A Comparison of Deaf College Students’ and Hard of Hearing College Students’ Experiences and Risk Factors of Psychological and Physical Abuse

A survey of 222 Deaf or hard of hearing college students in an upstate New York university provided a unique opportunity to explore possible differences between Deaf students’ and hard of hearing students’ experiences and risk factors of psychological and physical abuse in their intimate relationships. Previous research has indicated that Deaf and hard of hearing college students in the aggregate were significantly more likely to experience abuse than were hearing students. A comparison of Deaf students with hard of hearing students revealed that hard of hearing individuals were significantly more likely to experience physical abuse than were Deaf students but not more likely to experience psychological abuse. Findings also revealed that in most cases, traditional risk factors for partner violence (e.g., gender, race/ethnicity, living on campus) used in hearing college samples were not significant. Implications and directions for future research are discussed.


Introduction
Over the past three decades, increased attention has been paid to interpersonal violence on college campuses, yet only a limited number of empirical studies have focused on abuse among college students with disabilities, particularly students that are Deaf or hard of hearing Mason, 2010;Porter & McQuiller Williams, 2011a, 2011b. The small body of existing research on violence against persons that are Deaf and hard of hearing indicate that prevalence rates of experiencing interpersonal violence are more than doubled for Deaf and hard of hearing individuals in college samples and community populations when compared with hearing populations (Anderson, 2010;Barnett, McKee, Smith, & Pearson, 2011;Porter & McQuiller Williams, 2011a, 2011b. Despite the growing literature on the victimization experiences of Deaf and hard of hearing individuals, these investigations have not yet queried whether there are differences in experiences of physical and psychological abuse in intimate relationships between Deaf college students and hard of hearing college students. Previous research recommends the need to explore whether risk factors vary between Deaf and hard of hearing individuals and suggest that hard of hearing individuals may face a greater risk of victimization than Deaf individuals given that hard of hearing individuals are often members of mainstream culture and a Deaf subculture (Barrow, 2008). In response to this recommendation, the current study extends the literature on intimate partner violence (IPV) by providing a more comprehensive investigation of abuse by comparing the victimization experiences of Deaf and hard of hearing college students and examining whether risk factors for physical and psychological victimization vary between Deaf and hard of hearing college students.
The question about possible differences arises from the dangers inherent in aggregating groups that have similar characteristics but are not alike in many very important ways. Disaggregating Deaf and hard of hearing individuals also illustrates the importance for health professionals of avoiding a "one size fits all" approach to addressing interpersonal violence in these communities. While Deaf and hard of hearing individuals experience hearing loss, the term deaf (lower case "d") refers to individuals "that are medically incapable of hearing" and hard of hearing refers to "individuals for whom the sense of hearing, although defective, is functional with or without a hearing aid" (Barrow, 2008, pp. 9-10). The use of the capital "D" is to acknowledge the unique cultural identity 518930S GOXXX10.1177/2158244013518930SAGE OpenMcQuiller Williams and Porter  Anderson, Leigh, & Samar, 2011). Moreover, language, communication, and culture are radically dissimilar for Deaf students and for hard of hearing individuals. Individuals who identify with the Deaf culture share a common language and culture that embodies many subtle ways of communication beyond the use of ASL. For example, Deaf culture shares music, literature, plays, and other means of interaction that are by necessity dissimilar from the mainstream (Holcomb, 2013;Marschark & Spencer, 2010).
Hard of hearing individuals may or may not use ASL as their primary language and ASL may not be used at all. Hard of hearing individuals may or may not identify with Deaf culture (Kersting, 1997). Research suggests that hard of hearing college students evidence some difficulty in feelings of belonging to Deaf culture or to the mainstream, and some hard of hearing individuals have expressed that they do not feel they belong to either group-Deaf or hearing, and do not experience a culture among hard of hearing individuals (Kersting, 1997). Mainstreaming Deaf or hard of hearing students in their primary or high school education may affect individuals' ability to join either group. For example, if a hard of hearing individual is mainstreamed early in their education he or she may not learn ASL fluently, if at all, having developed other communication strategies.
Using a survey instrument with a sample of college students in the northeastern United States, the current study sought to compare two forms of dating violence, psychological and physical abuse, between Deaf college students and hard of hearing college students. The importance of examining psychological abuse with physical abuse has been noted (Raghavan, Swan, Snow, & Mazure, 2005) and previous research indicates that psychological abuse often occurs in conjunction with other forms of abuse (Aosved & Long, 2005). Psychological abuse refers to "words or actions [used] to isolate, humiliate, demean or control an intimate partner" (Rohrbaugh, 2006, p. 291). Research suggests that psychological abuse may have as great a negative impact on victims, if not greater, than physical violence (Adams, Sullivan, Bybee, & Greeson, 2008;Henning & Klesges, 2003).
Previous research has identified several risk factors for dating violence. Risk factors for dating violence are variables that are associated with its increased probability, but are not necessarily direct causes (Medeiros & Straus, 2006, p. 4). In the current study, a number of risk factors-gender, living alone, living on campus, and race/ethnicity-were included due to prior research with hearing samples that has found a relationship between these variables and victimization. Regarding gender, men and women have been found to perpetrate and experience abuse while in college. For example in a review of 15 studies examining female perpetrated physical abuse and psychological abuse among college students, in 14 of the 15 studies, rates for physical abuse ranged from 11.7% to 39% and 5 of the 15 studies reported rates of 40.4% to 89.3% for psychological abuse (Williams, Ghandour, & Kub, 2008). Recent research by Forke et al. (2008) of 910 women and men, conducted on three college campuses, found more than half of the abusive acts reported, including slapping and insulting, were perpetrated by a partner, and were more likely to be physical or emotional violence. More than half of college women and more than one fourth of college men had been victimized in their lifetime. During their college years, 10.2% of women and 2.8% of men experienced physical abuse and 16.2% of women and 5.9% of men reported experiencing psychological abuse. Cercone et al.'s (2005) study of college men and women found that women, more than men, reported committing physical assault. Other studies suggest that the rates of receiving and inflicting abuse are similar (Harned, 2001;Perry & Fromuth, 2005).
Previous research also suggests that living arrangements may be associated with victimization risk, whereby college students that live independently and off campus may be more vulnerable than those living with others and on campus (Forke et al., 2008;Lehrer, Lehrer, Lehrer, & Oyarzun, 2007). Some research also suggests that race/ethnicity may be associated with the risk of victimization, although studies are inconclusive. For example, some research has found higher rates of interpersonal violence among African Americans and Hispanic couples when compared with Whites (Caetano, Schafer, & Cunradi, 2001;Centers for Disease Control and Prevention, 2010;Eaton, Dais, Barrios, Brener, & Noonan, 2007;Howard, Qiu, & Boekeloo, 2003) while other studies have found no differences across racial/ ethnic groups (Coker et al., 2000;Field & Caetano, 2004;Temple & Freeman, 2011).

Physical and Psychological Abuse Among Deaf and Hard of Hearing College Students
There are nearly half a million Deaf people in the United States (Mitchell, Young, Bachleda, & Karchmer, 2006). In the United States, Deaf people do not see themselves as having a disability, but rather have a culture and way of communication that is denied by the dominate hearing culture (Holcomb, 2013;Sadusky & Obinna, 2002). While there is mounting evidence concerning the victimization experiences of people with disabilities Brownridge, 2009;Johnston-McCabe, Levi-Minzi, Van Hasselt, & Vanderbeek, 2011;Nannini, 2006;Powers et al., 2009), only a handful of empirical studies have addressed Deaf and hard of hearing college students' experiences with dating violence. Recent studies using college samples in the United States indicate that Deaf and hard of hearing individuals as an aggregate experience interpersonal violence at more than double the rate of hearing populations (Anderson, 2010;Porter & McQuiller Williams, 2011a, 2011b. For example, in a recent study conducted by Anderson and Leigh (2010), a significantly higher proportion of Deaf women undergraduates at a college in Washington, D.C., reported IPV victimization (i.e., physical assault and psychological aggression) than did hearing students in the previous year. Using a random sample of more than 1,000 college men and women, including more than 200 Deaf or hard of hearing students at a large U.S. northeastern university, it was found that Deaf or hard of hearing college students were twice as likely to report experiencing psychological abuse and nearly 2.5 times more likely to report experiencing physical abuse at the hands of a partner than were hearing students in the prior year (Porter & McQuiller Williams, 2011a, 2011b. Studies of IPV among Deaf or hard of hearing college students as a group at a predominantly Deaf college in Washington, D.C., found psychological abuse to be more prevalent (30%) than physical abuse (11%) in their current relationships among the Deaf or hard of hearing men and women respondents (Mason, 2010).  study of IPV during the last 12 months among 100 Deaf and hard of hearing undergraduate women students at the same university found psychological abuse to be much more prevalent (more than 90%) than physical abuse and 50% had been the victim of a physical assault.
Given the exploratory nature of this study, the research questions guiding this study are as follows: Research Question 1: Are there differences in experiences of physical and/or psychological victimization between Deaf college students and hard of hearing college students? Research Question 2: Do risk factors for physical and psychological victimization vary between Deaf and hard of hearing college students?

Data Collection
The data for this study were collected from college students at a university in upstate New York. Forty classes that were limited to Deaf and hard of hearing college students were randomly selected. After receiving approval from the Institutional Review Board at Rochester Institute of Technology (RIT), pen-and-paper questionnaires were distributed within those classes to students. A total of 222 respondents participated and the response rate was 100%.

Measures
The dependent variables for analysis were dummy variables created from a variety of questions pertaining to psychological and physical abuse. To measure psychological and physical abuse among dating partners within the past school year, a modified version of Straus, Hamby, Boney-McCoy, and Sugarman's (1996) Revised Conflict Tactics Scale (CTS2) was used to measure IPV by "a partner" over the previous school year. Use of the term partner denotes IPV may exist among heterosexual and same-sex partners. The CTS2 is a commonly used measure of IPV that measures the frequency with which respondents had experienced psychological and physical abuse from their dating partners. Three items assessed psychological abuse (e.g., insults and threats; Cronbach's α = .592). Seven items assessed physical abuse (e.g., slapping, kicking, choking, and beat up; Cronbach's α = .768). Subjects responded on a 4-point scale (never, 1-2 times, 3-10 times, more than 10 times).
Auditory status is the primary independent variable of interest. Auditory status was measured with the question: "Which best describes your auditory status?" Students were able to answer hard of hearing or Deaf. As discussed in the literature review, gender, living alone, living on campus, and race/ethnicity were included as variables due to prior research with hearing samples that has found a relationship between these variables and victimization. The victimization variables were dummy variables that indicated the presence or absence of abuse. Binary logistic regression analyses were used to examine the effect of auditory status and other variables on physical and psychological victimization. Data were analyzed using SPSS PASW Statistics 18 (SPSS, 2009).

Characteristics of the Sample
The sample of Deaf and hard of hearing students were nearly equal in gender and included 104 males (46.8%) and 118 females (53.2%). The majority of students were Deaf (n = 170, 76.6%) participants and 52 (23.4%) of the participants were hard of hearing. The majority of respondents were White (n = 152, 68.5%) with 22 African Americans (10%), 10 Hispanic/Latino(a) (4.5%), 24 Asian/Pacific Islander (10.8%), and 12 American Indian/Alaskan Native (5.4%). The sample was a little older with 96 students who were below 21 years of age with 126 students who were 21 years of age or more. Although none of the demographic indicators were statistically significant and associated with either Deaf or hard of hearing, it is interesting to note that more women were Deaf and more men were hard of hearing. Women were in the majority in the 21 years and older category for both auditory groups (Table 1).

Psychological Abuse
The most prevalent type of abuse at the hands of a partner was psychological abuse with 136 students or 61.3% of the sample reporting such abuse. Of those experiencing psychological abuse within the past year, 61.7% experienced at least one incident of abuse 1 to 2 times, while 38.3% experienced at least one incident of abuse 3 times or more. When auditory status is disaggregated, 63.5% (n = 31) of hard of hearing students and 61.6% (n = 113) of Deaf students reported experiencing psychological abuse by their partner in the past school year. Table 2 reports the binary regression results for psychological abuse using PASW Statistics 18. The binary regression analysis includes Deaf, hard of hearing, gender, race, and whether one lived on or off the college campus.
Living off campus was the only variable that was statistically significant and associated with psychological abuse in a binomial regression analysis that included Deaf or hard of hearing, residence, gender, and race. Those students who lived off campus were at a greater risk of experiencing psychological abuse than were those students who lived on campus (odds ratio [OR] = 0.604, p ≤ .087).

Physical Abuse
A significant number of Deaf and hard of hearing students experienced physical abuse by their partner in the last school year, with 88 students or 39.6% of the sample reporting such abuse. Of those experiencing physical abuse within the past year, 52.7% experienced at least one incident of abuse 1 to 2 times, while 47.3% experienced at least one incident of abuse 3 times or more. When auditory status is disaggregated, 53.8% (n = 28) hard of hearing students and 35.3% (n = 60) of Deaf students reported experiencing physical abuse by their partner in the past school year. Fifty out of 104 men reported physical abuse (48%) while 38 out of 118 women (32%) in the sample reported physical abuse. A binomial regression analysis that included gender, race, deaf or hard of hearing, and residence revealed two variables were statistically significant and associated with physical abuse (Table 3). The binomial regression found that male respondents (OR = 0.544, p ≤ .031) and hard of hearing students (OR = 1.994, p ≤ .034) were more likely to suffer physical abuse. While both groups were more at risk of physical abuse, the effect is greater for hard of hearing students. The strongest association in both analyses is for being hard of hearing and physical abuse with hard of hearing students experiencing nearly twice the risk of physical abuse than Deaf students.

Discussion
Findings from this study were consistent with existing studies that indicate that among Deaf and hard of hearing college students, physical abuse and psychological abuse are alarmingly high Porter & McQuiller Williams, 2011a, 2011b. While research on violence among college students has historically neglected the experiences of members of underrepresented groups such as Deaf and hard of hearing students, results of this study provide data on these relatively unexamined populations. The current study is unique because it is the first to disaggregate the victimization experiences of Deaf and hard of hearing students. The results of this study illustrate the importance for college health professionals and others dealing with college populations of avoiding a "one size fits all" approach to addressing dating violence. A substantially high number of hard of hearing and Deaf students reported experiencing psychological abuse, although in the current study there was not a significant difference between these groups. For the entire sample, with the exception of living off campus, no other traditional risk factors for psychological dating violence were significant. This suggests the need to investigate factors other than those relied on with hearing college samples to understand the dynamics of dating violence victimization among Deaf and hard of hearing college students.
For physical abuse, a significant difference was found between hard of hearing and Deaf students, with hard of hearing students more likely to experience such abuse. Barrow (2008) suggests that because hard of hard hearing individuals are often members of both Deaf culture mainstream (hearing) culture, this places them at a greater risk of abuse than Deaf individuals. As  acknowledges, within the dynamics of the relationships that include one hearing partner and a hard of hearing partner, there lays the potential for the hearing partner to abuse their hearing privilege. This may include the perpetrator using their hearing to manipulate the victim (not share with him or her what is being said) and/or communicating with police officers and others because they are hearing (Deaf Hope, 2006). This suggests the need for more directed research, including qualitative studies, on victimization and factors that contribute to it on college campuses.
When developing interventions to prevent incidences or to intervene in cases of relationship violence, it is important to understand that hard of hearing students may face different issues than Deaf students. Deaf students may have more of a support group than hard of hearing students via a shared Deaf culture and primary language-ASL (Kersting, 1997). Hard of hearing students may not use ASL as their primary language or at all and may not identify with or be accepted into Deaf culture (Kersting, 1997). Hard of hearing students do not view themselves as a culturally distinct group as do many of the Deaf students and may find acceptance into hearing groups difficult as well (Kersting, 1997). More knowledge is needed about the cultural assimilation and identification of hard of hearing students as well as their experiences with abuse.
Among the traditional risk factors used to examine dating violence in hearing college samples, only gender was significant, with males more likely to experience physical abuse than women. While this finding is consistent with previous research (Cercone et al., 2005), females receive far more physical injuries as a result of dating violence than do males (Straus & Ramirez, 2007). Accordingly, future research should examine the injuries sustained in violent dating situations.
Although the current study extends research on IPV in underrepresented groups, findings should be viewed with caution in light of several limitations. First, data were obtained by self-report. Thus, the possibility of deliberate response distortion must be considered. Second, present findings may not generalize beyond the particular sample. We note our sample consisted of a small number of Deaf and hard of hearing college men and women attending a midsized, private institution who may differ from other groups in their experiences of received psychological and physical abuse. The study does, however, provide evidence for future comparisons. Future studies would benefit from a multicampus approach. A study that looks at multiple universities or colleges could help in removing any biases inherent in one university or college. Additional research on partner violence among underrepresented groups is clearly warranted. Substantiation of the present findings, which indicate that partner abuse occurs with frequency among Deaf and hard of hearing college students, that hard of hearing students have significantly higher rates of physical abuse, and that most traditional risk factors for dating violence among hearing college samples are not significant when examined for Deaf and hard of hearing students, is crucial for the dissemination of educational information. When developing programs and services, college health professionals must strive for inclusivity, as well as develop targeted approaches for outreach to populations on their campuses that may be at greater risk of abuse.

Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding
The author(s) received no financial support for the research and/or authorship of this article.