception of social support.

Method

This is an exploratory, descriptive study with a quantitative approach.

Participants

A total of 634 women, aged between 18 and 58 years (M = 24.8; SD = 5.2), who identified themselves as lesbians and who had already had a steady or sporadic relationship with other women participated in this study. Women under 18 years old or those who did not identify themselves as lesbians did not participate in the investigation. Homosexual relationships were considered those in which women became emotionally or sexually involved with another woman, regardless of the period of this relationship, not necessarily being dating, marriage or monogamous relationship.

Instruments

Brazil Criterion: refers to a structured instrument used with the objective of measuring the socioeconomic level of the participant/family, based on the monthly income, possession of assets and level of education of other family members. The version updated by the Brazilian Association of Research Companies (ABEP, 2018Associação Brasileira de Empresas de Pesquisa. (2018). Critério de Classificação Econômica Brasil: Alterações na aplicação do Critério Brasil, válidas a partir de 16/04/2018 [Brazil Economic Classification Criteria: Modifications in the application of the Brazil Criterion, valid as of 04/16/2018]. São Paulo, SP: Author. Retrieved from https://www.abep.org/criterioBr/01_cceb_2018.pdf
https://www.abep.org/criterioBr/01_cceb_...
) was used.

Conflict Tactics Scale - Short Version (CTS): this is an instrument structured in the Likert model, which gradually measures attitudes when individuals find themselves in domestic and relationship conflicts, identifying how intimate partners behave in these situations. Thus, the higher the score, the greater the number of episodes of violence. The scale was originally developed by Straus, Hamby, Boney-McCoy and Sugarman (1996Straus, M. A., Hamby, S. L., Boney-McCoy, S., & Sugarman, D. B. (1996). The revised Conflict Tactics Scales (CTS2): Development and preliminary psychometric data. Journal of Family Issues, 17(3), 283-316. doi: 10.1177/019251396017003001
https://doi.org/10.1177/0192513960170030...
). The full version, Revised Conflict Tactics Scale (CTS2), was adapted and validated in Brazil with a kappa coefficient above 0.75 for all scales, except for sexual coercion, and internal consistency ranging from 0.65 to 0.86, making it suitable for use in research in the Brazilian context (Moraes & Reichenheim, 2002Moraes, C. L., & Reichenheim, M. E. (2002). Cross-cultural measurement equivalence of the Revised Conflict Tactics Scales (CTS2) Portuguese version used to identify violence within couples. Cadernos de Saúde Pública, 18(3), 783-796. doi: 10.1590/S0102-311X2002000300022
https://doi.org/10.1590/S0102-311X200200...
). The reduced version was adapted in Brazil by the Brazilian Institute of Geography and Statistics and the National School of Statistical Sciences in 1999. In this study, the short version of the instrument was chosen, due to its extension and aiming to reduce eventual dropouts by the participants. The short version consists of 10 items that are subdivided into the following dimensions: (a) no violence; (b) verbal/emotional violence; (c) physical violence; and (d) severe physical violence.

Scale of Perceived Social Support (adult version) (EPSUS-A): it was built by Rodriguez and Cohen (1998Rodriguez, M. S., & Cohen, S. (1998). Social support. In H. S. Friedman (Ed.), Encyclopedia of mental health (Vol. 3). New York, NY: Academic Press.) and its validation in Brazil was performed by Cardoso and Baptista (2014Cardoso, H. F., & Baptista, M. N. (2014). Escala de Percepção do Suporte Social (versão adulta) - EPSUS-A: Estudo das qualidades psicométricas [Scale of Perceived Social Support (adult version) - EPSUS-A: Study of psychometric qualities]. Psico-USF, 19(3), 499-510. doi: 10.1590/1413-82712014019003012
https://doi.org/10.1590/1413-82712014019...
), with satisfactory levels of reliability (α = 0. 94). The Brazilian version is composed of 36 items, divided into 4 dimensions: (i) affective - items that involve emotional support in which the individual is able to identify and rely on; (ii) social interaction - items in which the individual is able to perceive possible available links, such as social activities or those aimed at leisure; (iii) instrumental, perception of material support, such as financial or health assistance; and (iv) coping with problems, perception of advice and help in individual decision-making. The purpose of this scale is to functionally assess social support, that is, to analyze what supports are available and how satisfied respondents are with their network (Cardoso & Baptista, 2014Cardoso, H. F., & Baptista, M. N. (2014). Escala de Percepção do Suporte Social (versão adulta) - EPSUS-A: Estudo das qualidades psicométricas [Scale of Perceived Social Support (adult version) - EPSUS-A: Study of psychometric qualities]. Psico-USF, 19(3), 499-510. doi: 10.1590/1413-82712014019003012
https://doi.org/10.1590/1413-82712014019...
). Like the CTS, the EPSUS-Ais structured in a Likert model, so that the higher the score, the greater the respondent’s perceived social support.

Procedures

Data collection. Participants were recruited online, through social networks and through the snowball sampling technique. The questionnaires used were adapted so that the application could take place on the Google Forms platform. Calls were made on social networks and in groups already formed in other digital media, asking potential participants to express interest. Given the research questions and the possibility of non-adherence of the participants due to a possible identification, it was not asked about the city or state of origin. Thus, given the reach of the social networks whose link was disclosed, the sample is composed of women from all over Brazil. When contacting, the researcher explained the purpose of the investigation and how the data collection would take place. By reading and digitally signing the Informed Consent Form, they accessed the instruments that were used.

Data analysis. Latent Class Analysis (LCA) was used to identify groups of people, using as input variables Violence suffered by Intimate Partners (three dichotomized items referring to the dimensions Psychological Violence, Physical Violence and Attempt against Life, with 1 being the indication of the presence of at least one episode of violence and 0 the absence) and the Perception of Social Support (four dichotomous items referring to the Affective, Problem Coping, Instrumental and Social Interactions dimensions, with 1 being indicative of a high score and 0 for a moderate or low score, using the instrument’s norms as a reference).

The LCA was performed with the poLCA statistical package implemented in the R 4.0.3 statistical software. First, a three-class model was generated and its parameters were estimated. Then, new models were generated, increasing a class at each stage until the new model did not present any theoretical or statistical advantage over the previous models. In total, potentially relevant models containing 3 to 7 classes were identified. The statistical criteria to identify the model with the best fit were the Bayesian Information Criterion (BIC) and the Akaike Information Criterion (AIC). Visual and tabular representations were also used to identify the conceptual fit of each model, prioritizing the model with greater parsimony and interpretability, in order to avoid estimating more parameters than necessary to accurately represent the data.

To validate the heterogeneity between the groups, the total score on the Perceived Social Support Scale (EPSUS-A) and the frequency of violence suffered within the intimate relationship (CTS, considering all types of violence) were compared using models of latent class regression (Hagenaars & McCutcheon, 2002Hagenaars, J. A., & McCutcheon, A. L. (2002). Applied latent class analysis. Cambridge, United Kingdom: Cambridge University Press.). Sociodemographic variables (color/race and socioeconomic classification) were also included in the regression models to measure differences between classes/groupings in these dimensions.

Specifically, we sought to identify internally homogeneous (intragroup) and externally heterogeneous (intergroup) groups in relation to possible combinations of responses for these two constructs: (1) Victimization by Intimate Partner Violence: (a) Psychological, (b) Physical and (c) Against Life; and (2) Social Support: (a) Affective, (b) Material (Instrumental), (c) in Social Activities (Social Interaction) and (d) for Coping with Problems. From the identification of different patterns (groupings) of manifestation of these two phenomena, the second specific objective was to verify demographic and social differences between these groups.

Ethical Considerations

The research strictly followed the recommendations of the National Health Council (CNS) and the research project was developed from Resolutions 466/2012 and 510/2016. The Research Ethics Committee of the Universidade Federal de Sao Carlos evaluated the proposal and issued a favorable opinion regarding the study - CAAE no. 31530720.3.0000.5504. Only women who read and signed the Informed Consent Form (ICF) participated in the research.

Results

The model with four latent classes showed the best statistical fit (AIC 3 = 3330, AIC 4 = 3293, AIC 5 = 3297, AIC 6 = 3306, AIC 7 = 3317; BIC 3 = 3419, BIC 4 = 3413, BIC 5 = 3449, BIC 6 = 3489, BIC 7 = 3530) and the best theoretical coherence. Figure 1 revealed that Class 1 (23% of the sample) is characterized by low probability of suffering IPV and high probability of PSS, indicating that it is the group of women with the healthiest relationship and with the best PSS. Class 2 (50%) also has a low prevalence of IPV, however, they have low PSS, which places them in a vulnerable condition. Class 3 (5%) consists of women who have high PSS but still suffer IPV, denoting the possibility that PSS potentially acts as a protective factor in some strata but not in others - as in this specific case. Finally, Class 4 (22%) is composed of women with high indicators of IPV in their relationships and low PSS, representing the group with the greatest vulnerability to IPV.

Figure 1
Probability of the presence of indicators of violence and perceived social support given belonging to each class. CTS = Summarized Conflict Tactics Scale (1 = victim of the indicated type of violence); EPSUS = Scale of Perceived Social Support, adult version (1 = has support in the indicated dimension).

Table 1 summarizes the main descriptive statistics for each class. Regression analysis for latent classes did not identify significant effects of the sociodemographic variables age, socioeconomic class and race/color in the identified classes. With respect to all dimensions of the EPSUS-A, as well as the total score on the scale, classes 1 and 3 had significantly higher scores than classes 2 and 4 (p < 0.001). Regarding the CTS scale, the results indicate that classes 1, 2 and 4 experienced episodes of violence in relationships at a significantly higher frequency than class 3 (p < 0.001).

Table 1
Descriptive statistics of identified classes

Discussion

The results suggest that IPV and PSS are heterogeneous phenomena and that they are not always directly related. Classes were identified whose relationship between IPV and PSS is linear and corroborates the thesis that PSS acts as protection against IPV (such as Class 1, with low IPV and high PSS, and Class 4, with high IPV and low PSS). However, the patterns identified in Classes 2 and 3 show other types of relationships that these two variables can assume. Class 2, which has low IPV and low PSS, shows that the absence of PSS does not necessarily imply IPV. And Class 3, which presents IPV even with high PSS, indicates that PSS is not always sufficient to protect women from suffering IPV, signaling the need to identify and understand other variables underlying violence in these relationships.

Classes 1 and 4 corroborate the initial hypothesis of the study. In the case of Class 4, it was confirmed that lesbians with lower PSS suffer more IPV. It can be said that this class is the most vulnerable, as low access to social support can directly interfere with the likelihood of these victims seeking help or continuing in abusive relationships. Dias et al. (2019Dias, N. G., Costa, D., Soares, J., Hatzidimitriadou, E., Ioannidi-Kapolou, E., Lindert, J., ... Fraga, S. (2019). Social support and the intimate partner violence victimization among adults from six European countries. Family Practice, 36(2), 117-124. doi: 10.1093/fampra/cmy042
https://doi.org/10.1093/fampra/cmy042...
) observed that victims of IPV seek more informal help, such as friends and family, when compared to formal help (such as health centers and police, for example). Machisa et al. (2018Machisa, M. T., Christofides, N., & Jewkes, R. (2018). Social support factors associated with psychological resilience among women survivors of intimate partner violence in Gauteng, South Africa. Global Health Action, 11(Suppl. 3), 1491114. doi: 10.1080/16549716.2018.1491114
https://doi.org/10.1080/16549716.2018.14...
) add that the perception of social support is an influencing factor for victims of IPV to seek formal help, that is, depending on how supported the victim feels, the greater the probability of being instructed to seek this type of help.

Class 1 also supports the initial hypothesis that lesbians with higher levels of PSS have a lower percentage of IPV. In this case, interpersonal relationships are more encouraging and can mobilize these women to seek more constructive relationships, which is in line with the findings of Gerino et al. (2018Gerino, E., Caldarera, A. M., Curti, L., Brustia, P., & Rollè, L. (2018). Intimate partner violence in the golden age: Systematic review of risk and protective factors. Frontiers in Psychology, 9, 1595. doi: 10.3389/fpsyg.2018.01595
https://doi.org/10.3389/fpsyg.2018.01595...
). Furthermore, this support can increase the likelihood that these women will seek help when they experience some degree of violence. Figure 1 shows that, even the participants in this class, there is a percentage of psychological violence, albeit at a lower rate. In this regard, it is noteworthy that all groups indicate a probability of psychological violence close to 50% or higher, showing that this type of violence is quite prevalent in relationships - including those considered “healthy”. Some of the behaviors considered psychological violence still receive little attention or are considered to be less serious, which may explain why it is accepted or seen as natural in many relationships (WHO, 2021World Health Organization. (2021). Violence against women prevalence estimates, 2018: Global, regional and national prevalence estimates for intimate partner violence against women and global and regional prevalence estimates for non-partner sexual violence against women. Geneva, Switzerland: Author. Retrieved from https://www.who.int/publications/i/item/9789240022256
https://www.who.int/publications/i/item/...
).

Classes 2 and 3 presented other unexpected facets of the relationship between IPV and PSS: women who obtained a low percentage for both IPV and PSS and those who obtained a high percentage of IPV, still with a high percentage of PSS, respectively. In Class 2, other protective factors appear to be at work in the situation. Self-esteem, coping strategies and personality factors may be some of the elements that are contributing to the low prevalence of IPV (Gerino et al., 2018Gerino, E., Caldarera, A. M., Curti, L., Brustia, P., & Rollè, L. (2018). Intimate partner violence in the golden age: Systematic review of risk and protective factors. Frontiers in Psychology, 9, 1595. doi: 10.3389/fpsyg.2018.01595
https://doi.org/10.3389/fpsyg.2018.01595...
). However, it is necessary to emphasize that psychological violence was present, albeit in a low percentage, when compared to other classes.

In Class 3, issues such as stigma and double closets (Topa, 2010Topa, H. (2010). No arco-íris também há roxo: Violência conjugal nas relações lésbicas [Rainbow also has purple: Marital violence in lesbian relationships]. LES Online, 2(1), 13-21. Retrieved from https://lesonlinesite.files.wordpress.com/2017/03/violenciaconjugal.pdf
https://lesonlinesite.files.wordpress.co...
) may be interfering with the results. Steele et al. (2020Steele, S. M., Everett, B. G., & Hughes, T. L. (2020). Influence of perceived femininity, masculinity, race/ethnicity, and socioeconomic status on intimate partner violence among sexual-minority women. Journal of Interpersonal Violence, 35(1-2), 453-475. doi: 10.1177/0886260516683176
https://doi.org/10.1177/0886260516683176...
) observed that factors such as the internalized stigma of being in a situation of IPV can be an important variable as to whether or not to open up to friends and family about the violence they are experiencing. The aforementioned study found that people with a high percentage of internalized stigma were less likely to ask for help and talk to their support network, regardless of the intensity of the violence suffered. In relation to lesbians and other people belonging to the LGB community, this phenomenon may be related to double closets (Topa, 2010Topa, H. (2010). No arco-íris também há roxo: Violência conjugal nas relações lésbicas [Rainbow also has purple: Marital violence in lesbian relationships]. LES Online, 2(1), 13-21. Retrieved from https://lesonlinesite.files.wordpress.com/2017/03/violenciaconjugal.pdf
https://lesonlinesite.files.wordpress.co...
). In addition to the stigma, there is the victim’s fear of the reprisal she may suffer from other people for being in a homosexual relationship.

Other variables, which were not analyzed in this study, may also be related to the findings. An important example is the stressors present in people belonging to the LGB community, such as stigma, fear of being rejected and discrimination based on sexual orientation (Steele et al., 2020Steele, S. M., Everett, B. G., & Hughes, T. L. (2020). Influence of perceived femininity, masculinity, race/ethnicity, and socioeconomic status on intimate partner violence among sexual-minority women. Journal of Interpersonal Violence, 35(1-2), 453-475. doi: 10.1177/0886260516683176
https://doi.org/10.1177/0886260516683176...
). Such stressors permeate all the aforementioned classes, both in situations with high and low percentages of IPV and PSS. But the psychosocial resources related to the regulation of stressful experiences - such as socio-emotional skills or family support - vary among people, resulting in differences in the ways in which violence in an intimate relationship is manifested (WHO, 2021World Health Organization. (2021). Violence against women prevalence estimates, 2018: Global, regional and national prevalence estimates for intimate partner violence against women and global and regional prevalence estimates for non-partner sexual violence against women. Geneva, Switzerland: Author. Retrieved from https://www.who.int/publications/i/item/9789240022256
https://www.who.int/publications/i/item/...
).

It is important to emphasize that a large part of the campaigns to combat violence are aimed at situations involving heterosexual women, which in a way configures a rejection and exclusion of homosexual relationships (Luz & Gonçalves, 2014Luz, R. R., & Gonçalves, H. S. (2014). Violência doméstica entre casais homossexuais: A violência invisível [Domestic violence among homosexual couples: The invisible violence]. Bagoas-Estudos Gays: Gêneros e Sexualidades, 8(11), 79-99. Retrieved from https://periodicos.ufrn.br/bagoas/article/view/6544
https://periodicos.ufrn.br/bagoas/articl...
). Thus, situations in which formal aid service professionals are often unprepared to take in victims of the LGB community (Gonçalves & Carvalho, 2019Gonçalves, J. A., & Carvalho, A. R. R. F. (2019). Lesbianidade e psicologia na contemporaneidade: Uma revisão sistemática [Lesbianity and psychology in contemporianity: A systematic review]. Revista Gênero, 20(1), 135-156. doi: 10.22409/rg.v20i1.38495
https://doi.org/10.22409/rg.v20i1.38495...
). Such situations can decrease the likelihood of these victims to seek formal help (Santos et al., 2019Santos, N. C. R., Freitas, R., & Ceara-Silva, G. L. (2019). Violência conjugal lésbica: Relatos de assistentes sociais que atendem mulheres na cidade de Niterói [Lesbian marital violence: Reports of social workers attending women in the city of Niterói]. Serviço Social & Sociedade, (134), 124-141. doi: 10.1590/0101-6628.169
https://doi.org/10.1590/0101-6628.169...
).

Among the consequences that women victims of IPV may face, the systematic literature review carried out by Spencer et al. (2019Spencer, C., Mallory, A. B., Cafferky, B. M., Kimmes, J. G., Beck, A. R., & Stith, S. M. (2019). Mental health factors and intimate partner violence perpetration and victimization: A meta-analysis. Psychology of Violence, 9(1), 1-17. doi: 10.1037/vio0000156
https://doi.org/10.1037/vio0000156...
) identified high levels of anxiety, depression and Post Traumatic Stress Disorder (PTSD). Ogbe et al. (2020Ogbe, E., Harmon, S., Van den Bergh, R., & Degomme, O. (2020). A systematic review of intimate partner violence interventions focused on improving social support and/mental health outcomes of survivors. PLoS One, 15(6), e0235177. doi: 10.1371/journal.pone.0235177
https://doi.org/10.1371/journal.pone.023...
) observed that a positive intervention in situations of IPV is related to increased access to social support for the victim, such as strengthening community networks and access to formal structures, for example. Even so, it is necessary that further studies are carried out seeking correlation with other variables and other constructs.

In the present study, IPV and PSS were not related to sociodemographic variables, indicating that both violence and social support are present in all social strata. However, the percentage of violence is higher in relationships between couples with low economic status, with financial independence being an important protective factor for victims (Edwards et al., 2015Edwards, K. M., Sylaska, K. M., & Neal, A. M. (2015). Intimate partner violence among sexual minority populations: A critical review of the literature and agenda for future research. Psychology of Violence, 5(2), 112-121. doi: 10.1037/a0038656
https://doi.org/10.1037/a0038656...
; Steele et al., 2020Steele, S. M., Everett, B. G., & Hughes, T. L. (2020). Influence of perceived femininity, masculinity, race/ethnicity, and socioeconomic status on intimate partner violence among sexual-minority women. Journal of Interpersonal Violence, 35(1-2), 453-475. doi: 10.1177/0886260516683176
https://doi.org/10.1177/0886260516683176...
; WHO, 2021World Health Organization. (2021). Violence against women prevalence estimates, 2018: Global, regional and national prevalence estimates for intimate partner violence against women and global and regional prevalence estimates for non-partner sexual violence against women. Geneva, Switzerland: Author. Retrieved from https://www.who.int/publications/i/item/9789240022256
https://www.who.int/publications/i/item/...
). In addition, the WHO (2021World Health Organization. (2021). Violence against women prevalence estimates, 2018: Global, regional and national prevalence estimates for intimate partner violence against women and global and regional prevalence estimates for non-partner sexual violence against women. Geneva, Switzerland: Author. Retrieved from https://www.who.int/publications/i/item/9789240022256
https://www.who.int/publications/i/item/...
) mentions that economic instability between the couple can also be a risk factor for IPV, especially in situations where there is a lot of stress and the victim’s access to the support network and means of separation from the violent partner is limited.

Regarding sociodemographic representativeness, this study has limitations to be considered. The convenience method (snowball) by which the participants were recruited may explain the low representation of black, yellow and indigenous participants and from socioeconomic classes C2 and DE. It is possible that the relationship between these variables and the classes of IPV and PSS will become visible as people from these strata are reached by future research. For example, the literature indicates that black women are more vulnerable to violence in relationships, both in heterosexual and in homosexual relationships, when compared to white women (Steele et al., 2020Steele, S. M., Everett, B. G., & Hughes, T. L. (2020). Influence of perceived femininity, masculinity, race/ethnicity, and socioeconomic status on intimate partner violence among sexual-minority women. Journal of Interpersonal Violence, 35(1-2), 453-475. doi: 10.1177/0886260516683176
https://doi.org/10.1177/0886260516683176...
). The collection carried out online reached less the lower economic classes, possibly because the shares have taken place in similar social circles, such as people with higher education, access to electronic devices and the internet. In this sense, it is important that future research consider alternative strategies to achieve strata diversity.

This study fulfilled the objective of identifying the different shades of the relationship between Perceived Social Support and Violence in homosexual relationships among women. The finding of the four groups, which denote the diversity of patterns of manifestation of these two variables, shows the complexity and heterogeneity of the phenomenon. These findings show the importance of specializing primary and secondary prevention programs and policies, as people (and their intimate relationships) have specific functioning characteristics and needs. The present study showed that Social Support can act as an important protective factor against Violence, but it also showed that it is not always sufficient to prevent violence in relationships between women.

Thus, future research should focus on the analysis of other variables, such as the influence of improved social skills, resilience, personality characteristics, economic disparity between the couple, history of aggression in the past of the victim and the aggressor, and the victim’s level of information about violence in relationships. The inclusion of new variables relevant to the phenomenon will contribute to a better understanding of the etiology of these classes and may even contribute to the identification of new groups with different characteristics.

Finally, it is necessary to emphasize that these findings are the result of an exploratory study. Among the next steps are a confirmatory typological study, including other participants who were recruited during the same period and who responded to the same instruments, and another qualitative study that will broaden understanding, help explain the findings and validate the typologies found.

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  • Article derived from the first author’s master’s thesis under the supervision of the second, which will be defended in 2022, in the Graduate Program in Psychology at the Universidade Federal de São Carlos (UFSCar).

Edited by

Adriana Martins Saur

Publication Dates

  • Publication in this collection
    28 Mar 2022
  • Date of issue
    2022

History

  • Received
    03 Sept 2021
  • Reviewed
    19 Oct 2021
  • Accepted
    17 Nov 2021
Universidade de São Paulo, Faculdade de Filosofia Ciências e Letras de Ribeirão Preto, Programa de Pós-Graduação em Psicologia Av.Bandeirantes 3900 - Monte Alegre, 14040-901 Ribeirão Preto - São Paulo - Brasil, Tel.: (55 16) 3315-3829 - Ribeirão Preto - SP - Brazil
E-mail: paideia@usp.br