The rationale behind the IVIQ reflects a long-standing gap in psychiatric care. International studies have repeatedly documented that people with severe mental illness experience violent victimization at rates several times higher than the general population, while a smaller but clinically meaningful proportion also report perpetrating violence. Despite this dual burden, routine psychiatric intake examinations rarely include structured questions about violence, and research instruments designed specifically for this population have been scarce. Existing tools often focus on a single direction of violence, either victimization or perpetration, or are too lengthy and burdensome for everyday clinical use. The IVIQ was developed to address both shortcomings by covering physical violence, sexual violence, and threats in a single 26-item checklist, asking separately about victimization and perpetration and about two time frames, the past twelve months and the entire lifetime.

The choice of a self-report checklist format carries both advantages and trade-offs. Structured checklists can be administered quickly, require little interviewer training, and make it easier to compare results across patients, sites, and time points. At the same time, self-reported violence is inherently sensitive material. Respondents may underreport experiences that carry shame, fear of consequences, or painful memories, and they may also interpret items differently depending on their cultural background and personal understanding of what counts as violence. The exploratory design of the present study explicitly acknowledged these limitations, positioning the IVIQ as a starting point for instrument development rather than a finished diagnostic standard.

The sample of 479 adult psychiatric inpatients and outpatients recruited at six German hospitals represents a broad cross-section of routine mental health care rather than a narrowly defined diagnostic group. This breadth matters for a screening instrument intended for routine assessment, because it provides preliminary evidence on how the tool performs across the heterogeneous mix of conditions encountered in everyday psychiatric practice. The study was prospectively registered in the German Clinical Trials Register and the WHO International Clinical Trials Registry Platform under DRKS00032041, a step that supports transparency in how the investigation was planned and conducted. Ethical approval was obtained from the ethics committees at Leipzig University, the State Chamber of Physicians of Saxony, and Ulm University, and all participants provided written informed consent before taking part.

Among the most notable descriptive findings was the pattern of prevalence across the individual items. Lifetime sexual victimization emerged as one of the most frequently reported experiences, alongside threats of violence and being pushed within the past twelve months. This pattern is consistent with a wider body of literature showing that sexual victimization is strikingly common among people with severe mental illness, often beginning early in life and frequently recurring. It also highlights that less dramatic forms of physical aggression, such as pushing, and non-physical forms, such as threats, are highly prevalent in this population and deserve attention alongside severe physical assault.

The strong floor effects observed in the IVIQ sum scores deserve careful interpretation. A floor effect means that a large proportion of respondents scored at or near the lowest possible value, indicating no or minimal reported violence involvement. In a general population sample this might suggest limited usefulness, but in a clinical screening context it is not necessarily a flaw. Most psychiatric patients, like most people in the general population, have not experienced every form of violence asked about, so low average scores are expected. The practical implication is that sum scores alone may obscure important information: a patient scoring zero overall may still have endorsed a single highly consequential item, such as recent sexual victimization. This is why the authors suggest that different scoring approaches, including both cumulative burden scores and item-level or domain-specific evaluation, may be needed to capture the full range of violence involvement.

The frequent co-occurrence of victimization and perpetration reports aligns with a well-established finding in violence research. Across many studies and populations, individuals who report being victimized are more likely to also report perpetrating violence, and vice versa. This overlap has been described in terms of bidirectional violence and reflects complex dynamics within relationships, households, and social networks. For clinical practice, the message is that asking only about victimization or only about perpetration provides an incomplete picture. A patient who discloses aggressive behavior toward others may simultaneously be experiencing violence from others, and a patient presenting primarily as a victim may also have engaged in aggression. The IVIQ’s dual coverage makes such overlap visible in a way that single-direction instruments cannot.

The low to moderate inter-item correlations observed in the descriptive analyses suggest that the individual IVIQ items capture partly distinct phenomena rather than a single uniform construct of violence. This is consistent with the conceptual rationale of the instrument, which treats physical violence, sexual violence, and threats as different forms of interpersonal harm that may have different antecedents, contexts, and consequences. For researchers, low inter-item associations mean that aggregate scores should be interpreted cautiously and that item-level or domain-level analysis may be more informative. For clinicians, it underscores that a patient’s violence history is rarely uniform and that specific forms of involvement may require specific follow-up questions and support.

Temporal stability, assessed by readministering the instrument, varied considerably across items. High-prevalence behaviors showed more consistent reporting over time, whereas low-prevalence behaviors showed lower stability. This pattern is common in self-report instruments covering rare events, because small numbers of endorsements can shift substantially between assessments by chance alone. It may also reflect genuine changes in exposure over time, recall difficulties, or differences in how respondents interpret items on repeated occasions. The finding suggests that the IVIQ may be more reliable for tracking frequently occurring forms of violence than for rare but severe events, and that repeated administration should be interpreted with this variability in mind.

One of the most consequential findings concerns the relationship between social desirability and reporting. Using the Kurzskala Soziale Erwünschtheit-Gamma, a German scale for assessing the social desirability trait, the researchers found that higher social desirability predicted lower reporting of perpetration within the past twelve months. In other words, respondents who were more inclined to present themselves in a socially favorable light were less likely to disclose having perpetrated violence. This has direct implications for how violence screening should be implemented in clinical settings. Perpetration is likely to be systematically underreported, particularly in face-to-face contexts or when patients fear legal, social, or therapeutic consequences. Sensitive framing, clear assurances of confidentiality, and possibly self-administered formats may help reduce this bias. The finding also reinforces a broader principle in violence research: self-report data on sensitive behaviors should always be interpreted as a lower bound rather than an exact count.

The authors’ call for future versions to broaden the assessment of psychological violence points to an important conceptual limitation of the current instrument. Psychological violence, including coercive control, humiliation, intimidation, and systematic isolation, is increasingly recognized as a major component of interpersonal violence with substantial mental health consequences. Yet it is notoriously difficult to measure with brief checklist items, because it often involves patterns of behavior rather than discrete incidents. Expanding the IVIQ in this direction would align it with contemporary definitions of intimate partner violence and abuse that give central weight to non-physical forms of harm.

The involvement of Vorurteilsfrei e.V., a Leipzig-based anti-stigma organization, in the research team reflects a growing recognition that violence research involving psychiatric patients must be conducted with attention to stigma and power dynamics. People with mental illness frequently report being perceived as dangerous, a stereotype that can discourage honest disclosure of either victimization or perpetration. Trauma-informed assessment practices, which the authors explicitly emphasize, involve asking about violence in a way that prioritizes safety, choice, and control for the respondent, avoids re-traumatization, and provides pathways to support when disclosure occurs. Implementing a screening tool without such safeguards risks harming the very patients it is meant to help.

For clinical practice, the exploratory findings suggest several practical takeaways. A brief structured checklist can feasibly be administered in psychiatric settings and can surface violence experiences that would otherwise remain unaddressed. Prevalence patterns in the sample confirm that threats, pushing, and sexual victimization are common enough to warrant routine inquiry. The co-occurrence of victimization and perpetration means that both directions should be assessed. Floor effects and low inter-item correlations caution against relying on a single total score. Variability in temporal stability suggests caution when interpreting change over time, particularly for rare events. And the influence of social desirability, especially on perpetration reporting, argues for sensitive implementation and for treating self-reported perpetration as a probable underestimate.

For research, the study provides a foundation on which further instrument development can build. Future work will need to refine scoring approaches, expand coverage of psychological violence, examine the tool’s performance in more narrowly defined diagnostic groups, and evaluate whether structured violence screening leads to improved clinical outcomes such as earlier identification of victimization, better-targeted safety planning, and reduced revictimization. Validation against interview-based assessments and informant reports would also help clarify the accuracy of the self-report format. As it stands, the IVIQ represents an early but meaningful step toward making violence involvement a routine, measurable dimension of psychiatric assessment rather than an invisible burden carried silently by many patients.

Subject of Research: Validation of a self-report questionnaire for assessing violence victimization and perpetration in psychiatric patients

Article Title: Assessing interpersonal violence involvement in psychiatric patients: exploratory findings on the Interpersonal Violence Questionnaire (IVIQ)

Article References: Kittelmann, P., Helmert, C., Hojka, N., Karp, J., Pouwels, M., Scheuermann, A., Steglich, J., Krumm, S., & Schomerus, G. (2026). Assessing interpersonal violence involvement in psychiatric patients: exploratory findings on the Interpersonal Violence Questionnaire (IVIQ). BMC Psychiatry, 26(1), Article 715. https://doi.org/10.1186/s12888-026-08597-7

Image Credits: AI Generated

DOI: 10.1186/s12888-026-08597-7

Keywords: interpersonal violence, psychiatric patients, IVIQ, victimization, perpetration, self-report questionnaire, severe mental illness, trauma-informed care, social desirability, psychiatric assessment, screening tools, BMC Psychiatry

The research team, led by Maria Eduarda Cini da Cunha together with Thaís de Castro Jury Arnoud and Luísa Fernanda Habigzang, set out with a deliberately broad question. Rather than asking simply whether pornography causes aggression, they wanted to map the relationships between three variables at once: pornography consumption, the perpetration and experience of sexual violence, and acceptance of rape-related beliefs. Crucially, they also wanted to know how these relationships might differ between men and women, since decades of research have shown that gender shapes both media use and attitudes toward sexual violence in profound ways.

To capture this picture, the researchers combined four instruments. A sociodemographic questionnaire recorded basic characteristics of the sample, which included 481 women and was majority heterosexual, with 436 heterosexual respondents. A dedicated questionnaire measured patterns of pornography consumption, including frequency and type of use. The Rape Myth Acceptance Scale, a widely used psychological instrument originally developed in the United States and adapted for Brazilian Portuguese, quantified agreement with statements that minimize or justify sexual violence, such as the idea that victims provoke assaults through their behavior or clothing. Finally, a questionnaire on sexual behaviors and sexual violence asked respondents directly about experiences of perpetration and victimization.

The analytical strategy is what sets this study apart from much of the existing literature. In addition to standard descriptive statistics, which summarize how common each behavior or belief is in the sample, and comparative analyses, which test for differences between groups such as men and women, the team employed network analysis. This relatively recent technique, made accessible through tools such as the qgraph software package, treats psychological variables as nodes in a network and draws connections, or edges, between those that are statistically related. Instead of asking whether one variable predicts another on average across the whole sample, network analysis reveals the local structure of associations, showing which specific variables cluster together and which serve as bridges connecting otherwise separate clusters. In psychological science, this approach has become popular precisely because attitudes and behaviors rarely operate in isolation; they form systems of mutually reinforcing elements.

The results were striking on several fronts. Descriptively, men in the sample reported higher rates of pornography consumption than women, higher acceptance of rape myths, and higher rates of perpetrating sexual violence. This pattern echoes a large international literature. Studies from Denmark, Poland, Australia, and the United States have consistently found that men consume pornography more frequently than women, and meta-analytic reviews of gender differences in sexuality have documented robust gaps in both explicit media use and attitudes supporting aggression. The Brazilian findings suggest that these international patterns hold in a Latin American context marked by deep patriarchal traditions and persistently high levels of gender-based violence, as documented by the Brazilian Public Security Forum, whose surveys show that a large share of Brazilian women report having suffered some form of violence.

The network analysis delivered the study’s central insight. Within the estimated network, the perpetration of sexual violence emerged as positively and significantly connected to both pornography consumption and rape myth acceptance. In plain terms, the people most likely to report having committed acts of sexual violence were also the people most likely to consume pornography and to endorse beliefs that excuse rape. Importantly, a network edge represents an association, not proof of causation. The analysis cannot determine whether pornography consumption leads to violence, whether violent individuals seek out more explicit material, or whether some third factor, such as adherence to traditional gender norms or hostile sexism, drives all three variables simultaneously. The authors are careful on this point, and the broader literature reflects the same ambiguity. Meta-analyses of general population studies have found small but reliable associations between pornography consumption and actual acts of sexual aggression, while other reviews, including work by Ferguson and Hartley, argue that the causal evidence remains weak and contested.

What the network approach does offer is a way of thinking about these variables as a system. Rape myths have long been understood as a psychological scaffold for sexual violence. First formalized by researcher Martha Burt in 1980, the concept describes prejudicial and false beliefs about sexual aggression that function to deny or justify male violence against women. Subsequent research has shown that people who accept rape myths are more likely to blame victims, less likely to intervene as bystanders, and, in some studies, more likely to perpetrate assault themselves. A systematic review by Yapp and Quayle confirmed a consistent association between rape myth acceptance and male-on-female sexual violence. If pornography consumption is also connected to both of these nodes, as the Brazilian network suggests, then interventions that target rape myths may simultaneously weaken the ties that bind media habits to aggressive behavior.

The content of mainstream pornography provides one plausible mechanism for these connections, and it is a mechanism the authors discuss in light of prior research. Content analyses of popular online videos have documented that aggression, particularly toward women, is common in mainstream material, and studies by researchers such as Eran Shor and Kimberley Seida have found that both the prevalence and the intensity of aggression in popular pornography have increased over time, even as viewers appear to prefer it. Other work has shown that pornography often depicts sexual scripts in which women are objectified and in which resistance is portrayed as performance rather than refusal. According to social learning accounts of media effects, repeated exposure to such scripts can shape viewers’ expectations about what normal, desirable sex looks like, potentially reinforcing beliefs that women secretly want to be coerced. The Brazilian authors cite this body of evidence while stopping short of claiming that their cross-sectional data prove such an effect.

The practical implications of the study are framed in terms of prevention. The authors argue that their results can inform interventions designed to promote sexual and reproductive health and to prevent sexual violence, and they emphasize that such programs should acknowledge how widespread pornography consumption has become rather than treating it as a fringe behavior. In Brazil, where formal sex education remains limited and politically contested, pornography often functions as a de facto source of sexual information for young people, a phenomenon researchers have described as porn as sex education. Comprehensive sexuality education that critically addresses media literacy, consent, and gender equality could, in principle, interrupt the pathway by which distorted sexual scripts harden into rape-supportive beliefs. Bystander intervention programs, which have shown promise in university settings, similarly depend on reducing rape myth acceptance to motivate action.

Like all studies, this one carries limitations that shape how its findings should be read. The sample of 993 adults was recruited in a way that may not represent the full diversity of the Brazilian population, and self-reported data on sensitive topics such as pornography use and sexual violence perpetration are vulnerable to social desirability bias, a problem well documented in the literature, particularly among religious respondents. The cross-sectional design rules out causal inference, and the authors note that the paper’s underlying data are available only by request. Yet the study’s contribution lies less in settling the causality debate than in mapping, with modern network methods, the terrain on which that debate unfolds. In a country where sexual violence remains a daily reality for thousands of women, understanding how consumption habits, cultural myths, and violent behavior connect within the same psychological network is a step toward designing interventions that reach the right targets. The Brazilian findings suggest that those targets include not only individual behavior, but the web of beliefs that makes violence thinkable in the first place.

Subject of Research: Relationships between pornography consumption, sexual violence perpetration and victimization, and rape myth acceptance in Brazilian adults

Article Title: Consumption of Pornography, Sexual Violence, and Rape-Related Beliefs in Brazilian Adults

Article References: Cunha, M. E. C. D., Arnoud, T. D. C. J., & Habigzang, L. F. (2025). Consumption of Pornography, Sexual Violence, and Rape-Related Beliefs in Brazilian Adults. Trends in Psychology. https://doi.org/10.1007/s43076-025-00508-1

Image Credits: AI Generated

DOI: 10.1007/s43076-025-00508-1

Keywords: pornography, sexual violence, rape myths, Brazil, network analysis, gender differences, rape myth acceptance, psychology, victimization, perpetration, sex education, Trends in Psychology

The analysis drew on an unusual and methodologically valuable data source. The National Health Interview Survey, the nation’s flagship household health interview, includes a follow-back component called NHIS-Teen, in which a randomly selected teenager aged 12 to 17 in each participating household answers questions directly. In the 2021-2022 cycle, 1,127 parent-teenager pairs provided usable responses, allowing the researchers to place two informants from the same family side by side on three distinct measures of bullying involvement: in-person bullying victimization, cyberbullying victimization, and bullying perpetration.

The technical challenge in such work is not simply asking two people the same question; it is quantifying how well their answers agree beyond what chance would predict. The team employed three complementary statistics. Percent agreement offers a raw measure of concordance but is inflated when the behavior in question is rare, because most pairs agree trivially by both saying no. Weighted kappa, the classic chance-corrected coefficient introduced by Landis and Koch, adjusts for chance agreement and categorizes concordance on a scale from slight to almost perfect. Prevalence-adjusted bias-adjusted kappa, or PABAK, further corrects for imbalances in how often each response category occurs and for systematic tendencies of one informant to report more or less than the other. Applying all three measures, the researchers found weighted kappa values ranging from fair to moderate for each form of bullying involvement, indicating that parents and teenagers agreed far from perfectly.

The direction of the disagreement was strikingly consistent. Across all three bullying measures, prevalence estimates built on teenager self-report exceeded those built on parent report. In other words, when a family contained a teenager who had been bullied in person, bullied online, or had bullied others, the parent was often unaware of it, and the teenager was seldom over-reporting relative to the parent. This pattern matches the authors’ hypotheses, which were grounded in prior literature showing that children and adolescents disclose victimization selectively, and that some experiences, particularly those occurring in digital spaces parents cannot observe, remain invisible to the adults in the household.

Importantly, the extent of parent-teenager concordance was not uniform across the population. The researchers used bivariate logistic regression to identify sociodemographic characteristics associated with agreement, and found that concordance of bullying involvement varied by race and Hispanic origin. This finding carries practical weight: if agreement between parent and teenager differs across groups, then surveys that rely exclusively on parent proxy report may distort prevalence comparisons between racial and ethnic groups, potentially obscuring or exaggerating real disparities in bullying exposure.

The study went beyond agreement statistics to ask a deeper question: does it matter, for research on health consequences, who reports the bullying? Bullying victimization and perpetration have been linked in previous work to anxiety, depression, and increased suicidal thoughts and behaviors, and meta-analyses have documented these associations across dozens of studies. The NHIS-Teen team fit logistic regression models relating each of the three bullying measures to health outcomes, once using parent reports and once using teenager reports. The associations pointed in the same direction regardless of who served as the informant, but the magnitude of the associations differed between the two reporting sources, contradicting the hypothesis that parent-reported associations would uniformly be stronger.

That divergence in magnitude matters for how the scientific literature is read. If estimates of the harm associated with bullying shift depending on whether a parent or the teenager supplies the exposure information, then meta-analyses that pool studies mixing informants may carry hidden heterogeneity. More fundamentally, the results suggest that parent proxy reports are not interchangeable with adolescent self-reports, even though parent reports remain common in national child health surveys, largely because young children cannot reliably self-report and because proxy reporting is cheaper and faster to collect.

Why do parents miss so much? Developmental research offers several converging explanations. Adolescents gain increasing autonomy and spend large portions of their day away from parental observation, in classrooms, hallways, buses, and increasingly in online environments where interactions leave no physical trace. Disclosure to parents is voluntary and depends on trust, on the adolescent’s appraisal of whether telling will help, and on fears of escalation or confiscation of devices. Prior studies of children, parents, and teachers, including work in school-based samples, have similarly documented only modest agreement about victimization, with children’s own reports generally capturing more episodes. The present analysis extends that picture to a nationally representative household sample, strengthening the case that the discrepancy is a broad structural feature of how bullying is observed rather than an artifact of any single school or community.

The authors emphasize that their findings do not render parent reports useless. Parent and teenager reports may capture partially overlapping but non-identical constructs: a parent’s report reflects the family’s shared awareness of the child’s social world, which is itself meaningful for intervention, while a teenager’s report reflects lived experience more directly. The concordance statistics quantify the gap between these two vantage points. Weighted kappa in the fair-to-moderate range signals that neither source can stand in for the other without information loss. The authors suggest that future work examine how parent-teenager communication shapes social and emotional health, and whether families with more open communication show higher concordance, turning agreement itself into a potential marker of family functioning.

For policymakers and survey designers, the implications are concrete. National monitoring systems that track bullying solely through parent interviews may understate prevalence and misestimate subgroup differences, weakening the evidence base for school and public health programs. Building direct adolescent self-report into surveillance, as NHIS-Teen does, offers a model: the follow-back design preserves the efficiency of the household survey while recovering the teenage perspective. As bullying increasingly migrates into digital arenas that parents rarely see, the cost of relying on parental observation alone will likely grow, and studies like this one provide the quantitative justification for listening to teenagers directly.

Subject of Research: Parent-teenager concordance in reporting bullying involvement among U.S. adolescents

Article Title: Parent- and Teenager-Reported Concordance of Bullying Involvement in a National Sample of Teenagers

Article References: Ng, A. E., Bottoms-McClain, L., Black, L. I., Zablotsky, B., Bose, J., & Blumberg, S. J. (2026). Parent- and Teenager-Reported Concordance of Bullying Involvement in a National Sample of Teenagers. Journal of Child and Family Studies. https://doi.org/10.1007/s10826-026-03331-z

Image Credits: AI Generated

DOI: 10.1007/s10826-026-03331-z

Keywords: bullying, cyberbullying, concordance, parent-report, teenager self-report, NHIS-Teen, adolescent health, victimization, perpetration, weighted kappa, Parent-, Teenager-Reported