Domestic violence

Domestic violence
Classification and external resources
An illustration from JJ Grandville's Les cent proverbes captioned "Qui aime bien châtie bien" (Who loves well, punishes well), showing a man spanking a child, and another beating his wife.
eMedicine	article/805546
MeSH	D017579

Domestic violence, also known as domestic abuse, spousal abuse, child abuse or intimate partner violence (IPV), can be broadly defined as a pattern of abusive behaviors by one or both partners in an intimate relationship such as marriage, dating, family, friends or cohabitation.^[1] Domestic violence has many forms including physical aggression (hitting, kicking, biting, shoving, restraining, slapping, throwing objects), or threats thereof; sexual abuse; emotional abuse; controlling or domineering; intimidation; stalking; passive/covert abuse (e.g., neglect); and economic deprivation.^[1] Domestic violence may or may not constitute a crime, depending on local statutes, severity and duration of specific acts, and other variables. Alcohol consumption^[2] and mental illness^[3] can be co-morbid with abuse, and present additional challenges when present alongside patterns of abuse.

Awareness, perception and documentation of domestic violence differs from country to country, and from era to era. Estimates are that only about a third of cases of domestic violence are actually reported in the United States and the United Kingdom. According to the Centers for Disease Control, domestic violence is a serious, preventable public health problem affecting more than 32 million Americans, or over 10% of the U.S. population.^[4]

History

The first attested use of the expression "domestic violence" in a modern context, meaning "spouse abuse, violence in the home" was in 1977.^[5] Violence between spouses has long been considered a serious problem. The United States has a lengthy history of legal precedent condemning spousal abuse. In 1879, law scholar Nicholas St. John Green^[6] wrote, "The cases in the American courts are uniform against the right of the husband to use any [physical] chastisement, moderate or otherwise, toward the wife, for any purpose." Green also cites the 1641 Body of Liberties of the Massachusetts Bay colonists -— one of the first legal documents in North American history —- as an early de jure condemnation of violence by either spouse.

Popular emphasis has tended to be on women as the victims of domestic violence.^[3] Many studies^[7][8] show that women suffer greater rates of injury due to domestic violence, and some studies show that women suffer higher rates of assault.^[9] Yet, other studies show that while men tend to inflict injury at higher rates, the majority of domestic violence overall is reciprocal.^[10] However, the National Institute of Justice points out that the "studies that find that women abuse men equally or even more than men abuse women are based on data compiled through the Conflict Tactics Scale (CTS), a survey tool developed in the 1970s. CTS may not be appropriate for intimate partner violence research because it does not measure control, coercion, or the motives for conflict tactics; it also leaves out sexual assault and violence by ex-spouses or partners and does not determine who initiated the violence." Moreover, "national surveys supported by NIJ, Centers for Disease Control and Prevention, and Bureau of Justice Statistics that examine more serious assaults do not support the conclusion of similar rates of male and female spousal assaults. These surveys are conducted within a safety or crime context and clearly find more partner abuse by men against women."^[11] Michael Flood and Michael Kimmel separately argue that the men's rights movement "tells the lie that domestic violence is gender-equal or gender-neutral – that men and women assault each other at equal rates and with equal effects."^[12]

Modern attention to domestic violence began in the women's movement of the 1970s, particularly within feminism and women's rights, as concern about wives being beaten by their husbands gained attention. Only since the late 1970s, and particularly in the masculism and men's movements of the 1990s, has the problem of domestic violence against men gained any significant attention. Estimates show that 248 of every 1,000 females and 76 of every 1,000 males are victims of physical assault and/or rape committed by their spouses.^[13] A 1997 report says significantly more men than women do not disclose the identity of their attacker.^[14] There is no evidence however that male victims are more likely to under-report than female victims. In fact, men tend to over-estimate their partner’s violence and under-estimate their own, while women do the reverse (Kimmel 2001, 10-11).^[15] A 2009 study showed that there was greater acceptance for abuse perpetrated by females than by males.^[16] Several studies have confirmed that women’s physical violence towards intimate male partners is often in self-defense (DeKeseredy et al. 1997^[17]; Hamberger et al. 1994^[18]; Swan & Snow 2002, 301^[19]; Muelleman & Burgess 1998, 866^[20]).

Definitions

The term "intimate partner violence" (IPV) is often used synonymously with domestic abuse/domestic violence. Family violence is a broader definition, often used to include child abuse, elder abuse, and other violent acts between family members.^[21] Wife abuse, wife beating, and battering are descriptive terms that have lost popularity recently for at least two reasons:

• Acknowledgment that many victims are not actually married to the abuser, but rather cohabiting or other arrangement.^[22]
• Abuse can take other forms than physical abuse and males are often victims of violence as well. Other forms of abuse may be constantly occurring, while physical abuse happens occasionally.

These other forms of abuse have the potential to lead to mental illness, self-harm, and even attempts at suicide.^[23][24]

Amartya Sen calculated that more than 100 million females and follow up studies showed that between 60 million and 107 million women are missing worldwide.^[25]

The U. S. Office on Violence Against Women (OVW) defines domestic violence as a "pattern of abusive behavior in any relationship that is used by one partner to gain or maintain power and control over another intimate partner". The definition adds that domestic violence "can happen to anyone regardless of race, age, sexual orientation, religion, or gender", and that it can take many forms, including physical abuse, sexual abuse, emotional, economic, and psychological abuse.^[26]

The Children and Family Court Advisory and Support Service in the United Kingdom in its "Domestic Violence Policy" uses domestic violence to refer to a range of violent and abusive behaviours, defining it as:

Patterns of behaviour characterised by the misuse of power and control by one person over another who are or have been in an intimate relationship. It can occur in mixed gender relationships and same gender relationships and has profound consequences for the lives of children, individuals, families and communities. It may be physical, sexual, emotional and/or psychological. The latter may include intimidation, harassment, damage to property, threats and financial abuse.^[27]

In Spain, the 2004 Measures of Integral Protection Measures against Gender Violence defined gender violence as a violence that is directed at women for the very fact of being women. The law acknowledges that aggressions against women have a particular incidence in the reality of Spain and that gender violence stands as the most brutal symbol of the inequality persisting in Spain. According to the law, women are considered by their attackers as lacking the basic rights of freedom, respect, and power of decision.^[28]

Spousal abuse

Spousal abuse refers to a wide spectrum of abuse. This includes physical abuse, sexual abuse, psychological or emotional abuse, economic abuse, verbal abuse and financial abuse. Perpetrators can be either male or female, as can victims, although the overwhelming majority of research data to date conclude that abuse victims are by and large female, with battered males being extremely rare.^[29]

Common misunderstandings

Most of the information today confuses spousal abuse with domestic violence, which is only part of the whole spectrum of abuse. 'Domestic violence' is a specific form of violence in which physical, psychological, or sexual abuse is perpetuated by one spouse upon another, or by both partners upon each other. The term was coined in the late 1970s once such crimes were given wider attention in society. There are separate legalities and punishments applied to such a crime as opposed to random assault or assaults of another nature (see battered woman defence and battered person syndrome).

Gender of assailant

Women are much more likely to be murdered by an intimate partner. Among the persons killed by an intimate partner, about three quarters are female, and about a quarter are male: in 1999, in the US, 1,218 women and 424 men were killed by an intimate partner, regardless of which partner started the violence and of the gender of the partner.^[30] In the US, in 2005, 1181 females and 329 males were killed by their intimate partners.^[31][32]

Dr. Martin Fiebert, from the Department of Psychology of California State University, has compiled an annotated bibliography of research relating to spousal abuse by women on men. This bibliography examines 275 scholarly investigations: 214 empirical studies and 61 reviews and/or analyses, which demonstrate that women are as physically aggressive, or more aggressive, than men in their relationships with their spouses or male partners. The aggregate sample size in the reviewed studies exceeds 365,000.^[33]

However, in a review of the research Michael Kimmel found that violence is instrumental in maintaining control and that more than 90 percent of "systematic, persistent, and injurious" violence is perpetrated by men. He points out that most of the empirical studies that Fiebert reviewed used the same empirical measure of family conflict, i.e., the Conflict Tactics Scale (CTS) as the sole measure of domestic violence and that many of the studies noted by Fiebert discussed samples composed entirely of single people younger than 30, and not married couples.^[34] Kimmel argues that among various other flaws, the CTS is particularly vulnerable to reporting bias because it depends on asking people to accurately remember and report what happened during the past year. However, men tend to under-estimate their use of violence, while women tend to over-estimate their use of violence. Simultaneously men tend to over-estimate their partners use of violence while women tend to under-estimate their partners use of violence. Thus, men will likely over-estimate their victimization, while women tend to underestimate theirs.^[35]

Similarly, the National Institute of Justice states that the studies that find that women abuse men equally or even more than men abuse women are based on data compiled through the Conflict Tactics Scale, a survey tool developed in the 1970s and which may not be appropriate for intimate partner violence research because it does not measure control, coercion, or the motives for conflict tactics; it also leaves out sexual assault and violence by ex-spouses or partners and does not determine who initiated the violence. Furthermore, the NIJ contends that national surveys supported by NIJ, the Centers for Disease Control and Prevention, and the Bureau of Justice Statistics that examine more serious assaults do not support the conclusion of similar rates of male and female spousal assaults. These surveys are conducted within a safety or crime context and clearly find more partner abuse by men against women.^[36]

Straus and Gelles found in couples reporting spousal violence, 27% of the time the man struck the first blow; the woman in 24%. The rest of the time, the violence was mutual, with both partners brawling. The results were the same even when the most severe episodes of violence were analyzed. In order to counteract claims that the reporting data was skewed, female-only surveys were conducted, asking females to self-report, and the data was the same.

The simple tally of violent acts is typically found to be similar in those studies that examine both directions, but some studies show that men's violence may be more serious. Men's violence may do more damage than women's;^[37] women are much more likely to be injured and/or hospitalized, wives are much more likely to be killed by their husbands than the reverse (59%-41% Dept of Justice study), and women in general are more likely to be killed by their spouse than by all other types of assailants combined.^[38]

Coramae Richey Mann, a researcher at the Department of Criminal Justice, Indiana University/Bloomington, found that only 59% of women jailed for spousal murder claimed self-defense and that 30% had previously been arrested for violent crimes.

Women are far more likely to use weapons in their domestic violence, whether throwing a plate or firing a gun. Women are also much more likely than men to enlist help if they wish to kill their spouse; but such multiple-offender homicides are not counted toward domestic-violence statistics.

In their study of severely violent couples, Neil Jacobson and John Gottman conclude that the frequency of violent acts is not as crucial as the impact of the violence and its function, when trying to understand spousal abuse; specifically, they state that the purpose of battering of whatever direction is to control and intimidate, rather than just to injure.^[39]

There is a whole source of new evidence to suggest that some of the research into family abuse has been politicized. Sam and Bunny Sewell, Family Resources & Research state that "However, misleading statistics are a deliberate fund raising tactic for women's shelters. The shelter movement almost never mentions scientific studies".

Classification

All forms of domestic abuse have one purpose: to gain and maintain total control over the victim. Abusers use many tactics to exert power over their spouse or partner: dominance, humiliation, isolation, threats, intimidation, denial and blame.^[40]

The form and characteristics of domestic violence and abuse may vary in other ways. Michael P. Johnson argues for three major types of intimate partner violence. The typology is supported by subsequent research and evaluation by Johnson and his colleagues,^{[41][42][43][44]} as well as independent researchers.^[45][46][47]

Distinctions need to be made regarding types of violence, motives of perpetrators, and the social and cultural context. Violence by a person against their intimate partner is often done as a way for controlling "their partner", even if this kind of violence is not the most frequent.^[48] Other types of intimate partner violence also occur, including violence between gay and lesbian couples,^[49] and by women against their male partners.^[50]

Distinctions are not based on single incidents, but rather on patterns across numerous incidents and motives of the perpetrator. Types of violence identified by Johnson:^[50][51][52]

• Common couple violence (CCV) is not connected to general control behavior, but arises in a single argument where one or both partners physically lash out at the other. Intimate terrorism is one element in a general pattern of control by one partner over the other. Intimate terrorism is more common than common couple violence, more likely to escalate over time, not as likely to be mutual, and more likely to involve serious injury.^[50][52][53]
• Intimate terrorism (IT) may also involve emotional and psychological abuse.^[54][55][56]
• Violent resistance (VR), sometimes thought of as "self-defense", is violence perpetrated by victims against their abusive partners.^{[52][57][58][59][60]}
• Mutual violent control (MVC) is rare type of intimate partner violence occurs when both partners act in a violent manner, battling for control.^[50][61]

Another type is situational couple violence, which arises out of conflicts that escalate to arguments and then to violence. It is not connected to a general pattern of control. Although it occurs less frequently in relationships and is less serious than intimate terrorism, in some cases it can be frequent and/or quite serious, even life-threatening. This is probably the most common type of intimate partner violence and dominates general surveys, student samples, and even marriage counseling samples.

Types of male batterers identified by Holtzworth-Munroe and Stuart (1994) include "family-only", which primarily fall into the CCV type, who are generally less violent and less likely to perpetrate psychological and sexual abuse. IT batterers include two types: "Generally-violent-antisocial" and "dysphoric-borderline". The first type includes men with general psychopathic and violent tendencies. The second type are men who are emotionally dependent on the relationship.^[50][60][62] Support for this typology has been found in subsequent evaluations.^[63][64]

Others, such as the US Centers for Disease Control, divide domestic violence into two types: reciprocal violence, in which both partners are violent, and non-reciprocal violence, in which one partner is violent.

Physical

Physical abuse is abuse involving contact intended to cause feelings of intimidation, pain, injury, or other physical suffering or bodily harm.

Physical abuse includes hitting, slapping, punching, choking, pushing, and other types of contact that result in physical injury to the victim. Physical abuse can also include behaviors such as denying the victim of medical care when needed, depriving the victim of sleep or other functions necessary to live, or forcing the victim to engage in drug/alcohol use against his/her will.^[65] It can also include inflicting physical injury onto other targets, such as children or pets, in order to cause psychological harm to the victim.^[66]

Sexual

Sexual abuse is common in abusive relationships: The National Coalition Against Domestic Violence reports that between one-third and one-half of all battered women are raped by their partners at least once during their relationship. Any situation in which force is used to obtain participation in unwanted, unsafe, or degrading sexual activity constitutes sexual abuse. Forced sex, even by a spouse or intimate partner with whom consensual sex has occurred, is an act of aggression and violence. Furthermore, women whose partners abuse them physically and sexually are at a higher risk of being seriously injured or killed.^[40]

Categories of sexual abuse include:

1. Use of physical force to compel a person to engage in a sexual act against his or her will, whether or not the act is completed;
2. Attempted or completed sex act involving a person who is unable to understand the nature or condition of the act, unable to decline participation, or unable to communicate unwillingness to engage in the sexual act, e.g., because of underage immaturity, illness, disability, or the influence of alcohol or other drugs, or because of intimidation or pressure; and
3. Abusive sexual contact.

Emotional

Emotional abuse (also called psychological abuse or mental abuse) can include humiliating the victim privately or publicly, controlling what the victim can and cannot do, withholding information from the victim, deliberately doing something to make the victim feel diminished or embarrassed, isolating the victim from friends and family, implicitly blackmailing the victim by harming others when the victim expresses independence or happiness, or denying the victim access to money or other basic resources and necessities.

Emotional/verbal abuse is defined as any behavior that threatens, intimidates, undermines the victim’s self-worth or self-esteem, or controls the victim’s freedom.^[67] This can include threatening the victim with injury or harm, telling the victim that they will be killed if they ever leave the relationship, and public humiliation. Constant criticism, name-calling, and making statements that damage the victim’s self-esteem are also common forms of emotional abuse. Often perpetrators will use children to engage in emotional abuse by teaching them to harshly criticize the victim as well.^[68] Emotional abuse includes conflicting actions or statements which are designed to confuse and create insecurity in the victim. These behaviors also lead the victim to question themselves, causing them to believe that they are making up the abuse or that the abuse is their fault.^[66]

Emotional abuse includes forceful efforts to isolate the victim, keeping them from contacting friends or family. This is intended to eliminate those who might try to help the victim leave the relationship and to create a lack of resources for them to rely on if they were to leave. Isolation results in damaging the victim’s sense of internal strength, leaving them feeling helpless and unable to escape from the situation.^[68] Male privilege is often used to control victims and to maintain the perpetrator’s power in the relationship (such as the concept of a man being “head” of a household or defining a woman’s role as submissive).

People who are being emotionally abused often feel as if they do not own themselves; rather, they may feel that their significant other has nearly total control over them. Women or men undergoing emotional abuse often suffer from depression, which puts them at increased risk for suicide, eating disorders, and drug and alcohol abuse.^[69]

Verbal

Verbal abuse is a form of abusive behavior involving the use of language. It is a form of profanity that can occur with or without the use of expletives.

Abusers may ignore, ridicule, disrespect, and criticize others consistently; manipulate words; purposefully humiliate; falsely accuse; manipulate people to submit to undesirable behavior; make others feel unwanted and unloved; threaten economically; place the blame and cause of the abuse on others; isolate victims from support systems; harass; demonstrate Jekyll and Hyde behaviors, either in terms of sudden rages or behavioral changes, or where there is a very different "face" shown to the outside world vs. with victim.

While oral communication is the most common form of verbal abuse, it includes abusive words in written form.

Economic

Economic abuse is when the abuser has control over the victim's money and other economic resources. In its extreme (and usual) form, this involves putting the victim on a strict "allowance", withholding money at will and forcing the victim to beg for the money until the abuser gives them some money. It is common for the victim to receive less money as the abuse continues. This also includes (but is not limited to) preventing the victim from finishing education or obtaining employment, or intentionally squandering or misusing communal resources.^[70]

Stalking

Stalking is often considered a type of psychological intimidation that causes a victim to feel a high level of fear.^[4]

Signs and symptoms

Cycle of violence

Frequently, domestic violence is used to describe specific violent and overtly abusive incidents, and legal definitions will tend to take this perspective. However, when violent and abusive behaviours happen within a relationship, the effects of those behaviours continue after these overt incidents are over. Advocates and counsellors will refer to domestic violence as a pattern of behaviours, including those listed above.

Lenore Walker presented the model of a Cycle of violence which consists of three basic phases:

Tension Building Phase

Characterized by poor communication, tension, fear of causing outbursts. During this stage the victims try to calm the abuser down, to avoid any major violent confrontations.

Violent Episode

Characterized by outbursts of violent, abusive incidents. During this stage the abuser attempts to dominate his/her partner(victim), with the use of domestic violence.

Honeymoon Phase

Characterized by affection, apology, and apparent end of violence. During this stage the abuser feels overwhelming feelings of remorse and sadness. Some abusers walk away from the situation, while others shower their victims with love and affection.

Although it is easy to see the outbursts of the Acting-out Phase as abuse, even the more pleasant behaviours of the Honeymoon Phase serve to perpetuate the abuse. See also the cycle of abuse article.

Many domestic violence advocates believe that the cycle of violence theory is limited and does not reflect the realities of many men and women experiencing domestic violence.

Cause

There are many different theories as to the causes of domestic violence. These include psychological theories that consider personality traits and mental characteristics of the perpetrator, as well as social theories which consider external factors in the perpetrator's environment, such as family structure, stress, social learning. As with many phenomena regarding human experience, no single approach appears to cover all cases.

Psychological

In general, about 80% of both court-referred and self-referred men in these domestic violence studies exhibited diagnosable psychopathology, typically personality disorders. Estimates of personality disorder in the general population would be more in the 15-20% range [...] As violence becomes more severe and chronic, the likelihood of psychopathology in these men approaches 100%."^[3] Psychological theories focus on personality traits and mental characteristics of the offender. Personality traits include sudden bursts of anger, poor impulse control, and poor self-esteem. Various theories suggest that psychopathology and other personality disorders are factors, and that abuse experienced as a child leads some people to be more violent as adults. Studies have found high incidence of psychopathy among abusers.^[71][72][73]

Dutton has suggested a psychological profile of men who abuse their wives, arguing that they have borderline personalities that are developed early in life.^[74][75] Gelles suggests that psychological theories are limited, and points out that other researchers have found that only 10% (or less) fit this psychological profile. He argues that social factors are important, while personality traits, mental illness, or psychopathy are lesser factors.^[76][77][78]

Behavioral

Behavioral theories draw on the work of behavior analysts. Applied behavior analysis uses the basic principles of learning theory to change behavior. Behavioral theories of domestic violence focus on the use of functional assessment with the goal of reducing episodes of violence to zero rates ^[79]. This program leads to behavior therapy. Often by identifying the antecedents and consequences of violent action, the abusers can be taught self control.^[80] Recently more focus has been placed on prevention and a behavioral prevention theory.^[79]

Social theories

Looks at external factors in the offender's environment, such as family structure, stress, social learning, and includes rational choice theories.^[81]

Resource theory

Resource theory was suggested by William Goode (1971).^[82] Women who are most dependent on the spouse for economic well being (e.g. homemakers/housewives, women with handicaps, the unemployed), and are the primary caregiver to their children, fear the increased financial burden if they leave their marriage. Dependency means that they have fewer options and few resources to help them cope with or change their spouse's behavior.^[83]

Couples that share power equally experience lower incidence of conflict, and when conflict does arise, are less likely to resort to violence. If one spouse desires control and power in the relationship, the spouse may resort to abuse.^[84] This may include coercion and threats, intimidation, emotional abuse, economic abuse, isolation, making light of the situation and blaming the spouse, using children (threatening to take them away), and behaving as "master of the castle".^[85][86]

Social stress

Stress may be increased when a person is living in a family situation, with increased pressures. Social stresses, due to inadequate finances or other such problems in a family may further increase tensions.^[87] Violence is not always caused by stress, but may be one way that some people respond to stress.^[88][89] Families and couples in poverty may be more likely to experience domestic violence, due to increased stress and conflicts about finances and other aspects.^[90] Some speculate that poverty may hinder a man's ability to live up to his idea of "successful manhood", thus he fears losing honor and respect. Theory suggests that when he is unable to economically support his wife, and maintain control, he may turn to misogyny, substance abuse, and crime as ways to express masculinity.^[90]

Social learning theory

Social learning theory suggests that people learn from observing and modeling after others' behavior. With positive reinforcement, the behavior continues. If one observes violent behavior, one is more likely to imitate it. If there are no negative consequences (e. g. victim accepts the violence, with submission), then the behavior will likely continue. Often, violence is transmitted from generation to generation in a cyclical manner.^{[91][92][93][94][95]}

Power and control

In some relationships, violence is posited to arise out of a perceived need for power and control, a form of bullying and social learning of abuse.

Abusers' efforts to dominate their partners have been attributed to low self-esteem or feelings of inadequacy, unresolved childhood conflicts, the stress of poverty, hostility and resentment toward women (misogyny), hostility and resentment toward men (misandry), personality disorders, genetic tendencies and sociocultural influences, among other possible causative factors. Most authorities seem to agree that abusive personalities result from a combination of several factors, to varying degrees.

A causalist view of domestic violence is that it is a strategy to gain or maintain power and control over the victim. This view is in alignment with Bancroft's "cost-benefit" theory that abuse rewards the perpetrator in ways other than, or in addition to, simply exercising power over his or her target(s). He cites evidence in support of his argument that, in most cases, abusers are quite capable of exercising control over themselves, but choose not to do so for various reasons.^[96]

An alternative view is that abuse arises from powerlessness and externalizing/projecting this and attempting to exercise control of the victim. It is an attempt to 'gain or maintain power and control over the victim' but even in achieving this it cannot resolve the powerlessness driving it. Such behaviours have addictive aspects leading to a cycle of abuse or violence. Mutual cycles develop when each party attempts to resolve their own powerlessness in attempting to assert control.

Questions of power and control are integral to the widely utilized Duluth Domestic Abuse Intervention Project. They developed "Power and Control Wheel" to illustrate this: it has power and control at the center, surrounded by spokes (techniques used), the titles of which include:Coercion and threats, Intimidation, Emotional abuse, Isolation, Minimizing, denying and blaming, Using children, Economic abuse, Male privilege.

The model attempts to address abuse by one-sidedly challenging the misuse of power by the 'perpetrator'.

The power wheel model is not intended to assign personal responsibility, enhance respect for mutual purpose or assist victims and perpetrators in resolving their differences. It is an informational tool designed to help individuals understand the dynamics of power operating in abusive situations and identify various methods of abuse.

Critics of this model suggest that the one-sided focus, which presumes men are to blame for all domestic violence, is problematic.

Mental illness

Psychiatric disorders are sometimes associated with domestic violence, like Borderline personality disorder, Antisocial personality disorder, Bipolar disorder, Schizophrenia, Drug abuse and Alcoholism. In past medical knowledge, untreated Attention Deficit Hyperactive Disorder and Conduct disorders in childhood was associated with domestic violence in adulthood.

Gender aspects of abuse

The role of gender is a controversial topic related to the discussion of domestic violence.

Among the persons killed by an intimate partner, about three quarters are female, and about a quarter are male: in 1999, in the US, 1,218 women and 424 men were killed by an intimate partner, regardless of which partner started the violence and of the gender of the partner.^[30] In the US, in 2005, 1181 females and 329 males were killed by their intimate partners.^{[31] [32]}

The UN Declaration on the Elimination of Violence against Women (1993) states that “violence against women is a manifestation of historically unequal power relations between men and women, which have led to domination over and discrimination against women by men and to the prevention of the full advancement of women, and that violence against women is one of the crucial social mechanisms by which women are forced into a subordinate position compared with men.”^[97][98]

Erin Pizzey, the founder of an early women's shelter in Chiswick, London, has expressed her dismay at how domestic abuse has become a gender-political football, and expressed an unpopular view in her book Prone to Violence that roughly two-thirds of women in the refuge system had a predisposition to seek abusive relationships, and to inflict violence. Pizzey also expressed the view that domestic violence can occur against any vulnerable intimates, regardless of their gender.

A Freudian concept, repetition compulsion, has been cited as a possible cause of a woman who was abused in childhood seeking an abusive man (or vice versa), theoretically as a misguided way to "master" their traumatic experience.^[99]

There continues to be discussion about whether men or women are more abusive, whether women's abuse of men or men's abuse of women is typically more severe, and whether abused men should be provided the same resources and shelters that exist for women victims^[100] sekä Carney (2007)^[101]

A problem in conducting studies that seek to describe violence in terms of gender is the amount of silence, fear and shame that results from abuse within families and relationships. Another is that abusive patterns can tend to seem normal to those who have lived in them for a length of time. Similarly, subtle forms of abuse can be quite transparent even as they set the stage for further abuse seeming normal. Finally, inconsistent definition of what domestic violence is makes definite conclusions difficult to reach when compiling the available studies.^[102]

Martin S. Fiebert of the Department of Psychology at California State University, Long Beach, provides an annotated bibliography of over two hundred scholarly works which demonstrate that women and men often exhibit comparable levels of IPV violence.^[103] In a Los Angeles Times article about male victims of domestic violence, Fiebert suggests that "...consensus in the field is that women are as likely as men to strike their partner but that—as expected—women are more likely to be injured than men."^[104] However, he noted, men are seriously injured in 38% of the cases in which "extreme aggression" is used. Fiebert additionally noted that his work was not meant to minimize the serious effects of men who abuse women.

In a Meta-analysis, John Archer, Ph. D., from the Department of Psychology, University of Central Lancashire, UK, writes:

The present analyses indicate that men are among those who are likely to be on the receiving end of acts of physical aggression. The extent to which this involves mutual combat or the male equivalent to “battered women” is at present unresolved. Both situations are causes for concern. Straus (1997) has warned of the dangers involved—especially for women—when physical aggression becomes a routine response to relationship conflict. “Battered men”—those subjected to systematic and prolonged violence—are likely to suffer physical and psychological consequences, together with specific problems associated with a lack of recognition of their plight (George and George, 1998). Seeking to address these problems need not detract from continuing to address the problem of “battered women."^[105]

Donald G. Dutton and Tonia L. Nicholls, from the Department of Psychology at the University of British Columbia also undertook a meta-analysis of data in 2005. They concluded:

Clearly, shelter houses full of battered women demonstrate the need for their continued existence. Moreover, outside of North American and Northern Europe, gender inequality is still the norm (Archer, in press). However, within those countries that have been most progressive about women’s equality, female violence has increased as male violence has decreased (Archer, in press). There is not one solution for every domestically violent situation; some require incarceration of a terrorist perpetrator, others can be dealt with through court-mandated treatment, still others may benefit from couples therapy. However, feminist inspired intervention standards that preclude therapists in many states from doing effective therapy with male batterers are one outcome of this paradigm. The failure to recognize female threat to husbands, female partners, or children is another (Straus et al., 1980 found 10% higher rates of child abuse reported by mothers than by fathers).
The one size fits all policy driven by a simplistic notion that intimate violence is a recapitulation of class war does not most effectively deal with this serious problem or represent the variety of spousal violence patterns revealed by research. At some point, one has to ask whether feminists are more interested in diminishing violence within a population or promoting a political ideology. If they are interested in diminishing violence, it should be diminished for all members of a population and by the most effective and utilitarian means possible. This would mean an intervention/treatment approach based on other successful approaches from criminology and psychology.^[100]

Theories that women are as violent as men have been dubbed "Gender Symmetry" theories.^{[8][106][107][108][109]} On the other hand, Michael Kimmel of the State University of New York at Stony Brook found that men are more violent inside and outside of the home than women.^[110]

Both men and women have been arrested and convicted of assaulting their partners in both heterosexual and homosexual relationships. The bulk of these arrests have been men being arrested for assaulting women. However, in the case of reciprocal violence, frequently only the male perpetrator is arrested.^[111] Determining how many instances of domestic violence actually involve male victims is difficult. Male domestic violence victims may be reluctant to get help for a number of reasons.^[102] Another study has demonstrated a high degree of acceptance by women of aggression against men.^[112]

Murders of female intimate partners by men have dropped, but not nearly as dramatically.^[113] Men kill their female intimate partners at about four times the rate that women kill their male intimate partners. Research by Jacquelyn Campbell, PhD RN FAAN has found that at least two thirds of women killed by their intimate partners were battered by those men prior to the murder. She also found that when males are killed by female intimates, the women in those relationships had been abused by their male partner about 75% of the time. (See battered person syndrome and battered woman defense.)

Some researchers have found a relationship between the availability of domestic violence services, improved laws and enforcement regarding domestic violence and increased access to divorce, and higher earnings for women with declines in intimate partner homicide.^[114] However, both men and women are far less likely to be abused when married to each other. The bulk of injuries from domestic violence involves co-habitation or the distresses of relationship break-ups.

Gender roles and expectations can and do play a role in abusive situations, and exploring these roles and expectations can be helpful in addressing abusive situations, as do factors like race, class, religion, sexuality and philosophy. None of these factors cause one to abuse or another to be abused.

In 1997, the Canadian Advertising Foundation ruled that a national ad campaign that featured Nicole Brown Simpson's sister Denise with the slogan "Stop violence against women" was in fact portraying only men as aggressors, that it was not providing a balanced message and was, in fact, contributing to gender stereotyping. (The murder of Nicole Simpson also included the murder of Ronald Goldman.)^[115]

Domestic violence in same-sex relationships

Domestic violence also occurs in same-sex relationships. In an effort to be more inclusive, many organizations have made an effort to use gender-neutral terms when referring to perpetratorship and victimhood.

Historically domestic violence has been seen as a family issue and little interest has been directed at violence in same-sex relationships. It has not been until recently, as the gay rights movement has brought the issues of gay and lesbian people into public attention, when research has been conducted on same-sex relationships. A 1999 analysis of nineteen studies of partner abuse concluded that "[r]esearch suggests that lesbians and gay men are just as likely to abuse their partners as heterosexual men,"^[116] although the study also noted the uncertain nature of much of the contemporary research in the area. Gays and lesbians, however, face special obstacles in dealing with the issues that some researchers have labeled "the double closet". A recent Canadian study by Mark W. Lehman^[117] suggests similarities include frequency (approximately one in every four couples); manifestations (emotional, physical, financial, etc.); co-existent situations (unemployment, substance abuse, low self-esteem); victims' reactions (fear, feelings of helplessness, hypervigilance); and reasons for staying (love, can work it out, things will change, denial). At the same time, significant differences, unique issues and deceptive myths are typically present. Lehman points to added discrimination and fear gays and lesbians can face; dismissal by police and some social services; a lack of support from peers who would rather keep quiet about the problem in order not to attract negative attention toward the gay community; the impacts of HIV status or AIDS in keeping partners together, due to health care insurance/access, or guilt; outing used as a weapon; and encountering supportive services that are targeted and/or structured for the needs of heterosexual women and which may not meet the needs of gay men or lesbians.

Diagnosis

The American Psychiatric Association planning and research committees for the forthcoming DSM-5 (2012) have canvassed a series of new Relational disorders which include Marital Conflict Disorder Without Violence or Marital Abuse Disorder (Marital Conflict Disorder With Violence).^[118] Couples with marital disorders sometimes come to clinical attention because the couple recognize long-standing dissatisfaction with their marriage and come to the clinician on their own initiative or are referred by an astute health care professional. Secondly, there is serious violence in the marriage which is -"usually the husband battering the wife".^[119]

In these cases the emergency room or a legal authority often is the first to notify the clinician. Most importantly, marital violence "is a major risk factor for serious injury and even death and women in violent marriages are at much greater risk of being seriously injured or killed (National Advisory Council on Violence Against Women 2000)."^[120] The authors of this study add that "There is current considerable controversy over whether male-to-female marital violence is best regarded as a reflection of male psychopathology and control or whether there is an empirical base and clinical utility for conceptualizing these patterns as relational."^[120]

Recommendations for clinicians making a diagnosis of Marital Relational Disorder should include the assessment of actual or "potential" male violence as regularly as they assess the potential for suicide in depressed patients. Further, "clinicians should not relax their vigilance after a battered wife leaves her husband, because some data suggest that the period immediately following a marital separation is the period of greatest risk for the women. Many men will stalk and batter their wives in an effort to get them to return or punish them for leaving. Initial assessments of the potential for violence in a marriage can be supplemented by standardized interviews and questionnaires, which have been reliable and valid aids in exploring marital violence more systematically."^[120]

The authors conclude with what they call "very recent information"^[121] on the course of violent marriages which suggests that "over time a husband's battering may abate somewhat, but perhaps because he has successfully intimidated his wife. The risk of violence remains strong in a marriage in which it has been a feature in the past. Thus, treatment is essential here; the clinician cannot just wait and watch."^[121] The most urgent clinical priority is the protection of the wife because she is the one most frequently at risk, and clinicians must be aware that supporting assertiveness by a battered wife may lead to more beatings or even death.^[121]

Victim responses

Long-term effects

Domestic violence can trigger many different responses in victims, all of which are very relevant for any professional working with a victim. Major consequences of domestic violence victimization include psychological/mental health issues and chronic physical health problems. A victim’s overwhelming lack of resources can lead to homelessness and poverty.

Immediate effects

Physical

Bruises, broken bones, head injuries, lacerations, and internal bleeding are some of the acute effects of a domestic violence incident that require medical attention and hospitalization. Jones, R; Horan (1997). "The American college of obstetricians and gynecologists: A decade of responding to violence against women". International Journal of Gynecology and Obstetrics 58 (1): 43–50. doi:10.1016/S0020-7292(97)02863-4. PMID 9253665. </ref> Some chronic health conditions that have been linked to victims of domestic violence are arthritis, irritable bowel syndrome, chronic pain, pelvic pain, ulcers, and migraines. Berrios, D; Grady (1991). "Domestic violence: risk factors and outcomes". Western Journal of Medicine 17: 133–142. </ref> Victims who are pregnant during a domestic violence relationship experience greater risk of miscarriage, pre-term labor, and injury to or death of the fetus. Jones, R; Horan (1997). "The American college of obstetricians and gynecologists: A decade of responding to violence against women". International Journal of Gynecology and Obstetrics 58 (1): 43–50. doi:10.1016/S0020-7292(97)02863-4. PMID 9253665. </ref>

Psychological

Among victims who are still living with their perpetrators, high amounts of stress, fear, and anxiety are commonly reported. Depression is also common, as victims are made to feel guilty for ‘provoking’ the abuse and are constantly subjected to intense criticism. It is reported that 60% of victims meet the diagnostic criteria for depression, either during or after termination of the relationship, and have a greatly increased risk of suicidality.^[122] In addition to depression, victims of domestic violence also commonly experience long-term anxiety and panic, and are likely to meet the diagnostic criteria for Generalized Anxiety Disorder and Panic Disorder. The most commonly referenced psychological effect of domestic violence is Post-Traumatic Stress Disorder (PTSD). PTSD (as experienced by victims) is characterized by flashbacks, intrusive images, exaggerated startle response, nightmares, and avoidance of triggers that are associated with the abuse.^[123] These symptoms are generally experienced for a long span of time after the victim has left the dangerous situation. Many researchers state that PTSD is possibly the best diagnosis for those suffering from psychological effects of domestic violence, as it accounts for the variety of symptoms commonly experienced by victims of trauma.

Financial

Once victims leave their perpetrator, they can be stunned with the reality of the extent to which the abuse has taken away their autonomy. Due to economic abuse and isolation, the victim usually has very little money of their own and few people on whom they can rely when seeking help. This has been shown to be one of the greatest obstacles facing victims of DV, and the strongest factor that can discourage them from leaving their perpetrators. ^[124] In addition to lacking financial resources, victims of DV often lack specialized skills, education, and training that are necessary to find gainful employment, and also may have several children to support. In 2003, thirty-six major US cities cited DV as one of the primary causes of homelessness in their areas.^[125] It has also been reported that one out of every three homeless women are homeless due to having left a DV relationship. If a victim is able to secure rental housing, it is likely that her apartment complex will have “zero tolerance” policies for crime; these policies can cause them to face eviction even if they are the victim (not the perpetrator) of violence.^[125] While the number of shelters and community resources available to DV victims has grown tremendously, these agencies often have few employees and hundreds of victims seeking assistance which causes many victims to remain without the assistance they need.^[124]

Management

The response to domestic violence is typically a combined effort between law enforcement, social services, and health care. The role of each has evolved as domestic violence has been brought more into public view.

Domestic violence historically has been viewed as a private family matter that need not involve the government or criminal justice.^[126] Police officers were often reluctant to intervene by making an arrest, and often chose instead to simply counsel the couple and/or ask one of the parties to leave the residence for a period of time. The courts were reluctant to impose any significant sanctions on those convicted of domestic violence, largely because it was viewed as a misdemeanor offense.

Medical response

Medical professionals can make a difference in the lives of those who experience abuse. Many cases of spousal abuse are handled solely by physicians and do not involve the police. Sometimes cases of domestic violence are brought into the emergency room,^[127] while many other cases are handled by family physician or other primary care provider.^[128]

Medical professionals are in position to empower people, give advice, and refer them to appropriate services. The health care professional has not always met this role, with uneven quality of care, and in some cases misunderstandings about domestic violence.^[129]

Washaw (1993) suggests that many doctors prefer not to get involved in people's "private" lives. Clifton, Jacobs, and Tulloch (1996) found that training for general practitioners in the United States about domestic violence was very limited or they had no training. Abbott and Williamson found that knowledge and understanding of domestic violence was very limited among health care professionals in a Midlands, United Kingdom county, and that they don't see themselves as being able to play a major role in helping women in regards to domestic violence.^[129] Furthermore, in the biomedical model of health care, injuries are often just treated and diagnosed, without regard for the causes.^[130] As well, there is substantial reluctance for victims to come forward and broach the issue with their physicians.^[131] On average, women experience 35 incidents of domestic violence before seeking treatment.^[132]

In the U. S., the Institute of Medicine recognized the shortcomings of the health care system in its 2002 report entitled Confronting Chronic Neglect and attributed some of the problems cited to a lack of adequate training among health professionals.^[133] Health professionals have an ethical responsibility to recognize and address exposure to abuse in their patients, in the health care setting. For example, the American Medical Association's code of medical ethics states that "Due to the prevalence and medical consequences of family violence, physicians should routinely inquire about physical, sexual, and psychological abuse as part of the medical history. Physicians must also consider abuse in the differential diagnosis for a number of medical complaints, particularly when treating women." ^[134]

Duluth model

In 1981, the Duluth Domestic Abuse Intervention Project became the first multi-disciplinary program designed to address the issue of domestic violence. This experiment, conducted in Duluth, Minnesota, frequently referred to as the "Duluth Project."

It coordinated agencies dealing with domestic situations, drawing together diverse elements of the system, from police officers on the street, to shelters for battered women and probation officers supervising offenders.

This program has become a model for other jurisdictions seeking to deal more effectively with domestic violence. Corrections/probation agencies in many areas are supervising domestic violence offenders more closely, and are also paying closer attention to the victim's needs and safety issues.

There has been controversy as the Duluth framework depends on a strict "patriarchal violence" model and presumes that all violence in the home and elsewhere has a male perpetrator and female victim. Also evidence of success of the model is limited, with scholarly analysis and critique.

Many victims leave their abusers, only to return. Research has shown that a major factor in helping a victim to establish lasting independence from the abusive partner is her or his ability to get legal assistance. Economists at the Brennan Center for Justice analyzed Bureau of Justice Statistics data to determine what accounted for the nationwide reduction in reported abuse. Their findings revealed that one significant factor was the availability of legal services to assist abuse victims. Another major study by economists at Colgate University and the University of Arkansas flatly stated that the only public service that reduces domestic violence in the long term is legal aid. Legal assistance can provide essential safety planning, buttress a family’s economic position through child or spousal support, allay fears planted by the batterer about loss of custody, and help victims to secure needed government benefits.

Law enforcement

In the 1970s, it was widely believed that domestic disturbance calls were the most dangerous type for responding officers, who arrive to a highly emotionally charged situation. This belief was based on FBI statistics which turned out to be flawed, in that they grouped all types of disturbances together with domestic disturbances, such as brawls at a bar. Subsequent statistics and analysis have shown this belief to be false.^[135][136]

Statistics on incidents of domestic violence, published in the late 1970s, helped raise public awareness of the problem and increase activism.^[126][137] A study published in 1976 by the Police Foundation found that the police had intervened at least once in the previous two years in 85% of spouse homicides.^[138] In the late 1970s and early 1980s, feminists and battered women's advocacy groups were calling on police to take domestic violence more seriously and change intervention strategies.^[139] In some instances, these groups took legal action against police departments, including in Oakland, California and New York City, to get them to make arrests in domestic violence cases.^[140] They claimed that police assigned low priority to domestic disturbance calls.^[141]

The Minneapolis Domestic Violence Experiment was a study done in 1981-1982, led by Lawrence W. Sherman, to evaluate the effectiveness of various police responses to domestic violence calls in Minneapolis, Minnesota, including sending the abuser away for eight hours, giving advice and mediation for disputes, and making an arrest. Arrest was found to be the most effective police response. The study found that arrest reduced the rate by half of re-offending against the same victim within the following six months.^[142] The results of the study received a great deal of attention from the news media, including The New York Times and prime-time news coverage on television.^[143]

Many U. S. police departments responded to the study, adopting a mandatory arrest policy for spousal violence cases with probable cause.^[144] By 2005, 23 states and the District of Columbia had enacted mandatory arrest for domestic assault, without warrant, given that the officer has probable cause and regardless of whether or not the officer witnessed the crime.^[145] The Minneapolis study also influenced policy in other countries, including New Zealand, which adopted a pro-arrest policy for domestic violence cases.^[146]

However, the study was subject of much criticism, with concerns about its methodology, as well as its conclusions.^[143] The Minneapolis study was replicated in several other cities, beginning in 1986, with some of these studies having different results; one of which being the fact that the deterrent effect observed in the Minneapolis experiment was largely localized.^[147] In the replication studies which were far more broad and methodologically sound in both size and scope, arrest seemed to help in the short run in certain cases, but those arrested experienced double the rate of violence over the course of one year.^[147]

Criminologists do not fully understand the reasons why deterrent effects do not last over time. But they suggest that abusers who are employed and have ties to the community may initially fear punishment, though many cases do not make it all the way through the criminal justice process. If the victim is uncooperative during investigation, the prosecutor may choose not to pursue the case.^[148] If the case is pursued through the criminal justice system, sometimes the resulting sentence is minor. Subsequently, any fear that the abuser has of punishment may have diminished.^[149]

Each agency and jurisdiction within the United States has its own Standard Operating Procedures (SOP) when it comes to responding and handling domestic calls. Generally, it has been accepted that if the understood victim has visible (and recent) marks of abuse, the suspect is arrested and charged with the appropriate crime. However, that is a guideline and not a rule. Like any other call, domestic abuse lies in a gray area. Law enforcement officers have several things to consider when making a warrantless arrest:

• Are there signs of physical abuse?
• Were there witnesses?
• Is it recent?
• Was the victim assaulted by the alleged suspect?
• Who is the primary aggressor?
• Could the victim be lying?
• Could the suspect be lying?

Along with protecting the victim, law enforcement officers have to ensure that the alleged abusers' rights are not violated. Many times in cases of mutual combatants, it is departmental policy that both parties be arrested and the court system can establish truth at a later date. In some areas of the nation, this mutual combatant philosophy is being replaced by the primary abuser philosophy in which case if both parties have physical injuries, the law enforcement officer determines who the primary aggressor is and only arrests that one. This philosophy started gaining momentum when different government/private agencies started researching the effects. It was found that when both parties are arrested, it had an adverse affect on the victim. The victims were less likely to call or trust law enforcement during the next incident of domestic abuse.^[150]

In Spain, the 2004 "The Organic Act on Integrated Protection Measures against Gender Violence" established Courts of "Violence against Women." Spanish Courts may allow to hear the case behind closed doors and that proceedings should not be made public, order a person accused of gender violence to leave the abode he shared with his victim, suspend the alleged perpetrator of acts of gender violence from exercising parental authority, custody or guardianship with regard to the minors he or she specifies, and may order the suspension of the right to possess weapons.^[151]

Counseling for victims

Due to the extent and prevalence of violence in relationships, counselors and therapists should assess every client for domestic violence (both experienced and perpetrated). If the clinician is seeing a couple for couple’s counseling, this assessment should be conducted with each individual privately during the initial interview, in order to increase the victim’s sense of safety in disclosing DV in the relationship.^[152] In addition to determining whether DV is present, counselors and therapists should also make the distinction between situations where battering may have been a single, isolated incident or an ongoing pattern of control. The therapist must, however, consider that domestic violence may be present even when there has been only a single physical incident as emotional/verbal, economic, and sexual abuse may be more insidious.^[152]

Another important issue in assessing clients for DV lies in differing definitions of abuse – the therapist’s definition may differ from that of the client, and paying close attention to the way the client describes their experiences is crucial in developing effective treatment plans. The therapist must determine if it is in the best interest of the client to explain that some behaviors (such as emotional abuse) are considered domestic violence, even if she did not previously consider them as such.

If it becomes apparent to the therapist that domestic violence is taking place in a client’s relationship, there are several statements the clinician can make that have been shown to be effective in rapport-building and immediate crisis intervention with clients. Firstly, it is essential that the therapist believe the victim’s story and validate their feelings. It is recommended that the therapist acknowledge them for taking a risk in disclosing this information, and assure them that any ambivalent feelings they may be having are normal. The therapist should emphasize that the abuse they have experienced is not their fault, but should keep their feelings of ambivalence in mind and refrain from blaming their partner or telling them what to do. It is unreasonable for the therapist to expect that a victim will leave their perpetrator solely because they disclosed the abuse, and the therapist should respect the victim’s autonomy and allow them to make their own decisions regarding termination of the relationship. Finally, the therapist must explore options with the client (such as emergency housing in shelters, police involvement, etc.) in order to uphold their obligation to protect the welfare of the client.^[152]

Lethality assessment

A lethality assessment is a tool that can assist in determining the best course of treatment for a client, as well as helping the client to recognize dangerous behaviors and more subtle abuse in their relationship.^[153] In a study of victims of attempted domestic violence-related homicide, only about one-half of the participants recognized that their perpetrator was capable of killing them, as many domestic violence victims minimize the true seriousness of their situation.^[154] Thus, lethality assessment is an essential first step in assessing the severity of a victim’s situation.

Safety planning

Safety planning allows the victim to plan for dangerous situations they may encounter, and is effective regardless of their decision on whether remain with their perpetrator. Safety planning usually begins with determining a course of action if another acute incident occurs in the home. The victim should be given strategies for their own safety, such as avoiding confrontations in rooms where there is only one exit and avoiding certain rooms that contain many potential weapons (such as kitchens, bathrooms, etc.).^[66] The victim can then be given a list of items that they should have available (extra money, keys, important documents) in a convenient and hidden place, so that they are able to leave the home suddenly if they need to. Safety planning can also include thinking of ‘code words’ the victim can use with children in order to have the children call the police, determining contacts the victim may have if they needs to leave the situation, and setting up a way to signal an emergency with a trusted neighbour.

Counseling for offenders

The main goal for treatment for offenders of domestic violence is to minimize the offender’s risk of future domestic violence, whether within the same relationship or a new one. Treatment for offenders should emphasize minimizing risk to the victim, and should be modified depending on the offender’s history, risk of reoffending, and criminogenic needs.^[155] The majority of offender treatment programs are 24–36 weeks in length and are conducted in a group setting with groups not exceeding 12 participants.^[156] Groups are also standardized to be gender specific (male offenders only or female offenders only). It has been demonstrated that domestic violence offenders maintain a socially acceptable façade to hide abusive behavior, and therefore accountability is the recommended focus of offender treatment programs. Anger management alone has not been shown to be effective in treating domestic violence offenders, as domestic violence is based on power and control and not on problems with regulating anger responses.^[157] Anger management is recommended as a part of an offender treatment curriculum that is based on accountability, along with topics such as recognizing abusive patterns of behavior and re-framing communication skills. Any corresponding problems should also be addressed as part of domestic violence offender treatment, such as problems with substance abuse or other mental illness.^[156]

Effects on responders

Vicarious trauma

Due to the gravity and intensity of hearing victims’ stories of abuse, professionals (police, counselors, therapists, advocates, medical professionals) are at risk themselves for secondary or vicarious trauma (VT), which causes the responder to experience trauma symptoms similar to the original victim after hearing about the victim’s experiences with abuse.^[158] Research has demonstrated that professionals who experience vicarious trauma show signs of exaggerated startle response, hypervigilance, nightmares, and intrusive thoughts although they have not experienced a trauma personally and do not qualify for a clinical diagnosis of PTSD.^[158] Researchers concluded that although clinicians have professional training and are equipped with the necessary clinical skills to assist victims of domestic violence, they may still be personally affected by the emotional impact of hearing about a victim’s traumatic experiences. Iliffe et al. found that there are several common initial responses that are found in clinicians who work with victims: loss of confidence in their ability to help the client, taking personal responsibility for ensuring the client’s safety, and remaining supportive of the client’s autonomy if they makes the decision to return to their perpetrator.^[158] It has also been shown that clinicians who work with a large number of victims may alter their former perceptions of the world, and begin to doubt the basic goodness of others. Iliffe et al. found that clinicians who work with victims tend to feel less secure in the world, become “acutely aware” of power and control issues both in society and in their own personal relationships, have difficulty trusting others, and experience an increased awareness of gender-based power differences in society.^[158]

The best way for a clinician to avoid developing VT is to engage in good self-care practices. These can include exercise, relaxation techniques, debriefing with colleagues, and seeking support from supervisors.^[158] Additionally, it is recommended that clinicians make the positive and rewarding aspects of working with domestic violence victims the primary focus of thought and energy, such as being part of the healing process or helping society as a whole. Clinicians should also continually evaluate their empathic responses to victims, in order to avoid feelings of being drawn in to the trauma that the victim experienced. It is recommended that clinicians practice good boundaries, and find a balance in expressing empathic responses to the victim while still maintaining personal detachment from their traumatic experiences.^[158]

Burnout

Vicarious trauma can lead directly to burnout, which is defined as “emotional exhaustion resulting from excessive demands on energy, strength, and personal resources in the work setting”.^[159] The physical warning signs of burnout include headaches, fatigue, lowered immune function, and irritability.^[160] A clinician experiencing burnout may begin to lose interest in the welfare of clients, be unable to empathize or feel compassion for clients, and may even begin to feel aversion toward the client.^[159] If the clinician experiencing burnout is working with victims of domestic violence, the clinician risks causing further great harm through re-victimization of the client. It should be noted, however, that vicarious trauma does not always directly lead to burnout and that burnout can occur in clinicians who work with any difficult population – not only those who work with domestic violence victims.

Other resources

Several projects have aided in filling the voids in the justice system as it pertains to the protection of people who have experienced domestic violence. One such initiative, The Hope Card Project, makes an attempt to remedy several problems through the issuance of an ID card to victims of abuse. The card is used to identify both parties in a domestic violence protection order and provides additional resources to the victim through a voucher program for services."There is no photograph on a protection order, so a photograph is a bonus, not a necessity. There are several methods used to obtain the photograph. Some jurisdictions have a photograph taken of the offender during the first hearing while both parties are present. Another method is for officers to take a photograph in the field or retrieve a booking photograph from their local jail. In a lot of cases the victim brings a photograph and it is scanned. Lastly, the new online site has some state motor vehicle department photograph databases connected for that purpose. This is the ideal method." The Hope Card Project

Prognosis

New research illustrates that there are strong associations between exposure to domestic violence and abuse in all their forms and higher rates of many chronic conditions. The strongest evidence comes from the Adverse Childhood Experiences' series of studies which show correlations between exposure to abuse or neglect and higher rates in adulthood of chronic conditions, high risk health behaviors and shortened life span.^[161] Evidence of the association between physical health and violence against women has been accumulating since the early 1990s.^[162] Moreover, it is important to consider the effect of domestic violence and its psychophysiologic sequelae on women who are mothers of infants and young children. Several studies have shown that maternal interpersonal violence-related posttraumatic stress disorder (PTSD) can, despite traumatized mother's best efforts, interfere with their child's response to the domestic violence and other traumatic events.^[163][164] Thus, practitioners and service agencies addressing the needs of domestic violence victims should assess the victim-as-parent and evaluate the safety and well-being of children in the home.

More recently work by such researchers as Corso^[165] have begun to quantify the economic impact of exposure to violence and abuse. A recent publication, Hidden Costs in Health Care: The Economic Impact of Violence and Abuse, ^[166] makes the case that such exposure represents a serious and costly public health issue that should be addressed by the health care system.

Epidemiology

Domestic violence occurs across the world, in various cultures,^[167] and affects people across society, irrespective of economic status,^[22] and gender.^[168] Family conflict studies find approximately equal rates of both verbal and physical assault by women and men in heterosexual relationships.^[168]

In the United States, according to the Bureau of Justice Statistics in 1995 women reported a six times greater rate of intimate partner violence than men.^[103][169] The National Crime Victimization Survey (NCVS) indicates that in 1998 about 876,340 violent crimes were committed in the U.S. against women by their current or former spouses, or boyfriends.^[170] However studies have found that men are much less likely to report victimization in these situations.^[168]

Fighting the prevalence of domestic violence in Kashmir has brought Hindu and Muslim activists together.^[171] Additionally, aspects of Islamic law have been criticized for promoting domestic violence^[172] One study found that half of Palestinian women have been the victims of domestic violence.^[173] 80% of women surveyed in rural Egypt said that beatings were common and often justified, particularly if the woman refused to have sex with her husband.^[174] The Human Rights Watch found that up to 90% of women in Pakistan were subject to verbal, sexual, emotional or physical abuse, within their own homes.^[175] Up to two-thirds of women in certain communities in Nigeria's Lagos State say they are victims to domestic violence.^[176]

Statistics published in 2004, show that the rate of domestic violence victimisation for Indigenous women in Australia may be 40 times the rate for non-Indigenous women.^[177]

A 2006 study showed that women in the United States commit domestic violence against men 33% more often than men do against women, and women commit severe domestic violence twice as often as men.^[178]

The rate of minor assaults by women was 78 per 1,000 couples, compared with a rate for men of 72 per 1,000. The severe assault rate was 46 per 1,000 couples for assaults by women and 50 per 1,000 for assaults by men. Neither difference is statistically significant. Since these rates are based exclusively on information provided by women respondents, the near-equality in assault rates cannot be attributed to a gender bias in reporting." ^[7] Results will vary, depending on specific wording of survey questions, how the survey is conducted, the definition of abuse or domestic violence used, the willingness or unwillingness of victims to admit that they have been abused and other factors.

One analysis found that "women are as physically aggressive or more aggressive than men in their relationships with their spouses or male partners".^[103] However, studies have shown that women are more likely to be injured. Archer's meta-analysis^[8] found that women suffer 65% of domestic violence injuries. A Canadian study showed that 7% of women and 6% of men were abused by their current or former partners, but female victims of spousal violence were more than twice as likely to be injured as male victims, three times more likely to fear for their life, twice as likely to be stalked, and twice as likely to experience more than ten incidents of violence.^[179] However, Strauss notes that Canadian studies on domestic violence have simply excluded questions that ask men about being victimized by their wives.^[7]

Some studies show that lesbian relationships have similar levels of violence as heterosexual relationships,^[180] while other studies report that lesbian relationships exhibit substantially higher rates of physical aggression.

See also

References

Further reading

• Dutton, Donald G. (2006). Rethinking Domestic Violence. Vancouver, BC, Canada: UBC Press. ISBN 0774813040. OCLC 64670496. 
• Hamel, John; Nicholls, Tonia L. (2007). Family Interventions in Domestic Violence: A Handbook of Gender-Inclusive Theory and Treatment. New York, NY: Springer Pub.. ISBN 082610245X. OCLC 70122424. 
• Hampton, Robert L.; Gullotta, Thomas P. and Ramos, Jessica M. (2006). Interpersonal Violence in the African American Community: Evidence-Based Prevention and Treatment Practices. New York, NY: Springer. ISBN 0387295976. OCLC 70200773. 
• Jackson, Nicky Ali (2007). Encyclopedia of Domestic Violence. New York, NY: Routledge. ISBN 9780415969680. OCLC 82772380. 
• McCue, Margi Laird (2008). Domestic Violence: A Reference Handbook (2nd ed.). Santa Barbara, CA: ABC-CLIO. ISBN 9781851097791. OCLC 123232304. 
• Radford, Lorraine and; Hester, Marianne (2006). Mothering through Domestic Violence. London, UK; Philadelphia, PA: Jessica Kingsley Publishers. ISBN 1843104733. OCLC 65205017. 
• Roberts, Albert R. (2007). Battered Women and their Families: Intervention Strategies and Treatment Programs (3rd ed.). New York, NY: Springer Pub.. ISBN 9780826145925. OCLC 76791906. 
• Shackelford, T. K., Goetz, A. T., Buss, D. M., Euler, H. A., & Hoier, S. (2005). When we hurt the ones we love: Predicting violence against women from men's mate retention tactics. Personal Relationships, 12, 447-463. Full text
• Shipway, Lynn (2004). Domestic violence: a handbook for health professionals. New York: Routledge. ISBN 9780415282208. http://books.google.com/?id=jMV89zMsHwMC&printsec=frontcove. 
• Wallace, Harvey (2004). Family Violence: Legal, Medical, and Social Perspectives. Allyn & Bacon. ISBN 0205418228. 
• Wilcox, Paula (2006). Surviving Domestic Violence: Gender, Poverty and Agency. Houndmills, England; New York, NY: Palgrave Macmillan. ISBN 1403941130. OCLC 62325091. 

External links

• Family violence at the Open Directory Project
• Domestic violence against women at the Open Directory Project
• Power and Control: Domestic Violence in America, a film about domestic violence; the film's web site has extensive interview excerpts and transcripts with academics, advocates, activists, survivors and others relevant to understanding domestic abuse
• RAINN. Information about the rights of spouses and how to protect oneself from spousal abuse.
• Stop Abuse For Everyone. Services for victims of domestic violence who typically fall between the cracks, such as abused men, gay and lesbian victims, the elderly, teens, and immigrants.
• Domestic Violence Against Men In Colorado. Information and research about partner violence against men.
• Family Violence Prevention Fund.
• World Health Organisation Multi-country Study on Women's Health and Domestic Violence against Women 2005
• Fundamentalism linked to intimate partner violence