accurately predict outcome because of the influence of other intersectionalities, both within a community and a larger, national, or global scale. In particular, one major impact on the risk of intimate partner violence is the role of gender inequality and race. But, despite interventions that might seek to empower women, violence might not necessarily be reduced because of the other contextual factors involving perpetrators, norms around behavior, other inequities such as lack of education or increased substance abuse, and other structural issues. Dr. Raj also the noted the importance of moving upstream and thinking about interventions that address larger social issues such as incarceration and homelessness.

In thinking about an ecological framework within which to explore intimate partner violence, Dr. Raj also noted the importance of addressing “biology, behavior, state.” The first is the physiological or neurological processes that might be occurring at the individual level, as noted by other speakers. The second might include comorbidities such as substance abuse or risk-taking behavior. The third might include mental health. Also at the individual level, she highlighted the importance of gender equality in the context of the relationship (versus as a social norm) as a possible point of interruption. She also highlighted the importance of family norms, particularly in the context of reinforcement learning, noting how certain violent behaviors might lead to a favorable outcome and no repercussions; and in observational learning, children modeling parents’ behavior as socialization. She closed on the importance of understanding that the acceptability of violence is also transmitted through generations and across communities.

INTERRUPTING THE TRANSMISSION OF VIOLENCE

In thinking about how violence is transmitted across the ecological dimensions, through generations, and from individual to individual, speakers also examined the possibility for interruption. Dr. Ursano stated that not all interventions present themselves so readily:

But we must keep in mind that strep throat is not a penicillin deficiency and yet penicillin is a marvelous intervention for the infection of strep. Similarly perhaps the most important psychological intervention ever invented is in fact the seatbelt because the seatbelt prevents a psychiatric illness. It prevents posttraumatic stress disorder (PTSD) because people who are injured are at four times greater risk of developing PTSD. As we begin to think from mechanisms to interventions, we are going to have to take on several different lenses to be able to accomplish that.

Dr. Raj noted several interventions in her presentation designed to prevent violence specifically, but with applicability for interruption as well, as they focus on the transmission of social norms. She also noted some



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