Systematic Review of Interventions to Address Suicidality among People with a History of IPV

Overview: The purpose of this oral paper is to present findings from a systematic review that examines and describes interventions that address suicidality among people with a history of intimate partner violence, including common core components, intervention modalities, target population, theoretical foundations, and efficacy, as well as directions for future research.Proposal text:

Background: Suicidality, encompassing both suicidal ideation and suicide attempt(s) (Crosby et al., 2011), is a major contributor to death and disability worldwide (WHO, 2021). Research has shown a critical link between intimate partner violence (IPV) and suicidal ideation and attempts (Devries et al., 2013; Park et al., 2020). While multiple studies have examined the mechanisms that explain this association, there have been no review papers that examine interventions to address suicidality among people with a history of IPV. The purpose of this paper is to examine and describe interventions that address suicidality among people with a history of IPV, including intervention modalities, level of intervention, core components, target population, theoretical foundations, efficacy, as well as promises and gaps of current interventions.

Methods: Adhering to 2020 PRISMA guidelines, we conducted a systematic review of interventions that address suicidality among people with a history of IPV. Seven electronic databases were searched: Academic Search Premier, ERIC, CINAHL, PubMed, PsychInfo, Social Work Abstract, and Sociological Abstracts. Intervention studies were included if they reported quantitative findings related to suicidality (e.g. self-harm, suicidal thoughts, attempts, contemplation). We did not limit studies by age, global location, study design, sexual orientation, or gender.

Results: 1,389 peer-reviewed papers were identified through the search. Twenty papers met the inclusion criteria for full-text review, which yielded six relevant papers, but a total of five interventions. All five studies targeted women; one additionally included men. Three studies were randomized control trials. Sample sizes varied widely from n=42 to n=353. All but one intervention were individual level interventions; the remaining one targeted both individual and structural level factors, including employment and gender attitudes. Studies were guided by a wide range of theories such as empowerment framework, theory of triadic influence, and cognitive model of psychopathology. Studies were conducted in the United States, Spain, South Africa, and Iran. Most interventions targeted explicitly women with a history of IPV (n=4). Only three studies reported significant intervention effects on suicidality (risk, thoughts, preparation/active ideation).

Conclusions: Despite evidence that shows a link between IPV and suicidality, we found few interventions that address or measure changes in suicidality among populations with a history of IPV. Although the studies yielded through our systematic review suggested some potential promising effects, other studies found no changes. Given the wide range of sample sizes, designs, modalities, number of sessions, use of measures, theoretical foundations and content, findings from our review paper suggest the need for more robust designs, consistent use of measures, and work across more diverse populations and global locations. Additionally, this review suggests the need for more attention to suicidality as part of mental health and risk focused interventions among populations with a history of IPV. Finally, findings suggest the need to explore alternative levels of interventions – potentially developing interventions that do not solely operate on the individual level, such as focusing on the relational level with sources of social support, and other networks.