Domestic violence, also called intimate partner violence (IVP), partner abuse, and spousal abuse, is a serious, preventable public health problem that affects millions of Americans. The terms domestic violence or intimate partner violence describe physical, sexual, or psychological harm by a current or former partner or spouse. This type of violence can occur among heterosexual or same-sex couples and does not require sexual intimacy.
Domestic violence can vary in frequency and severity. It often starts with emotional abuse. This behavior can progress to physical or sexual assault, and several types of domestic violence may occur together.
Types of Domestic Violence
There are four main types of intimate partner violence (Saltzman et al. 2002):
- Physical violence is the intentional use of physical force with the potential for causing death, disability, injury, or harm. Physical violence includes, but is not limited to, scratching; pushing; shoving; throwing; grabbing; biting; choking; shaking; slapping; punching; burning; use of a weapon; and use of restraints or one's body, size, or strength against another person.
- Sexual violence is divided into three categories: 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, to decline participation, or to communicate unwillingness to engage in the sexual act, e.g., because of illness, disability, or the influence of alcohol or other drugs, or because of intimidation or pressure; and 3) abusive sexual contact.
- Threats of physical or sexual violence use words, gestures, or weapons to communicate the intent to cause death, disability, injury, or physical harm.
- Psychological/emotional violence involves trauma to the victim caused by acts, threats of acts, or coercive tactics. Psychological/emotional abuse can include, but is not limited to, humiliating the victim, 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, and denying the victim access to money or other basic resources. It is considered psychological/emotional violence when there has been prior physical or sexual violence or prior threat of physical or sexual violence. In addition, stalking is often included among the types of IPV. Stalking generally refers to "harassing or threatening behavior that an individual engages in repeatedly, such as following a person, appearing at a person's home or place of business, making harassing phone calls, leaving written messages or objects, or vandalizing a person's property" (Tjaden & Thoennes 1998).
Domestic Violence Is A Serious Public Health Problem
- Each year, women experience about 4.8 million intimate partner related physical assaults and rapes. Men are the victims of about 2.9 million intimate partner related physical assaults. (Tjaden and Thoennes 2000).
- Intimate partner abuse resulted in 2,340 deaths in 2007. Of these deaths, 70% were females and 30% were males. (Bureau of Justice Statistics 2011).
- The medical care, mental health services, and lost productivity (e.g., time away from work) cost of domestic violence was an estimated $5.8 billion in 1995. Updated to 2003 dollars, that's more than $8.3 billion. (CDC 2003; Max et al. 2004).
- Physical violence by an intimate partner has also been associated with a number of adverse health outcomes (Breiding, Black, and Ryan, 2008). Several health conditions associated with intimate partner violence may be a direct result of the physical violence (for example, bruises, knife wounds, broken bones, back or pelvic pain, headaches). Studies have also demonstrated the impact of intimate partner violence on the endocrine and immune systems through chronic stress or other mechanisms (Crofford, 2007; Leserman and Drossman, 2007) Examples include:
- Fibromyalgia
- Irritable bowel syndrome
- Gynecological disorders
- Pregnancy difficulties like low birth weight babies and perinatal deaths
- Sexually transmitted diseases including HIV/AIDS
- Central nervous system disorders
- Gastrointestinal disorders
- Heart or circulatory conditions
- Children may become injured during violent incidents between their parents. A large overlap exists between intimate partner violence and child maltreatment (Appel and Holden 1998).
- Physical violence is typically accompanied by emotional or psychological abuse (Tjaden and Thoennes 2000). IPV-whether sexual, physical, or psychological-can lead to various psychological consequences for victims (Bergen 1996; Coker et al. 2002; Heise and Garcia-Moreno 2002; Roberts, Klein, and Fisher 2003):
- Depression
- Antisocial behavior
- Suicidal behavior in females
- Anxiety
- Low self-esteem
- Inability to trust others, especially in intimate relationships
- Fear of intimacy
- Symptoms of post-traumatic stress disorder
- Emotional detachment
- Sleep disturbances
- Flashbacks
- Replaying assault in the mind
- Women with a history of intimate partner abuse are more likely to display behaviors that present further health risks (e.g., substance abuse, alcoholism, suicide attempts) than women without a history of intimate partner abuse.
- Partner abuse is associated with a variety of negative health behaviors (Heise and Garcia-Moreno 2002; Plichta 2004; Roberts, Auinger, and Klein 2005; Silverman et al. 2001). Studies show that the more severe the violence, the stronger its relationship to negative health behaviors by victims.
- Engaging in high-risk sexual behavior
- Unprotected sex
- Decreased condom use
- Early sexual initiation
- Choosing unhealthy sexual partners
- Multiple sex partners
- Trading sex for food, money, or other items
- Using harmful substances
- Smoking cigarettes
- Drinking alcohol
- Drinking alcohol and driving
- Illicit drug use
- Unhealthy diet-related behaviors
- Fasting
- Vomiting
- Abusing diet pills
- Overeating
- Overuse of health services
Risk Factors for Domestic Violence
Risk factors are associated with a greater likelihood of intimate partner violence victimization or perpetration. They are contributing factors and may or may not be direct causes. Not everyone who is identified as "at risk" becomes involved in violence.
Some risk factors for domestic violence victimization and perpetration are the same. In addition, some risk factors for victimization and perpetration are associated with one another; for example, childhood physical or sexual victimization is a risk factor for future perpetration and victimization.
A combination of individual, relational, community, and societal factors contribute to the risk of becoming a victim or perpetrator of IPV. Understanding these multilevel factors can help identify various opportunities for prevention.
Individual Risk Factors
- Low self-esteem
- Low income
- Low academic achievement
- Young age
- Aggressive or delinquent behavior as a youth
- Heavy alcohol and drug use
- Depression
- Anger and hostility
- Antisocial personality traits
- Borderline personality traits
- Prior history of being physically abusive
- Having few friends and being isolated from other people
- Unemployment
- Emotional dependence and insecurity
- Belief in strict gender roles (e.g., male dominance and aggression in relationships)
- Desire for power and control in relationships
- Perpetrating psychological aggression
- Being a victim of physical or psychological abuse (consistently one of the strongest predictors of perpetration)
- History of experiencing poor parenting as a child
- History of experiencing physical discipline as a child
Relationship Factors
- Marital conflict-fights, tension, and other struggles
- Marital instability-divorces or separations
- Dominance and control of the relationship by one partner over the other
- Economic stress
- Unhealthy family relationships and interactions
Community Factors
- Poverty and associated factors (e.g., overcrowding)
- Low social capital-lack of institutions, relationships, and norms that shape a community's social interactions
- Weak community sanctions against violence (e.g., unwillingness of neighbors to intervene in situations where they witness violence)
Societal Factors
- Traditional gender norms (e.g., women should stay at home, not enter workforce, and be submissive; men support the family and make the decisions)
Domestic Violence Prevention
The goal is to stop domestic violence before it begins. There is a lot to learn about how to prevent abuse between intimate partners. We do know that strategies that promote healthy behaviors in relationships are important. Programs that teach young people skills for dating can prevent violence. These programs can stop violence in dating relationships before it occurs.
We know less about how to prevent intimate partner abuse in adults. However, some programs that teach healthy relationship skills seem to help stop violence before it ever starts.
References
Appel AE, Holden GW. 1998 The co-occurrence of spouse and physical child abuse: a review and appraisal. J Fam Psychol 12:578-599.
Bergen RK. 1996. Wife rape: understanding the response of survivors and service providers. Thousand Oaks (CA): Sage.
Breiding MJ, Black MC, Ryan GW. 2008. Chronic disease and health risk behaviors associated with intimate partner violence - 18 U.S. states/territories, 2005. Ann Epidemiol 18:538-544.
Centers for Disease Control and Prevention (CDC). Costs of intimate partner violence against women in the United States. Atlanta (GA): CDC, National Center for Injury Prevention and Control; 2003. [cited 2006 May 22]. Available from: URL: www.cdc.gov/ncipc/pub-res/ipv_cost/ipv.htm.
Coker AL, Davis KE, Arias I, Desai S, Sanderson M, Brandt HM, et al. 2002. Physical and mental health effects of intimate partner violence for men and women. Am J Prev Med 23(4):260-268.
Crofford LJ. Violence, stress, and somatic syndromes. 2007. Trauma Violence Abuse 8:299-313.
Department of Justice, Bureau of Justice Statistics. Intimate partner violence [online]. [cited 2011 Jan 07]. Available from URL: http://bjs.ojp.usdoj.gov/index.cfm?ty=tp&tid=971#summary.
Heise L, Garcia-Moreno C. 2002. Violence by intimate partners. In: Krug E, Dahlberg LL, Mercy JA, et al., editors. World report on violence and health. Geneva (Switzerland): World Health Organization. p. 87-121.
Leserman J, Drossman DA. 2007. Relationship of abuse history to functional gastrointestinal disorders and symptoms. Trauma Violence Abuse 8:331-343.
Max W, Rice DP, Finkelstein E, Bardwell RA, Leadbetter S. The economic toll of intimate partner violence against women in the United States. Violence and Victims 2004;19(3):259-72.
Plichta SB. 2004. Intimate partner violence and physical health consequences: policy and practice implications. J Interpers Violence 19(11):1296-1323.
Roberts TA, Auinger P, Klein JD. 2005. Intimate partner abuse and the reproductive health of sexually active female adolescents. J Adolesc Health 36(5):380-385.
Roberts TA, Klein JD, Fisher S. 2003. Longitudinal effect of intimate partner abuse on high-risk behavior among adolescents. Arch Pediatr Adolesc Med 157(9):875-981.
Saltzman LE, Fanslow JL, McMahon PM, Shelley GA. Intimate partner violence surveillance: uniform definitions and recommended data elements, version 1.0. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2002. Available from: http://www.cdc.gov/ncipc/pub-res/ipv_surveillance/intimate.htm
Silverman JG, Raj A, Mucci L, Hathaway J. 2001. Dating violence against adolescent girls and associated substance use, unhealthy weight control, sexual risk behavior, pregnancy, and suicidality. JAMA 286(5):572-579
Tjaden P, Thoennes N. Stalking in America: Findings from the National Violence Against Women Survey. Washington (DC): Department of Justice (US); 1998. Publication No. NCJ 169592. Available from: http://www.ncjrs.gov/pdffiles/169592.pdf
Tjaden P, Thoennes N. Extent, nature, and consequences of intimate partner violence: findings from the National Violence Against Women Survey. Washington (DC): Department of Justice (US); 2000. Publication No. NCJ 181867. Available from: URL: www.ojp.usdoj.gov/nij/pubs-sum/181867.htm.
Adapted from
Understanding Intimate Partner Violence
CDC Fact Sheet 2011
http://www.cdc.gov/violenceprevention/pdf/IPV_factsheet-a.pdf
Intimate Partner Violence
Centers for Disease Control and Prevention
http://www.cdc.gov/ViolencePrevention/intimatepartnerviolence/definitions.html
Page last updated: September 20, 2010