statement of research problem on domestic violence

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CHAPTER ONE INTRODUCTION AND STATEMENT OF THE PROBLEM

Related Papers

Adrian D Van Breda

Domestic violence is a social problem that has been going on for decades. In Zambia, domestic violence cuts across all cultures and the most affected usually are women and children. This descriptive study was conducted in two communities of Katete district of Zambia with the purpose of understanding men’s and women’s perceptions on domestic violence. To meet the overall purpose of this study, the following objectives were set: 1. To establish what men and women perceive to be domestic violence. 2. To outline the services known to be available to victims of domestic violence. 3. To investigate the barriers to seeking assistance among victims of domestic violence 4. To gather views from respondents on the kinds of strategies that would reduce the prevalence of domestic violence. 5. To provide recommendations to stakeholders and the government on a policy direction for domestic violence. A number of literatures which were in text forms were gathered through the library and various websites. Despite insufficient statistics to justify the occurrence of domestic violence in Zambia, it was indicated through literature that it was a problem. Through some of the literature, the student had adopted an ecological perspective which was instrumental in the provision of various ways of understanding the occurrence of domestic violence. Prior to the data collection, the student obtained permission from the participants. The student interviewed a total of 34 men and women through the use of focus groups as a method of data collection. Through this study, six major themes were identified and broken down into sub-themes or categories which had emerged from the study. The themes had included: (A) men’s and women’s perceptions of domestic violence; (B) dominant types of domestic violence; (C) causes of domestic violence; (D) availability of services for the victims of domestic violence; (E) barriers to seeking help by victims of domestic violence; and (F) strategies to reduce domestic violence. From the findings of this study, various issues emerged, the most critical of which is that women equally contribute to precipitating domestic violence in relationships. Additionally, various barriers that hinder survivors of domestic violence from accessing relevant services were underlined. Nevertheless, participants were able to bring out the positive contributions of some of the services of domestic violence despite the noted challenges in terms of availability and accessibility. In the final chapter, general recommendations were presented which among them included sensitisation on the services of domestic violence by stakeholders, need for facilities for domestic violence victims and psychological support for the victims of domestic violence.

Erick Malambo

Gender based violence (GBV) has negative effects on women and it also goes against human rights, seeing that different forms of violence are inflicted on women. This study used ZDHS data of 2013-14 to conduct a study on the occurrence of GBV among women in the reproductive age (15-49) in Zambia. The types of violence that have been identified are; physical violence, emotional violence and sexual violence. Perpetrators of violence are mainly victims’ husband or partner as well as close family members. A small number of women also perpetrate violence against their partners. With regards to the help seeking behavior of victims, more of them do not seek help and when they do, they usually seek help from their partner’s family or their own family. Factors that contribute to gender based violence include alcohol consumption of perpetrators and also victims’ pre-exposure to violence. This pre-exposure is in terms of violence between parents and also victims coming from a relationship that was abusive. Socio-economic and demographic characteristics of GBV victims that have an influence on occurrence of GBV include age, education and wealth of victims. Therefore, GBV occurs in different types and is perpetrated by people close to the victims.

Yvone Nenga

nopele matafeo

Esther Namisi

Ndabuli T . Mugisho

Domestic violence is a branch of Gender Based Violence (GBV). Domestic violence is directed towards family members, particularly the wife and so it is rampant in the world. This research delves in the beliefs and attitudes towards male domestic violence in South Kivu province of the Democratic Republic of Congo (DRC). It also provides a comprehensive understanding of some different factors, forms, reasons and consequences of such violence in the province. This research used qualitative approach with focus group and in-depth interviews with adult men in the mentioned province. There were organised two focus groups and two in-depth interviews. Fourteen men participated to these interviews. The researcher selected them with the help of the provincial authorities. The dynamism of men’s beliefs and attitudes towards domestic violence in this province is of paramount importance to understand. The research found that South Kivu men believe that asserting power and masculinity in the family in general, particularly to the wife is their right. This connectivity promotes the widespread of GBV in the province. The participants also revealed that society fosters men’s power and masculinity over family members. This actually makes domestic violence become a culture in the area. In combating domestic violence through means of education, awareness raising and law reinforcement and its fair implementation, families can be harmonious. This is possible if society motivates men to use their power and masculinity in a constructive way, and if the victims are helped to restore their self esteem, regain hope and break the silence.

Texila International Journal of Nursing

Texila International Journal

Social and cultural beliefs in different communities of Zambia have continued to perpetrate Gender Based Violence and this has affected victims in many ways. The impact of GBV has led to an increase in morbidity and mortality rates globally after its physical, mental, emotional and social inflictions on the victims. This has placed a cost on the quality of life as lifestyle changes occur. Therefore, the aim of this study was to establish the socio-cultural factors that are associated with Gender Based Violence in Chipata City. This study adopted an explorative mixed method design. The study sequentially collected quantitative and qualitative data. Responses were gotten from 381 respondents. The sample was deduced from 1,922 female victims were registered from 2014 to 2016 at the GBV One Stop Centre. The discussions about the study revealed that and weak community support, poor relationships, alcohol and poverty, are among the major contributing factors to GBV. The major health effects could be either physical implications like a loss of an organ after assault, unwanted pregnancies and STI infections. Most of these findings were attributed to the spouses/partners. Sensitization, in this case, could be the answer to curb the incidences of GBV. In conclusion, the study explored the experiences female survivors in Chipata city have had following Gender Based Violence. Socio-cultural and economic factors have had a major impact in enhancing GBV and victims mentioned that poverty, substance abuse and inactive law enforcement directly fueled the acts of violence. The key recommendation is massive sensitization about GBV and reinforcing laws to strengthen the curbing of violence.

John Hamel , Teri Lambert

This is the table for the research highlighted in the associated manuscript.

Jenny K Morrison

Violence against women has a serious impact not only on those who experience it, but on the country’s social and economic situation as well. To address the serious toll that domestic violence takes on Cambodia, the Royal Government of Cambodia (RGC) has made reducing domestic violence a priority. In particular, the RGC is focused on addressing the Cambodian Millennium Development Goal (CMDG) 3, which aims to “promote gender equality and empower women”; and the overall Target 8 within this goal, which is to “reduce significantly all forms of violence against women and children.” The final report contributes evidence in support of the RGC’s strategy to reduce domestic violence.

Texila International Journal of Public Health

Texila International Journal , Beatrice Banda

Social and cultural beliefs in different communities of Zambia have continued to perpetrate Gender Based Violence and this has affected victims in many ways. The impact of GBV has led to an increase in morbidity and mortality rates globally after its physical, mental, emotional and social inflictions on the victims. This has placed a cost on the quality of life as lifestyle changes occur. Therefore, the aim of this study was to establish the socio-cultural factors that are associated with Gender Based Violence in Chipata City. This study adopted an explorative mixed method design. The study sequentially collected quantitative and qualitative data. Responses were gotten from 381 whose sample was deduced from 1,922 female victims, registered from 2014 to 2016 at the GBV One Stop Centre and Chipata City. The study discussions revealed weak community support, poor relationships, alcohol and poverty as being among the major contributing factors to GBV. Major health effects could either be physical implications like a loss of an organ after assault, unwanted pregnancies and STI infections, whose findings were attributed to spouses/partners. Sensitization, in this case, could help curb the incidences of GBV. On conclusion, the study explored the experiences female survivors in Chipata city have had following Gender Based Violence. Socio-cultural and economic factors fueled GBV and victims mention poverty, substance abuse and inactive law enforcement directly enhancing these acts of violence. The key recommendation is massive sensitization about GBV and reinforcing laws to strengthen the curbing of violence.

EDITORIAL article

Editorial: new perspectives on domestic violence: from research to intervention.

$\r\nLuca Roll*$

1 Department of Psychology, University of Turin, Turin, Italy
2 School of Health and Social Work, University of Hertfordshire, Hertfordshire, United Kingdom

Editorial on the Research Topic New Perspectives on Domestic Violence: from Research to Intervention

In a document dated June 16th 2017, the United States Department of Justice stated that Domestic Violence (DV) has a significant impact not only on those abused, but also on family members, friends, and on the people within the social networks of both the abuser and the victim. In this sense, children who witness DV while growing up can be severely emotionally damaged. The European Commission (DG Justice) remarked in the Daphne III Program that 1 in 4 women in EU member states have been impacted by DV, and that the impact of DV on victims includes many critical consequences: lack of self-esteem, feeling shame and guilt, difficulties in expressing negative feelings, hopelessness and helplessness, which, in turn, lead to difficulties in using good coping strategies, self-management, and mutual support networks. In 2015 the EU Agency for Fundamental Rights affirmed that violence against women can be considered as a violation of human rights and dignity. Violence against women exists in each society and it can be related to any social, economic and cultural status and impact at the economic level. It includes physical, sexual, economic, religious, and psychological abuse.

Although men experience domestic violence by women, the rate of DV among women is much higher than that of men, especially in the category of being killed due to DV.

Recent studies have shown that between 13 and 61% of women (15–49 years old) report to have been physically abused at least once by an intimate partner. Domestic Violence takes place across different age groups, genders, sexual orientations, economic, or cultural statuses. However, DV remains largely under-reported due to fear of reprisal by the perpetrator, hope that DV will stop, shame, loss of social prestige due to negative media coverage, and the sense of being trapped with nowhere to go:

Hence, it is estimated that 90% of cases of DV continue to be identified as a non-denounced violence.

The aim of this Special Issue of Frontiers of Psychology is to gather updated scientific and multidisciplinary contributions about issues linked to domestic violence, including intimate partner violence (IPV). We encouraged contributions from a variety of areas including original qualitative and quantitative articles, reviews, meta-analyses, theories, and clinical case studies on biological, psycho-social and cultural correlates, risk and protective factors, and the associated factors related to the etiology, assessment, and treatment of both victims and perpetrators of DV.

We hope that this Special Issue will stimulate a better informed debate on Domestic Violence, in relation to its psychosocial impact (in and outside home, in school, and workplace), to DV prevention and intervention strategies (within the family and in society at large), in addition to specific types of DV, and to controversial issues in this field as well.

The Special Issue comprises both theoretical reviews and original research papers. 7 research papers, 6 reviews (policy and practice review, systematic review, review and mini-review) and 1 methodological paper are included.

The first section comprises 2 systematic review and 3 original research papers focused on factors associated with Domestic Violence/Intimate Partner Violence/feminicide. Velotti et al. conducted a systematic review focused on the role of the attachment style on IPV victimization and perpetration. Several studies included failed to identify significant associations. The authors suggest to consider other variables (e.g., socioeconomic condition) that in interaction with attachment styles could explain the differences found between the studies. Considering the clinical contribution that these findings can provide to the treatment of IPV victims and perpetrators, future studies are needed. From a systematic review conducted by Gerino et al. focused on IPV in the “golden age” (old age), economic and educational conditions, younger age (55–69), membership in ethnic minorities, cognitive and physical impairment, substance abuse, cultural and social values, sexism and racism, were found as risk factors; depression emerged as risk factor and consequence of IPV. However, social support was identified as main protective factor. Also help-seeking behaviors and local/national services had a positively impact the phenomenon. Furthermore, the role of the parental communication was highlighted ( Rios-González et al. ) In that mothers encourage daughters to engage in relationship with ethical men, while removing from their representation attractive features and enhancing the double standard of viewing ethical man as unattractive vs. violent and attractive man. Fathers' communication directed toward young boys supports the dominant traditional masculinity, objectifying girls and emphasizing chauvinist values. These communicative dynamics impact males' behavior and females' choice of the partner while increasing the attraction toward violent men, and thus influencing the risk to be involved in IPV episodes.

Furthermore, factors associated with multiple IPV victimization by different partners were identified. From the study of Herrero et al. , experiencing child abuse emerged as a main predictor (“conditional partner selection process”). Similarly, adult victimization perpetrated by other than the intimate partner influences multiple IPV episodes. Moreover, this phenomenon is more frequent among younger women and those with lower income satisfaction. Length of relationship and greater psychological consequences to previous IPV are positively associated with multiple IPV episodes, while previous physical abuse is negatively related with subsequent victimization. The risk of multiple IPV episodes is reduced in countries with greater human development, suggesting the role of structural factors.

Regarding reasons of feminicide, passion motives assume the main role, followed by family problems, antisocial reasons, predatory crimes that comprise sexual component, impulsivity and mental disorders. The risk of overkilling episodes is higher when the perpetrator is known by the victim and when the murder is committed for passion reasons ( Zara and Gino ).

The second section includes papers focused on IPV/DV in particular contexts (one research paper, two reviews). Within separated couples, where conflicts are common, both men and women experience psychological aggression. However, some particularities emerged: women started to suffer of several kinds of psychological violence that was aimed to control (complicating the separation process), dehumanize and criticize them. Men report only few forms of violence experienced (likely due to the men's social position that narrows their disclosure opportunity), which mainly concern the limitation of the possibility to meet children ( Cardinali et al. ). Regarding same-sex couples ( Rollè et al. ), both similarities and differences in comparison with heterosexual couples emerged. IPV among LGB people is comparable or even higher than heterosexual episodes. Unique features present in same-sex IPV concern identification and treatment aspects, mainly due to the absence of solutions useful in addressing obstacles to help-seeking behaviors (related to fear of discrimination within LGB community), and the limitation of treatment programs tailored to the particularities of the LGB experience. Similarly, within First Nation's communities in Canada, IPV is a widespread phenomenon. However, the lack of preventing programs and the presence of intervention solutions that fail to address its cultural origins, limit the reduction of the problem and the recovery of victims. Klingspohn suggests the development of interventions capable to guarantee cultural safety and consequently to reduce discrimination and marginalization that Aboriginal people experience with mainstream health care system and which limit help-seeking behaviors.

The third section comprises two reviews and one research paper concerned with the impact of Intimate Partner and Domestic Violence. The systematic review conducted by Onwumere et al. highlighted the financial and emotional burden that violence perpetrated by psychotic patients entails for their informal carers (mainly close family relatives). Moreover, the authors identified within the studies included positive association between victimization and trauma symptoms, fear, and feeling of powerless and frustration.

Among people who suffered of Domestic Violence with a romantic or non-romantic partner who became their stalker, stalking victimization entails physical and emotive consequences for both male and female victims. Females suffered more than males of depressive and anxiety symptoms (although for both genders symptoms were minimal), while males experienced more anger. Furthermore, both genders adopted at least one “moving away” strategy in coping with stalking episodes, and the increasing of stalking behaviors determined a reduction in coping strategies use. This latter finding is likely to be due to the distress experienced ( Acquadro Maran and Varetto ).

Children abuse—which occurs often in Domestic Violence—results in emotional trauma as well as physical and psychological consequences that can negatively impact the learning opportunities. The school staff's ability to identify abuse signals and to refer to professionals constitute their main role. However, lack of skills and confidence among teachers regarding this function emerged, and further training for the school staff to increase support provided to abused children is needed ( Lloyd ).

Lastly, the fourth section includes two papers (one review and one methodological paper) that provide information on intervention and prevention programs and one research paper which contributes to the development and validation of the Willingness to Intervene in Cases of Intimate Partner Violence Against Women (WI-IPVAW) Scale. Gracia et al. The instrument demonstrated—both in the long and in its short form—high reliability and construct validity. The development of WI-IPVAW can contribute to the evaluation of the t role that can be played by people who are aware of the violence and understand attitudes toward IPV that can influence perpetrator's behavior and victim disclosure. The origin of violence within intimate relationship during adolescence calls for the development of preventive programs able to limit the phenomenon. The mini-review conducted by Santoro et al. highlighted the necessity to consider the relational structure where women are involved (history of poly-victimization re-victimization), and the domination suffered according to the gender model structured by the patriarchal context. Moreover, considering that violence can occur after separation or divorce, requires in child custody cases the evaluation of parenting and co-parenting relationship. This process can provide an opportunity to assess and treat some kind of violent behavior (Conflict-Instigated Violence, Violent Resistance, Separation-Instigated Violence). According to these consideration, Gennari et al. elaborated a model for clinical intervention (relational-intergenerational model) useful to address these issues during child custody evaluation. The model is composed of three levels aimed at understanding intergenerational exchange and identify factors that contribute to safeguard family relationship. This assessment process allows parents to reflect on information emerged during the evaluation process and activate resources useful to promote a constructive change of conflict dynamics and violent behaviors.

Author Contributions

All authors listed have made a substantial, direct and intellectual contribution to the work, and approved it for publication.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

We would like to thanks all the authors and the reviewers who contributed to the present article collection, for their dedication to our topics and to their readiness to share their knowledge, and thus to increase the research in this field; KathWoodward, Specialty Chief Editor of Gender, Sex, and Sexuality Studies that believed in our project, and to Dr. Tommaso Trombetta for his collaboration during last year.

Keywords: domestic violence, intimate partner abuse, intimate partner violence (IPV), gender violence against women, same sex intimate partner violence, systematic review, perpetrator and victim of violence, perpetrator

Citation: Rollè L, Ramon S and Brustia P (2019) Editorial: New Perspectives on Domestic Violence: From Research to Intervention. Front. Psychol. 10:641. doi: 10.3389/fpsyg.2019.00641

Received: 25 February 2019; Accepted: 07 March 2019; Published: 28 March 2019.

Edited and reviewed by: Kath Woodward , The Open University, United Kingdom

Copyright © 2019 Rollè, Ramon and Brustia. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Luca Rollè, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Domestic Violence Against Women: Systematic Review of Prevalence Studies

Original Article
Published: 15 December 2009
Volume 25 , pages 369–382, ( 2010 )

Cite this article

statement of research problem on domestic violence

Samia Alhabib 1 ,
Ula Nur 2 &
Roger Jones 3

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To systematically review the worldwide evidence on the prevalence of domestic violence against women, to evaluate the quality of studies, and to account for variation in prevalence between studies, using consistent definitions and explicit, rigorous methods. Systematic review of prevalence studies on domestic violence against women. Literature searches of 6 databases were undertaken for the period 1995 to 2006. Medline, Embase, Cinahl, ASSIA, ISI, and International Bibliography of the Social Sciences were searched, supplemented by hand searching of the reference lists from studies retrieved and specialized interdisciplinary journals on violence. A total of 134 studies in English on the prevalence of domestic violence against women, including women aged 18 to 65 years, but excluding women with specific disabilities or diseases, containing primary, empirical research data, were included in the systematic review. Studies were scored on eight pre-determined criteria and stratified according to the total quality score. The majority of the sudies were conducted in North America (41%), followed by Europe (20%). 56% of studies were population-based, and 17% were carried out either in primary or community health care settings. There was considerable heterogeneity both between and within geographical locations, health care settings, and study quality The prevalence of lifetime domestic violence varies from 1.9% in Washington, US, to 70% in Hispanic Latinas in Southeast US. Only 12% scored a maximum of 8 on our quality criteria, with 27% studies scored 7, and 17% scored 6. The mean lifetime prevalence of all types of violence was found to be highest in studies conducted in psychiatric and obstetric/gynecology clinics. Results of this review emphasize that violence against women has reached epidemic proportions in many societies. Accurate measurement of the prevalence of domestic violence remains problematic and further culturally sensitive research is required to develop more effective preventive policies and programs.

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Examining the short and long-term impacts of child sexual abuse: a review study

Risk and Protective Factors for Child Maltreatment: a Review

Anderson, K. L. (1997). Gender, status, and domestic violence: an integration of feminist and family violence approaches. Journal of Marriage and the Family, 50 (3), 655–669.

Article Google Scholar

Caetano, R., Cunradi, C., Clark, C., & Schafer, J. (2000). Intimate partner violence and drinking patterns among white, black, and hispanic couples in the U.S. Journal of Substance Abuse, 11 (2), 123–138.

Article CAS PubMed Google Scholar

Campbell, J. C. (1995). Adult response to violence. In J. C. Campbell (Ed.), Violence: A plague in our land (pp. 19–29). Washington, DC: American Academy of Nursing.

Google Scholar

Campbell, J. C. (2002). Health consequences of intimate partner violence. Lance, 359 , 1331–1336.

Campbell, D., Masaki, B., & Torres, S. (1997). Water on the rock: Changing domestic violence perception in the African American, Asian American, and Latino communities. In E. Klein, J. Campbell, E. Soler & M. Ghez (Eds.), Ending domestic violence: Changing public perceptions/halting the epidemic (pp. 65–70). Calif Sage: Thousands Oaks.

Dickers, K. (2002). Systematic reviews in epidemiology: why are we so far behind? International Journal of Epidemiology, 31 , 6–12.

Douki, S., Nacef, F., Belhadje, A., Bouasker, A., & Ghachem, R. (2003). Violence against women in Arab and Islamic countries. Archives of Women Ment Health, 6 , 165–171.

Ellsberg, M., & Heise, L. (2005). Researching violence against women: A practical guide for researchers and Aactivists . Washington DC: World Health Organization, PATH.

Ellsberg, M., Jansen, H., Heike, L., Watts, C., & Garcia-Moreno, C. (2008). Intimate partner violence and women’s physical and mental health in the WHO multi-country study on women’s health and domestic violence: an observational study. Lancet, 371 , 1165–1172.

Article PubMed Google Scholar

Fagan, J., & Browne, A. (1994). Violence between spouses and intimates: Physical aggresion between men and women in intimate relationships. In A. Reiss & J. Roth (Eds.), Understanding and preventing violence: Social influences, Vol. 3 (pp. 115–292). Washington, DC: National Academy.

Garcia-Moreno, C., Jansen, H., Ellsberg, M., Heike, L., & Watts, C. (2006). Prevalence of intimate partner violence: findings from the WHO multi-country study on women’s health and domestic violence. Lancet, 368 , 1260–1269.

Gelles, R. (1997). Intimate violence in families (pp. 146–149). London: Sage.

Golding, J. M., Taylor, D. L., Menard, L., & King, M. J. (2000). Prevalence of sexual abuse history in a sample of women seeking treatment for premenstrual syndrome. Journal of Psychosomatic Obstetatric and Gynecology, 21 , 69–80.

Hagemann-White, C. (2001). European research on the prevalence of violence against women. Violence Against Women, 7 , 732–759.

Hamby, S. L., Poindeter, V. C., & Caray-little, B. (1996). Four measures of partner violence: construct similarity and classification differences. Journal of Marriage and the Family, 58 , 127–139.

Harris, R. J., Firestone, J. M., & Vega, W. A. (2005). The interaction of country of origin, acculturation, and gender role ideology on wife abuse. Social Science Quarterly, 86 (2), 463–483.

Heise, L., Ellsberg, M., & Gottemoeller, M. (1999). Ending violence against women . Baltimore: John’s Hopkins University School of Public Health; Population Information Program. Report No.11, Series L.

Joachim, J. (2000). Shaping the human rights agenda: the case of violence against women. In M. K. Meyer & E. Prugl (Eds.), Gender politics in global governance (pp. 142–160). Lanham: Rowman and Little Field.

Khawaja, M., & Barazi, R. (2005). Prevalence of wife beating in Jordanian refugee camps: reports by men and women. Journal of Epidemiological Community Health, 59 , 840–841.

Koss, M. P. (1993). Detecting the scope of rape: a review of prevalence research methods. Journal of Interpersonal Violence, 8 (2), 198–222.

Krauss, H. (2006). Perspectives on violence. Annals of the New York Academy of Science, 108 , 4–21.

Loney, P., Chambers, L., Bennett, K., Roberts, J., & Stratford, P. (2000). Critical appraisal of the health research literature: prevalence or incidence of a health problem. Chronic Diseases in Canada, 19 (4), 170–176.

Mahoney, M. (1991). Legal images of battered women: redefining the issues of separation. Michigan Law Review, 90 , 165–194.

McFarlane, J., Christoffel, K., Bateman, L., Miller, V., & Bullock, L. (1991). Assessing for abuse: self-report versus nurse interview. Public Health Nurse, 8 , 245–250.

Article CAS Google Scholar

Merry, S. (2003). Constructing a global law-violence against women and the human rights system. Law and Social Inquiry: A new global legality. American Bar Foundation , 941–977.

Michalski, J. (2004). Making sociological sense out of trends in intimate partner violence. Violence against Women, 10 (6), 652–675.

Plichta, S. (1992). The effects of woman abuse on health care utilization and health status: a literature review. Women’s Health Issues, 2 (3), 154–163.

Rydstrom, H. (2003). Encounting “hot” anger: domestic violence in contemporary Vietnam. Violence Against Women, 9 , 676–697.

Sadowski, L., Hunter, W., Bangdiwala, S., & Munoz, S. (2004). The world studies of abuse in the family enviroment (WorldSAFE): a model of a multi-national study of family violence. Injury Control and Safety Promotion, 11 (2), 81–90.

Sokoloff, N., & Pratt, C. (2005). Domestic violence at the margines: readings on race, class, gender, and culture. Rutgers University Press , 42–47.

Walling, M. K., Reiter, R. C., O’Hara, M. W., Milburn, A. K., Lilly, G., & Vincent, S. D. (1994). Abuse history and chronic pain in women. I. Prevalences of sexual abuse and physical abuse. Obstetric and Gynecology, 84 , 193–199.

CAS Google Scholar

Waltermaurer, E. (2005). Measuring intimate partner violence (IPV); you may only get what you ask for. Journal of Interpersonal Violence, 20 (4), 501–506.

Wisner, C. L., Glimmer, T. P., Saltzman, L. E., & Zink, T. M. (1999). Intimate partner violence against women: do victims cost health plans more? Journal of Family Practice, 48 , 439–443.

CAS PubMed Google Scholar

World Bank. (1993). Investing in health: World development indicators: World Development Report . New York: Oxford University Press.

World Health Organization. (1997). Violence against women: A priority health issue. http://www.who.int/gender/violence/prioreng/en/index.html (accessed April, 8 2008).

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Acknowledgements

We would like to acknowledge the advice given by Dr. Kalwant Sidhu, Director of the MSc Programme at King’s College London, Martin Hewitt, who provided advice on literature searching, Dr. Paul Seed, who provided statistical advice, Prof. Gene Feder and Prof. Tony Ades for commenting on the paper before submission for publication and to Jeremy Nagle in the British Library, who helped to track down references.

Contributorship

Samia Alhabib had the original idea for the study which was refined by Roger Jones. Data collection, critical appraisal of studies and general data analysis were undertaken by Samia Alhabib. Meta-analysis and sensitivity analysis were undertaken by Ula Nur. Samia Alhabib and Roger Jones drafted and finalized the manuscript.

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Alhabib, S., Nur, U. & Jones, R. Domestic Violence Against Women: Systematic Review of Prevalence Studies. J Fam Viol 25 , 369–382 (2010). https://doi.org/10.1007/s10896-009-9298-4

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DOI : https://doi.org/10.1007/s10896-009-9298-4

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Published: 17 March 2022

Magnitude and determinants of intimate partner violence against women in East Africa: multilevel analysis of recent demographic and health survey

Sewnet Adem Kebede 1 ,
Adisu Birhanu Weldesenbet 2 &
Biruk Shalmeno Tusa 2

BMC Women's Health volume 22 , Article number: 74 ( 2022 ) Cite this article

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Violence against women is a significant public health problem, and human rights abuse, and is associated with multiple adverse physical, mental, sexual, and reproductive health effects. The current study aimed to determine the magnitude of intimate partner violence (IPV) and its determinant factors in East African countries.

We utilized the most recent demographic and health survey data from 11 East African countries, which was comprised of a weighted sample of 55,501 ever-married women. A multilevel multivariable logistic regression analysis was applied. We used an adjusted odds ratio with a 95% CI and a p value ≤ 0.05 in the multilevel logistic model to declare significant factors associated with IPV.

The overall prevalence of all forms of IPV in East African countries was 32.66% [95% CI 32.27, 33.05], with the highest IPV occurring in Uganda (14.93%) and the lowest IPV recorded in Comoros (0.87%). In the multivariable multilevel logistic regression model, women’s education, residence, sex of household head, current pregnancy, husband drinking alcohol, attitude towards wife-beating husband controlling behavior, and women’s decision-making autonomy were significantly associated with IPV.

The risk factors noted above increase the likelihood of a woman experiencing IPV. Therefore, we recommend establishing effective health and legal response services for IPV, raising awareness of the existing legislation service and improving its application, strengthening legislations on purchasing and selling of alcohol, strengthening joint (both husband and wife) decision-making power by empowering women, improving the educational level of women, and establishing measures to break the culture of societal tolerance towards IPV.

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Intimate partner violence (IPV) refers to any behavior within an intimate relationship that causes physical, psychological, or sexual harm to those in the relationship [ 1 ]. It is one of the most prevalent types of violence against women, and it involves physical violence such as slapping, striking, kicking, and beating, as well as sexual violence, mental abuse, and controlling behaviors by an intimate partner [ 2 , 3 ]. Violence against women is a significant public health problem, a human rights abuse, and is associated with multiple adverse physical, mental, sexual, and reproductive health effects [ 4 ].

Globally, 30% of women have experienced physical and/or sexual violence by their intimate partners in their lifetime [ 5 ]. According to studies, 13–61% of IPV victims have experienced physical violence by a partner, 4–49% have experienced severe physical violence by a partner, 6–59% have experienced sexual violence by a partner at some point in their lives, and 20–75% have experienced one emotionally abusive act in their lifetime. The percentage of ever-partnered women who reported ever experiencing any physical or sexual violence by their current or most recent husband or cohabiting partner ranged from 18% in Cambodia to 48% in Zambia for physical violence, and 4% to 17% for sexual violence. According to a study from 10 countries, physical or sexual IPV ever reported by currently married women ranged from 17% in the Dominican Republic to 75% in Bangladesh [ 6 , 7 , 8 ].

In low- and middle-income countries, in which most African countries are included, the prevalence of IPV is much higher due to the high social acceptance of violence and poor socioeconomic status, with studies reporting 36% of violence during pregnancy. In Africa, IPV during pregnancy ranged from 2.3 to 57.1% [ 9 , 10 ]. Low levels of education and a lack of decision-making power in these regions make women more dependent on their male partners and increase their likelihood of experiencing violence [ 10 ].

Intimate partner violence has both short-term and long-term effects on women’s physical and mental health, and its adverse effects sometimes extend to infants of women who experienced IPV. History of experiencing violence is therefore a risk factor for many diseases and conditions [ 3 ]. Alcohol and drug abuse, eating and sleep disorders, physical inactivity, poor self-esteem, post-traumatic stress disorder, smoking, and self-harm are major consequences of IPV among women, and children, anxiety, depression, poor school performance, and unfavorable health outcomes are major threats [ 11 ].

Even though the prevalence of IPV has remained significant worldwide, no study has been conducted to investigate the extent and related determinants of IPV against women in Eastern Africa. As a result, the current study used Demographic and Health Survey (DHS) data to determine the magnitude of IPV and its determinant factors in East Africa. The finding of this study provides evidence for planners, decision-makers, stakeholders, and health professionals in planning for the reduction of IPV, which is helpful to overcome the negative consequences of IPV.

Study period and setting

We conducted secondary data analysis using the most recent demographic and health survey (DHS) in the following East African countries (Burundi, Ethiopia, Kenya, Comoros, Malawi, Mozambique, Rwanda, Tanzania, Zambia, Zimbabwe, and Uganda) from 2012 to 2018.

Data source

The data were accessed from the demographic and health survey (DHS) program official database www.measuredhs.com . Demographic and health surveys are nationally representative household surveys that provide data that is comparable across the countries for monitoring and impact evaluation indicators in the areas of population, health, and nutrition. The DHS uses a stratified two-stage cluster design: enumeration areas (EA) (first stage) and in each EA selected, a sample of households is drawn (second stage). Detailed survey procedure [ 12 ].

For this study, individual record (IR) datasets were used in each country. The data were obtained from all ever-married women 15–49 selected and interviewed for the violence module in each country. We used DHS surveys done in 11 East African countries and a weighted sample of 55,501 ever-married women from Burundi (6558), Ethiopia (4469), Kenya (4023), Comoros (2093), Malawi (4984), Mozambique (5610), Rwanda (1691), Tanzania (7102), Uganda (6879), Zambia (6598) and Zimbabwe (5494) were included in the study.

Measurements of variable and operational definitions

Outcome variable.

The outcome variable for this study was IPV. Intimate partner violence is defined as any behavior within an intimate relationship that causes physical, emotional, or sexual harm to those in the relationship, whether current or former spouses or current or former partners [ 1 ] (Additional file 1 ).

Physical violence

Ever-married women who have experienced one or more of the specified acts (any of pushing you, shaking you, or throwing something at you; slapping you; twisting your arm or pulling your hair; punching you with his/her fist or with something that could hurt you; kicking you, dragging you, or beating you up; trying to choke you or burn you on purpose; or threatening or attacking you with a knife, gun, or any other weapon) [ 1 ].

Sexual violence

Ever-married women who have experienced one or more of the specified acts (any physical force you to have sexual intercourse with him even when you do not want to; physically forcing you to perform any other sexual acts you do not want to; forcing you with threats or in any other way to perform sexual acts you do not want to) [ 1 ].

Emotional violence

Ever-married women who have experienced one or more of the specified acts (any of saying or doing something to humiliate you in front of others; threaten to hurt or harm you or someone close to you; insult you or make you feel bad about yourself) [ 1 ].

Intimate partner violence

Ever-married women who have experienced physical violence or sexual violence or emotional violence by their current or most recent husbands/partners in the 12 months preceding the survey.

Explanatory variable

Community media exposure.

It was defined as the proportion of women who had media exposure in a cluster. The aggregate of individual women’s media exposure can show the overall media exposure of women within the cluster. It was categorized into higher and lower community media exposure based on national median value since these were not normally distributed. Community Paternal education was defined as the proportion of husbands who attended primary, secondary, and higher education within the cluster. The aggregate of an individual husband’s primary, secondary, and higher educational attainment can show the overall educational status of the husband within the cluster. They were categorized into two categories: those with a higher proportion of the husband’s education within the cluster and those with a lower proportion of the husband’s education based on the national median value since these were not normally distributed.

Attitude towards wife-beating

It was measured based on the following five questions that ever-married women were asked about whether situations of hitting or beating a wife were justifiable in the following situations: if she goes out without telling him; neglects their children; argues with him; refuses to have sex with him, and burns the food. If they said "yes" to any one of the above questions, they were classified as having an attitude towards wife-beating [ 13 ].

Husband controlling behavior

Five questions were used in this study to assess husband controlling behavior. Ever married woman was asked about her husband controlling behavior. Husband jealous if respondent talks with other men, husband accuses respondents of unfaithfulness, the husband doesn’t permit respondent to meet female friends, husband insists on knowing where the respondent is or husband tries to limit respondent’s contact with family [ 14 ].

Data management and analysis

After extracting the variables based on literature, we pooled the data from 11 East African countries together. Before any statistical analysis, the data were weighted using sampling weight, primary sampling unit, and strata to compensate for under or over-representing certain households in a sample, allowing it to reflect the population as a whole. Because of clustering and sampling, virtually all random sample surveys must use weights to make estimates that are valid for the whole population. The pooled prevalence of IPV with a 95% confidence interval (CI) was reported for East African countries from 2012 to 2018.

Multilevel multivariable logistic regression analysis was used since the outcome variable is binary (“1” if women experience IPV and “0” otherwise). We fitted four models to identify determinant factors of IPV. The first model is the null model without determinant factor, the second model is the model with only individual-level factors, the third model is the model with only community-level factors, and the final model with both the individual and community-level factors. Variables with a p value < 0.2 in the bivariable analysis were considered in the multivariable multilevel logistic regression model. We used an adjusted odds ratio (AOR) with a 95% CI and p value ≤ 0.05 in the multilevel logistic model to declare significant factors associated with IPV.

Socio-demographic characteristics

A total of 55,501 ever-married women aged 15–49 from 11 East African countries were included in this study. The median age of the women was 30 years old, with an interquartile range of 25 to 37, and about 38% of women were aged 20–29 years. Most women lived in rural areas (72.53%) and only 4% of women attended higher education. More than half of the study participants were working at the time of the survey (Table 1 ).

Magnitude of intimate partner violence

The overall magnitude of all forms of IPV in East African countries was 32.66% [95% CI 32.27, 33.05], with the highest IPV occurring in Uganda (14.93%) and the lowest IPV recorded in Comoros (0.87%) (Fig. 1 ).

Magnitude of intimate partner violence in East African countries recent demographic and health surveys from 2012 to 2018

Determinants of intimate partner violence

Intra-cluster Correlation Coefficient (ICC) and Likelihood ratio (LR) tests were checked. The best-fitted model for the data was a two-level multilevel logistic regression model. The ICC in the null model was 0.15 (95% CI 0.14, 0.16), indicating that the variations between clusters were responsible for around 15% of the overall variability of IPV and the remaining was attributable to individual differences (Table 2 ).

In the multivariable multilevel logistic regression model, women’s education, residence, sex of household head, current pregnancy, husband drinking alcohol, attitude towards wife beat, husband controlling behavior, and women’s decision-making autonomy were significantly associated with IPV.

Living in the rural parts of East Africa increased the likelihood of experiencing IPV by 16% (AOR = 1.16, 95% CI 1.14, 1.47) as compared with living in the urban areas of East Africa. The likelihood of experiencing IPV was decreased by 32% among women who had a secondary level education as compared to women who had no education (AOR = 0.68, 95% CI 0.49, 0.94).

The odds of experiencing IPV were decreased by 23% among female-headed households as compared to male-headed households (AOR = 0.77, 95% CI 0.61, 0.97). Intimate partner violence was more likely to occur among women who had an unintended pregnancy (wanted later pregnancy and/or unwanted pregnancy) (AOR = 1.24, 95% CI 1.04, 1.49) and (AOR = 1.37, 95% CI 1.01, 1.91) than women who had wanted pregnancy.

A husband who drinks alcohol was 3.45 times more likely to commit physical, emotional, or sexual violence on his wife as compared to a husband who didn’t drink alcohol (AOR = 3.45, 95% CI 2.91, 4.11). The odds of IPV among women who had an attitude toward wife beating were increased by 71% as compared to women who had no attitude toward wife-beating (AOR = 1.71, 95% CI 1.45, 2.02). Husbands who had controlling behavior were 6.21 times more likely to commit physical, emotional, or sexual violence on their wives as compared to a husband who had no controlling behavior (AOR = 6.21, 95% CI 5.09, 7.56).

The probability of IPV among women who had decision-making autonomy on their health care and major household purchases decreased by 18% (AOR = 0.82, 95% CI 0.66, 0.99) and 22% (AOR = 0.78, 95% CI 0.64, 0.95) than their counterpart respectively. Women who had decision-making autonomy to visit their families increased the occurrence of IPV by 37% as compared to their counterparts (AOR = 1.37, 95% CI 1.12, 1.68).

Intimate partner violence affects millions of women of all ages globally. It has both direct and indirect lifelong impacts on their health. Therefore, knowing the magnitude and associated factors of IPV in East Africa may offer evidence for East African countries' policymakers to design targeted prevention and intervention programs aimed at decreasing IPV and preventing risk factors. The pooled prevalence of IPV in East African countries was 32.66% [95% CI 32.27, 33.05], with the highest IPV occurring in Uganda (14.93%) and the lowest IPV recorded in Comoros (0.87%). This was consistent with the studies done in Ivory Coast [ 15 , 16 ]. The finding was lower than the study conducted in western African countries [ 17 , 18 ].

The study showed that the residence of the respondents had a significant association with IPV. Women who were from a rural part of East African countries were found to experience IPV as compared with those from the urban part of East African countries. This finding is in line with other studies done in Iran and Ethiopia [ 19 , 20 ]. Women living in rural areas experience a higher rate of IPV. This could be explained by women who do seek help but find difficulty in accessing services due to geographical isolation, lack of transportation, and not having access to their income [ 21 , 22 ]. Additionally, rural parts of the countries had no or few institutions that help to intervene against IPV or prevent the violence before its occurrence. There may be also cultural value differences or disparity.

In the current analysis, educated women were less likely to experience IPV as compared to women who had no formal education, which has been confirmed in previous studies [ 23 , 24 ]. The possible explanation could be education is one of the mechanisms to empower and develop a sense of self-esteem among women.

This study showed that IPV occurrence was decreased among female-headed households as compared to male-headed households, which is in contrast with the study done in India [ 25 ]. This discrepancy could be due to cultural differences.

Consistent with the previous studies [ 26 , 27 , 28 ], unintended pregnancy was found to have a significant association with IPV. This could be explained by women who experienced IPV and unintended pregnancy mostly living together in situations without a good relationship. In another direction, unintended pregnancy may be occurring due to sexual violence by a partner or husband.

Intimate partner violence increased linearly with the husband’s alcohol intake. This finding is consistent with the study which was done in Gambia, Ethiopia, Ghana, and Malawi [ 17 , 18 , 28 , 29 ]. The possible explanation could be the effect of alcohol on the cognitive capabilities, reducing self-control of individuals lower inhibitions, and heightening patriarchal ideologies, thus arousing dominant toxic masculinities. After drinking alcohol, the user may behave aggressively and leave individuals less capable of negotiating a non-violent resolution to the problem within the relationship. Furthermore, excessive drinking can exacerbate financial difficulties, children’s problems, or other family stressors. This can create marital tension and conflict, increasing the risk of violence [ 30 ].

The present study documented those women who have an attitude towards wife-beating were more likely to experience IPV. This finding is consistent with the studies done in Zimbabwe [ 31 ]. The possible explanation could be over time they may develop tolerant attitudes toward IPV violence against women and consider the violence as normal in their life process.

A direct strong relationship exists between husband controlling behavior and occurrence of IPV against women. This finding is most consistent with the findings of previous studies in Ghana [ 17 ] and Gambia [ 18 ]. This could be explained by community perception of male superiority which is expressed through control of women.

The odds of IPV among women who had decision-making autonomy on their health care and major household purchases decreased by 18% and 22% than their counterparts respectively. This finding is in line with other reports elsewhere [ 31 , 32 , 33 ]. While women who had decision-making autonomy to visit their family was negatively associated with IPV. Women who had decision-making autonomy to visit their family increase the occurrence of IPV by 37% as compared to their counterparts which are in line with the study done in Sub-Saharan Africa [ 23 ]. The possible explanation could be that women who have decision-making autonomy are able to fight for their rights and resist some of the decisions of men.

Strength and limitation

The data used in this study was representative of 11 East African countries and we must consider heterogeneity. In this study, some limitations were presented. Firstly, the findings may not build a causality relationship between participant characteristics and IPV experience due to the cross-sectional nature of the study. Secondly, underreporting of IPV due to social desirability bias.

In East Africa, near to one-third of women experience IPV. Women’s education, residence, sex of household head, current pregnancy, husband drinks alcohol, attitude towards wife beat, husband controlling behavior, and women’s decision-making autonomy were the major determinants of IPV. Therefore, we recommend establishing effective health and legal response services to IPV, raising awareness on the existing legislation service and improving its application, strengthening legislations on purchasing and selling of alcohol, strengthening joint (both husband and wife) decision making power by empowering women, improving the educational level of the women and establishing measures to break the culture of societal tolerance towards IPV.

The odds of women experiencing IPV were higher among women who had decision-making autonomy to visit their families. This may indicate a power struggle within the household. Women may be more vulnerable to IPV if women are empowered in the home without the support of men.

Availability of data and materials

All data generated or analysed during this study are included in this manuscript.

Abbreviations

Adjusted odds ratio

Confidence interval

Enumeration area

Demographic and Health Survey

Intra-cluster Correlation Coefficient

Likelihood ratio

World Health Organization. Understanding and addressing violence against women: Intimate partner violence. World Health Organization, 2012.

World Health Organization. Prevalence and health effects of intimate partner violence and non-partner sexual violence. Italy: WHO Publication; 2013.

Google Scholar

Heise L, Ellsberg M, Gottemoeller M. Ending violence against women. Population Reports. 1999;27(4):1–44.

Garcia-Moreno C, Jansen HA, Ellsberg M, Heise L, Watts CH. Prevalence of intimate partner violence: findings from the WHO multi-country study on women’s health and domestic violence. The Lancet. 2006;368(9543):1260–9.

Article Google Scholar

Butchart A, Mikton C, Dahlberg LL, Krug EG. Global status report on violence prevention 2014. London: BMJ Publishing Group Ltd; 2015.

Book Google Scholar

World Health Organization. WHO multi-country study on women's health and domestic violence against women: initial results on prevalence, health outcomes and women's responses. World Health Organization; 2005.

Kishor S, Johnson K. Profiling domestic violence: a multi-country study. Stud Fam Plann. 2005;36(3):259–61.

Hindin MJ, Kishor S, Ansara DL. Intimate partner violence among couples in 10 DHS countries: predictors and health outcomes. Calverton: Macro International Incorporated; 2008.

Devries KM, Kishor S, Johnson H, Stöckl H, Bacchus LJ, Garcia-Moreno C, et al. Intimate partner violence during pregnancy: analysis of prevalence data from 19 countries. Reprod Health Matters. 2010;18(36):158–70.

Shamu S, Abrahams N, Temmerman M, Musekiwa A, Zarowsky C. A systematic review of African studies on intimate partner violence against pregnant women: prevalence and risk factors. PLoS ONE. 2011;6(3): e17591.

Article CAS Google Scholar

Krug EG, Mercy JA, Dahlberg LL, Zwi AB. The world report on violence and health. The lancet. 2002;360(9339):1083–8.

Croft TN, Marshall AM, Allen CK, Arnold F, Assaf S, Balian S. Guide to DHS statistics. Rockville, Maryland, USA: ICF. 2018.

Croft TN, Marshall AM, Allen CK. Guide to DHS statistics, DHS-7. The Demographic and health surveys program. ICF, Rockville. 2018.

Kwagala B, Wandera SO, Ndugga P, Kabagenyi A. Empowerment, partner’s behaviours and intimate partner physical violence among married women in Uganda. BMC Public Health. 2013;13(1):1–10.

Peltzer K, Pengpid S. Female genital mutilation and intimate partner violence in the Ivory Coast. BMC Womens Health. 2014;14(1):1–5.

Akani BC. Prevalence and risk factors of intimate partner violence in COTE D’IVOIRE. 2020.

Ogum Alangea D, Addo-Lartey AA, Sikweyiya Y, Chirwa ED, Coker-Appiah D, Jewkes R, et al. Prevalence and risk factors of intimate partner violence among women in four districts of the central region of Ghana: baseline findings from a cluster randomised controlled trial. PLoS ONE. 2018;13(7): e0200874.

Jabbi A, Ndow B, Senghore T, Sanyang E, Kargbo JC, Bass P. Prevalence and factors associated with intimate partner violence against women in The Gambia: a population-based analysis. Women Health. 2020;60(8):912–28.

Vakili M, Nadrian H, Fathipoor M, Boniadi F, Morowatisharifabad MA. Prevalence and determinants of intimate partner violence against women in Kazeroon, Islamic Republic of Iran. Violence Vict. 2010;25(1):116–27.

Chernet AG, Cherie KT. Prevalence of intimate partner violence against women and associated factors in Ethiopia. BMC Womens Health. 2020;20(1):22.

Campo M, Tayton S. Domestic and family violence in regional, rural and remote communities. Melbourne, Australia: Australian Institute of Family Studies; 2015.

Coll CV, Ewerling F, García-Moreno C, Hellwig F, Barros AJ. Intimate partner violence in 46 low-income and middle-income countries: an appraisal of the most vulnerable groups of women using national health surveys. BMJ Glob Health. 2020;5(1):1–10.

Ahinkorah BO, Dickson KS, Seidu A-A. Women decision-making capacity and intimate partner violence among women in sub-Saharan Africa. Arch Public Health. 2018;76(1):1–10.

Kapiga S, Harvey S, Muhammad AK, Stöckl H, Mshana G, Hashim R, et al. Prevalence of intimate partner violence and abuse and associated factors among women enrolled into a cluster randomised trial in northwestern Tanzania. BMC Public Health. 2017;17(1):1–11.

Dalal K. Does economic empowerment protect women from intimate partner violence? J Injury Violence Res. 2011;3(1):35.

Tiruye TY, Harris ML, Chojenta C, Holliday E, Loxton D. The mediation effect of contraceptive use and women’s autonomy on the relationship between intimate partner violence and unintended pregnancy in Ethiopia. BMC Public Health. 2020;20(1):1–14.

Adhena G, Oljira L, Dessie Y, Hidru HD. Magnitude of intimate partner violence and associated factors among pregnant women in Ethiopia. Adv Public Health. 2020;2020: 1682847.

Lencha B, Ameya G, Baresa G, Minda Z, Ganfure G. Intimate partner violence and its associated factors among pregnant women in Bale Zone, Southeast Ethiopia: a cross-sectional study. PLoS ONE. 2019;14(5): e0214962.

Chilanga E, Collin-Vezina D, Khan MN, Riley L. Prevalence and determinants of intimate partner violence against mothers of children under-five years in Central Malawi. BMC Public Health. 2020;20(1):1–14.

Spratt K, Trang TT. Public sector response to gender-based violence in Vietnam. AIDSTAR-One; 2012.

Bengesai AV, Khan HT. Female autonomy and intimate partner violence: findings from the Zimbabwe demographic and health survey, 2015. Culture Health Sex. 2021;23:927–44.

Ebrahim NB, Atteraya MS. Women’s household decision-making and intimate partner violence in Ethiopia. Acad J Interdiscip Stud. 2019;8(2):284.

Naved RT, Persson LÅ. Factors associated with spousal physical violence against women in Bangladesh. Stud Fam Plann. 2005;36(4):289–300.

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Acknowledgements

We would like to thank the measure DHS for providing us with the data.

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Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

Sewnet Adem Kebede

Department of Epidemiology and Biostatistics, College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia

Adisu Birhanu Weldesenbet & Biruk Shalmeno Tusa

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The conception of the work, design of the work, acquisition of data, analysis, and interpretation of data was done by SA. Data curation, drafting the article, revising it critically for intellectual content, validation, and final approval of the version to be published was done by SA, AB, and BS. All authors read and approved the final manuscript.

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Kebede, S.A., Weldesenbet, A.B. & Tusa, B.S. Magnitude and determinants of intimate partner violence against women in East Africa: multilevel analysis of recent demographic and health survey. BMC Women's Health 22 , 74 (2022). https://doi.org/10.1186/s12905-022-01656-7

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Domestic Violence: A Q & A With Trauma Researcher Maja Bergman

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The prevalence of domestic violence in the United States is alarming, transcending geographic, socioeconomic, and cultural boundaries.

On average, nearly 20 people per minute are physically abused by an intimate partner, according to National Coalition Against Domestic Violence . This equates to more than 10 million men and women annually.

Maja Bergman, PhD

“Domestic violence is not exclusive to physical harm; it also encompasses emotional abuse, such as manipulation, control, and isolation,” said Maja Bergman, PhD, a clinical psychologist and researcher at the New York State Psychiatric Institute whose work focuses on trauma. “These experiences can lead to long-lasting psychological trauma.”

Dr. Bergman began her career in Sweden doing clinical work focused on trauma, particularly within families. Her desire to pursue trauma research brought her to New York 10 years ago, where she found a research interviewer position at NYSPI and began doctoral studies at Fordham University. Maintaining her focus on traumatic stress, Dr. Bergman conducted research at the PTSD Research and Treatment Program led by Yuval Neria, PhD, professor of clinical medical psychology (in psychiatry and epidemiology), where she has worked since 2017.

In honor of Domestic Violence Awareness Month, Columbia Psychiatry News spoke with Dr. Bergman about the types of challenges domestic violence survivors face, the most effective therapies for those who experience domestic abuse, and warning signs that someone may be an abuser.

What is domestic violence? In what forms does it present itself?

Domestic violence occurs in the home and family domain in many forms. Most often the term is used to refer to intimate partner violence, such as being physically abused or assaulted by a sexual or romantic partner, but it can also include witnessing this type of violence between parents or physical abuse between other family members. When parents are violent toward their children, we more typically refer to it as child abuse, but domestic violence may also include an adult child in the household who is violent toward one or both of their parents.

Are women its primary victims?

Domestic violence can affect anyone regardless of age, race, gender, sexual orientation, socioeconomic background or education level. A common misconception about domestic violence is that males are always the perpetrators and females are victims. There is violence in same sex relationships—from women to women, men to men—as well as women to men in heterosexual relationships.

What percentage of people are victims of domestic abuse?

The statistics concerning domestic violence can be hard to interpret due to varying definitions, but it is estimated that 1 in 3 women and 1 in 4 men have experienced some form of physical violence by an intimate partner, and 1 in 7 women and 1 in 25 men have been injured by an intimate partner. Across the U.S., more than 10 million domestic violence incidents are estimated each year, and in 2021 the National Domestic Violence Hotline responded to over 400,000 calls, chats, and texts. In many of these cases, children are present in the household and approximately 1 in 15 children are exposed to intimate partner violence each year. Of the children exposed to domestic violence, 90% directly witness the violence.

New York City recently amended its definition of domestic violence to include economic abuse and extended protections to victims. How does this invisible form of domestic violence typically present itself? What effects can it have on victims?

It is unfortunately a very common form of abuse and often implemented to maintain power and keep abused partners from leaving the relationship by way of financial dependence. Economic abuse can take the form of controlling access to money or preventing people from earning money—either by keeping someone from going to work or seeking employment, sabotaging existing employment, or demanding that someone gives up employment. It can also take the form of accruing debt in someone’s name, coerced debt accrual, or destroying a person’s credit. In addition to making it difficult to leave the abusive relationship, economic abuse often continues to create problems for survivors—such as debt, poor credit history, and lack of funds to continue rebuilding their lives—even after they have left the relationship.

What sort of challenges do domestic violence survivors face?

In addition to physical injuries, financial abuse and financial stress are common in the context of domestic violence and further contribute to the psychological burden. Typical psychological effects of domestic violence include post-traumatic stress reactions and depression. Domestic violence is also associated with increased suicidal behaviors. Incidents of domestic are rarely isolated and usually escalate in frequency and severity without interventions.

What types of therapy are helpful to work through the trauma of domestic abuse?

There are many forms of psychotherapy that can be helpful following domestic abuse. If a survivor is experiencing post traumatic reactions, such as intrusive memories, flashbacks, physical reactivity to reminders, and avoidance of things that may remind them of the abuse, a trauma-focused treatment such as prolonged exposure may be the best option. If more depressive symptoms and feelings of shame or guilt are central, an affect-focused therapy, such as interpersonal psychotherapy, may be better suited.

Are there any warning signs that someone may be an abuser?

Because domestic violence is widespread and not limited to particular social groups, it can be impossible to tell beforehand, yet many survivors will feel shame and guilt about not having been able to tell sooner. The physical abuse is usually not the first form of control or abuse. Signs to look out for may include:

Your own feelings: Are you afraid of your partner? If you are afraid to speak freely or say no to sex, this could be a important warning sign that something is going on in the relationship that should be addressed.
Behaviors that may precede violence include your partner accusing you of having an affair; becoming critical or controlling (such as telling you what to wear and how you should look); threatening you or someone close to you with violence or harm; destroying items when angry; and controlling your money or cutting you off from other important relationships in your life.

What can we do to stop domestic abuse and promote domestic violence awareness?

There are many good national and local campaigns to promote awareness, but we may also want to look for signs that it may be happening to someone close to us. Such signs may include:

Unexplained injuries or excuses for bruises and injuries that don’t match up to the stories behind them
Personality changes, particularly decreased self-esteem
Never having money on hand despite being gainfully employed
Intense worry about how their partner will react
Wearing clothes that don’t fit the season, like long sleeves or scarves in summer to cover bruises

If you expect that someone is experiencing domestic violence, don’t be afraid to ask. Talk to them and let them know that they have support. I think we have a lot of work to do in terms of reducing stigma and shame as well as availability of services, including help for victims and abusers to find their way to healthy, respectful, and nonviolent relationships.

If you, or someone you know, is affected by domestic violence, a good place to start may be to call to the National Domestic Violence Hotline at 1-800-799-SAFE (1-800-799-7233), where trained counselors can listen and help to figure out next steps.

Media Contact

Carla Cantor Director of Communications, Columbia Psychiatry 347-913-2227 | [email protected]

How Cross-National Research on Domestic Violence Shelters Can Help Reduce Barriers to Service

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Since the 1970s, domestic violence has gained attention from researchers and public commentators. Survivors of such violence, we have learned, often face difficulties in obtaining the services they need. But most research has focused on the United States, so little is known about services for domestic violence and access to those services in other countries. To advance our comparative knowledge, Lisa R. Muftić and I investigated the extent to which barriers to service are similar in the United States and Bosnia and Herzegovina.

Comparative Research on Barriers to Service Provision

Although domestic violence has happened for at least a millennia, only in the past four decades has there been a push for systematic examination of the offense. This body of research has rapidly expanded to cover topics ranging from factors influencing domestic violence, to the physical and psychological consequences and responses by the criminal justice system. Yet one key area remains under-researched, barriers to service provision for survivors of domestic violence. As survivors seek out help to reduce and prevent further victimization, they commonly encounter intertwined challenges – such as costs, transportation, and family norms – that affect whether they can obtain needed services. Research on such barriers in the United States is slowly accumulating, but similar studies have been infrequent on an international level. What is more, researchers usually examine one culture or country at a time and do not make comparisons. Our research closes this gap and offers insight into how the barriers facing survivors of domestic violence vary across geographic and cultural settings.

In total, we examined eighteen different barriers to service utilization in five different categories: citizenship and language barriers; familial barriers; financial barriers; service provider barriers; and a combination of other obstacles. In addition to uncovering barriers to service, our study investigated the effectiveness of other local agencies that assist survivors as well as characteristics of survivors and domestic violence shelters.

From surveys of directors of domestic violence shelters in the United States, specifically Texas, as well as in Bosnia and Herzegovina, several important findings emerged:

Citizenship and language barriers – such as not speaking the native language and fear of deportation – were more problematic in Texas than Bosnia and Herzegovina.
Family barriers were important everywhere – such as pressure not to come forward from family members, fear that a significant other will find out about a victim trying to get assistance or children will be removed, and fear of harm from the abuser.
In Bosnia and Herzegovina, lack of insurance, long wait times, and the community negatively labeling women seeking help were more problematic than in Texas.
Lack of transportation was a significantly greater problem in Texas.
Emergency medical personnel, nurses, and doctors were perceived as more adequately meeting the needs of survivors in Bosnia and Herzegovina than in Texas.
Survivors in Bosnia and Herzegovina more frequently spoke the native language fluently and were married to their abusers or were suspected victims of human trafficking. Compared to Texas victims, they were also more likely to report their victimization to police and have a safety plan when they came into the shelter.
A greater proportion of survivors in Texas identified as lesbian, gay, bisexual or transgender or from outside of the country. Texas victims were also more likely to have problems with drugs or alcohol, suffer from mental illness, have a physical disability, and more often had a safety plan by the time they left the shelter.
Compared to shelters in Bosnia and Herzegovina, those in Texas had assisted more survivors in a given year, maintained more full and part time staff, and had more beds.
Shelters in Bosnia and Herzegovina had longer maximum lengths of time a survivor could stay in the shelter.

Overall, differences across nations were minimal for 12 out of 18 barriers studied. Factors referring to language and citizenship revealed the sharpest differences.

How Research on Barriers Can Improve Service Provision

Research findings such as ours can help shelters, service providers, and policymakers make improvements – and cross-national comparisons help to pinpoint which barriers are universal and which are tied to specific contexts. Culturally relevant barriers may well vary according to the location and type of population being served. For instance, language barriers were important in Texas but not in Bosnia. Our findings highlight the need to recognize cultural variations among individuals. In addition, financial and transportation barriers can be eased by strengthening ties among local governmental agencies, non-governmental organizations, and day care centers.

Moving forward, there are two key areas for further research. We need better understandings of access to resources after victims leave shelters and we also need a greater grasp of barriers in urban and rural locations. The issues facing domestic violence survivors and service providers may vary across nations – but there may also be critical divergences between urban and rural settings. One-size-fits-all solutions are unlikely to work either within or between countries.

Read more in Jonathan Grubb and Lisa R. Muftić, “ A Comparative Analysis of Domestic Violence Shelter Staff Perceptions Regarding Barriers to Services in Bosnia and Herzegovina and the United States ” International Journal of Offender Therapy and Comparative Criminology (2017).

“I see it as a partnership.” Faculty support survivors of domestic violence through comprehensive research.

Published April 8, 2024
Faculty Research Profiles , Research News

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Lexington, KY – In an era where domestic violence remains a critical and pervasive issue, the University of Kentucky College of Social Work (CoSW) stands out for its unwavering commitment to combatting this societal challenge.

The first statewide report on Domestic Violence released by Team Kentucky in June 2023 underscored the alarming prevalence of this issue, with over 45% of women and 35.5% of men in the commonwealth experiencing intimate partner violence (IPV) in their lifetimes.

Drs. Kathryn Showalter and Laneshia Conner , alongside doctoral candidates Stephanie Ratliff and Rujeko Machinga-Asaolu were invited to lead multiple sessions during the National Network to End Domestic Violence (NNEDV) 7 th Annual Economic Justice Summit.

“We were invited to share findings on often-overlooked IPV factors, such as co-occurring substance misuse, the economic impact of domestic violence, the vulnerability of older adults, psychological abuse, and workplace violence protection orders,” said Showalter. “It was an extremely rewarding and fruitful effort after years of building positive relationships at NNEDV.”

Dr. Kathryn Showalter, a leading researcher at UK , has secured two pilot grants from the University of Kentucky’s Center for Research on Violence Against Women (CRVAW) and the Center for Clinical and Translational Sciences (CTTS).

Dr. Laneshia Conner is an assistant professor at COSW, a second-year CTTS DREAM Scholar and a recipient of the University’s BIRWHC grant.

Stephanie Ratliff, CoSW Director of Social Work Field Education and doctoral candidate, shared that she sees the role of peer-reviewed research on IPV as a collaborative tool to empower domestic violence programs and shelters.

“Limited or inaccurate data can have a detrimental impact on services for survivors and critical funding decisions,” Ratliff explains. “Research is pivotal in bridging the gap between empirical evidence and practical application, enhancing services and guiding targeted investments. I see our research as a partnership.”

The group’s collaborative research particularly emphasizes the economic impact wrought by IPV, including perpetrators’ financial sabotage and employment interference. This can leave survivors financially dependent and struggling to secure economic independence.

“Abusive partners strategically sabotage their victims immediate financial security as well as their ability to maintain careers into the future” Showalter said. “These findings are especially relevant for female dominated sectors, like nursing in which their is opportunity to advance and thus opportunity to control.”

Shelters and domestic violence programs often lack the resources to conduct peer-reviewed research, focusing their efforts on providing survivors with immediate needs like housing, food, transportation, and childcare.

This team’s research not only addresses economic sabotage and employment interference by perpetrators but also strengthens domestic violence programs through empirical evidence crucial for securing funding. Their research focuses on empowering these programs to offer comprehensive services, including harm reduction strategies and policy changes to combat discriminatory practices, thus supporting IPV survivors’ journey towards safety and stability.

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For 85 years, the University of Kentucky College of Social Work (CoSW) has been a leader in social work education. As a college, we promote community and individual well-being through translational research and scholarship, exemplary teaching, and vital community engagement. We are committed to the people and social institutions throughout Kentucky, the nation, and the world. Like the University, CoSW is an organization that cultivates a diverse academic community characterized by interpersonal fairness and social justice. We are fiercely committed to developing outstanding social work professionals — leaders who will serve individuals, families, and communities through innovative and effective practices that are guided by cultural competency, systematic ethical analysis, and a keen and pragmatic understanding of the human condition.

Players and umpires link arms for a moment of silence for victims of gender-based violence ahead of a Round 8 AFL game

A minute’s silence is fine but when it comes to violence against women, being quiet isn’t enough

Associate Professor Sport Management and Sport Integrity Lead, University of Canberra

Editor of the feminist academic blog BroadAgenda at the Faculty of Business, Government and Law at University of Canberra., University of Canberra

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Sport has a role to play in creating a culture of respect, yet women in sport are often seen as “less than” on almost every measure: salaries, sponsorship, broadcasting, leadership, access, media, coaching, officiating, uniforms and support.

Research shows three out of four Australian men are gender equality supporters, but very few (17%) prioritise taking any action.

As Australia grapples with a “ national crisis ” of violence against women, what can men in sport do to help?

What does the research tell us?

Rigid gender norms can play a part in fuelling male violence against women and children. And sport is an arena, excuse the pun, where rigid gender norms flourish.

When it comes to sport and gendered violence, a special level of toxic attack and misogyny is reserved for women who “dare” to play , watch and work in sport , and this is particularly heightened for women of colour and/or presumed to be from the LGBTQI+ community, whether identifying or not.

Sport also regularly promotes alcohol and gambling, with evident impacts on women and children – whenever there are big sporting events, violence against women by spectators increases .

Players, coaches, commentators and officials repeatedly avoid sanctions, or get a slap on the wrist, and go on to secure leadership roles in sport, sometimes despite allegations of serious gender-based offences.

The message this sends to younger players and fans is that misogyny is acceptable and that “heroes” are beyond reproach. This green-lights sexism , and completely undermines any messages around equality.

Tracey Gaudry has held a trifecta of roles relevant to this discussion. Not only was she previously a former champion cyclist, and former CEO of Hawthorn Football Club, she has also been Respect Victoria’s CEO.

Back in 2020 she nailed the confluence of issues :

“Gender inequality is a driver of violence against women and it can start out small. Because sport comes from a male-dominant origin, those things build up over time and become a natural part of the sporting system and an assumed part.”

What are sports codes and teams doing?

Professional sport organisations and clubs have been trying to address abusive behaviour towards women for decades. Both the AFL and NRL began developing respect and responsibility programs and policies 20 years ago, yet the abuse, and the headlines, continue – against both women in the game, and at home.

There are also opportunities for clubs to take action even if their governing bodies don’t. Semi-professional rugby league club the Redfern All Blacks, for example, are showing leadership: players who are alleged to be perpetrators are banned from playing until they’re prepared to talk about it openly, and prove they are committed to changing their behaviour.

Education is also vital.

At the elite level, most codes are trying to educate those within their sports – the NRL’s Voice Against Violence program, led by Our Watch, is the same organisation the AFL has recently partnered with .

The NRL also implements the “Change the Story” framework in partnership with ANROWS and VicHealth, which includes a zero tolerance education program for juniors transitioning into seniors.

What more should be done?

The AFL’s recent minute silence gesture to support women affected by violence does not go far enough.

Men, especially those in leadership positions, can take action by actively dishonouring the men who have abused women.

Some of the men we celebrate around the country for their service as players, presidents, life members and coaches have been abusive towards women and children.

Recently, the AFL demanded Wayne Carey – who has a long history of domestic violence allegations and assault convictions – be denied his NSW Hall of Fame Legend status . The next step is to see Carey struck off his club and AFL honour rolls.

The same treatment should apply to other convicted abusers such as Jarrod Hayne and Ben Cousins – the list goes on.

To take a stand on violence against women, award winners who have been convicted for, or admitted to, abuse against women should be explicitly called out with an asterisk next to their names – “dishonoured for abuse against women”.

And current and future awards must be ineligible to abusers. Serious crimes should mean a life ban for all roles in sport.

If there is a criminal conviction, or an admission of disrespectful behaviour (abuse, sexism, racism, ableism or homophobia), then action must immediately be taken to strip them of their privileges.

What about the grey area of allegations?

One tricky challenge for sport organisations is how to deal with allegations that don’t result in criminal convictions.

The legal system has systematically failed to protect women from sexual predators, so we can’t rely solely on a conviction to act.

In 2019, the NRL introduced a discretionary “no fault, stand down” rule for players charged with serious criminal offences, and/or offences involving women and children. Under this rule, players must stand down from matches until the matter is resolved.

All sports should, as a baseline starting point, be following suit.

Where to from here?

It’s time sport organisations and fans acknowledged two things can be true: good, even great, athletes, coaches or administrators can be bad humans.

Sporting codes need a zero-tolerance approach for abuse of women which should apply to fans, players, coaches, umpires, referees and administrators.

All codes should strongly consider implementing the “no fault, stand down” rule similar to the NRL. Perpetrators should not be allowed back into high-profile roles. Supporters must also be held to account – if fans can be banned for racism , they can be banned for sexism.

At all levels and across all sports, we must send the message from the ground up: misogyny is unacceptable and the consequence for your bad behaviour is that you are no longer welcome.

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Continuing Education Activity

Family and domestic violence is a common problem in the United States, affecting an estimated 10 million people every year; as many as one in four women and one in nine men are victims of domestic violence. Virtually all healthcare professionals will at some point evaluate or treat a patient who is a victim of domestic or family violence. Domestic and family violence includes economic, physical, sexual, emotional, and psychological abuse of children, adults, or elders. Domestic violence causes worsened psychological and physical health, decreased quality of life, decreased productivity, and in some cases, mortality. Domestic and family violence can be difficult to identify. Many cases are not reported to health professionals or legal authorities. This activity describes the evaluation, reporting, and management strategies for victims of domestic abuse and stresses the role of team-based interprofessional care for these victims.

Identify the epidemiology of domestic violence.
Describe the types of domestic violence.
Explain challenges associated with reporting domestic violence.
Review some interprofessional team strategies for improving care coordination and communication to identify domestic violence and improve outcomes for its victims.
Introduction

Family and domestic violence including child abuse, intimate partner abuse, and elder abuse is a common problem in the United States. Family and domestic health violence are estimated to affect 10 million people in the United States every year. It is a national public health problem, and virtually all healthcare professionals will at some point evaluate or treat a patient who is a victim of some form of domestic or family violence. [1] [2] [3] [4] [5]

Unfortunately, each form of family violence begets interrelated forms of violence. The "cycle of abuse" is often continued from exposed children into their adult relationships and finally to the care of the elderly.

Domestic and family violence includes a range of abuse, including economic, physical, sexual, emotional, and psychological, toward children, adults, and elders.

Intimate partner violence includes stalking, sexual and physical violence, and psychological aggression by a current or former partner. In the United States, as many as one in four women and one in nine men are victims of domestic violence. Domestic violence is thought to be underreported. Domestic violence affects the victim, families, co-workers, and community. It causes diminished psychological and physical health, decreases the quality of life, and results in decreased productivity.

The national economic cost of domestic and family violence is estimated to be over 12 billion dollars per year. The number of individuals affected is expected to rise over the next 20 years, increasing the elderly population.

Domestic and family violence is difficult to identify, and many cases go unreported to health professionals or legal authorities. Due to the prevalence in our society, all healthcare professionals, including psychologists, nurses, pharmacists, dentists, physician assistants, nurse practitioners, and physicians, will evaluate and possibly treat a victim or perpetrator of domestic or family violence. [6] [7]

Definitions

Family and domestic violence are abusive behaviors in which one individual gains power over another individual.

Intimate partner violence typically includes sexual or physical violence, psychological aggression, and stalking. This may include former or current intimate partners.
Child abuse involves the emotional, sexual, physical, or neglect of a child under 18 by a parent, custodian, or caregiver that results in potential harm, harm, or a threat of harm.
Elder abuse is a failure to act or an intentional act by a caregiver that causes or creates a risk of harm to an elder.

Center for Disease Control and Prevention (CDC)

Domestic violence, spousal abuse, battering, or intimate partner violence, is typically the victimization of an individual with whom the abuser has an intimate or romantic relationship. The CDC defines domestic violence as "physical violence, sexual violence, stalking, and psychological aggression (including coercive acts) by a current or former intimate partner."

Domestic and family violence has no boundaries. This violence occurs in intimate relationships regardless of culture, race, religion, or socioeconomic status. All healthcare professionals must understand that domestic violence, whether in the form of emotional, psychological, sexual, or physical violence, is common in our society and should develop the ability to recognize it and make the appropriate referral.

Violence Abuse Types

The types of violence include stalking, economic, emotional or psychological, sexual, neglect, Munchausen by proxy, and physical. Domestic and family violence occurs in all races, ages, and sexes. It knows no cultural, socioeconomic, education, religious, or geographic limitation. It may occur in individuals with different sexual orientations.

Reason Abusers Need to Control [8] [9] [10]

Anger management issues
Low self-esteem
Feeling inferior
Cultural beliefs they have the right to control their partner
Personality disorder or psychological disorder
Learned behavior from growing up in a family where domestic violence was accepted
Alcohol and drugs, as an impaired individual may be less likely to control violent impulses

Risk Factors

Risk factors for domestic and family violence include individual, relationship, community, and societal issues. There is an inverse relationship between education and domestic violence. Lower education levels correlate with more likely domestic violence. Childhood abuse is commonly associated with becoming a perpetrator of domestic violence as an adult. Perpetrators of domestic violence commonly repeat acts of violence with new partners. Drug and alcohol abuse greatly increases the incidence of domestic violence.

Children who are victims or witness domestic and family violence may believe that violence is a reasonable way to resolve a conflict. Males who learn that females are not equally respected are more likely to abuse females in adulthood. Females who witness domestic violence as children are more likely to be victimized by their spouses. While females are often the victim of domestic violence, gender roles can be reversed.

Domination may include emotional, physical, or sexual abuse that may be caused by an interaction of situational and individual factors. This means the abuser learns violent behavior from their family, community, or culture. They see violence and are victims of violence.

Epidemiology

Domestic violence is a serious and challenging public health problem. Approximately 1 in 3 women and 1 in 10 men 18 years of age or older experience domestic violence. Annually, domestic violence is responsible for over 1500 deaths in the United States. [11] [12] [13]

Domestic violence victims typically experience severe physical injuries requiring care at a hospital or clinic. The cost to individuals and society is significant. The national annual cost of medical and mental health care services related to acute domestic violence is estimated at over $8 billion. If the injury results in a long-term or chronic condition, the cost is considerably higher.

Financial hardship and unemployment are contributors to domestic violence. An economic downturn is associated with increased calls to the National Domestic Violence Hotline.

Fortunately, the national rate of nonfatal domestic violence is declining. This is thought to be due to a decline in the marriage rate, decreased domesticity, better access to domestic violence shelters, improvements in female economic status, and an increase in the average age of the population.

Most perpetrators and victims do not seek help.
Healthcare professionals are usually the first individuals with an opportunity to identify domestic violence.
Nurses are usually the first healthcare providers victims encounter.
Domestic violence may be perpetrated on women, men, parents, and children.
Fifty percent of women seen in emergency departments report a history of abuse, and approximately 40% of those killed by their abuser sought help in the 2 years before death.
Only one-third of police-identified victims of domestic violence are identified in the emergency department.
Healthcare professionals who work in acute care need to maintain a high index of suspicion for domestic violence as supportive family members may, in fact, be abusers.

Child Abuse

Age, family income, and ethnicity are all risk factors for both sexual abuse and physical abuse. Gender is a risk factor for sexual abuse but not for physical abuse.

Each year there are over 3 million referrals to child protective authorities. Despite often being the first to examine the victims, only about 10% of the referrals were from medical personnel. The fatality rate is approximately two deaths per 100,000 children. Women account for a little over half of the perpetrators.

Intimate Partner Violence

According to the CDC, 1 in 4 women and 1 in 7 men will experience physical violence by their intimate partner at some point during their lifetimes. About 1 in 3 women and nearly 1 in 6 men experience some form of sexual violence during their lifetimes. Intimate partner violence, sexual violence, and stalking are high, with intimate partner violence occurring in over 10 million people each year.

One in 6 women and 1 in 19 men have experienced stalking during their lifetimes. The majority are stalked by someone they know. An intimate partner stalks about 6 in 10 female victims and 4 in 10 male victims.

At least 5 million acts of domestic violence occur annually to women aged 18 years and older, with over 3 million involving men. While most events are minor, for example grabbing, shoving, pushing, slapping, and hitting, serious and sometimes fatal injuries do occur. Approximately 1.5 million intimate partner female rapes and physical assaults are perpetrated annually, and approximately 800,000 male assaults occur. About 1 in 5 women have experienced completed or attempted rape at some point in their lives. About 1% to 2% of men have experienced completed or attempted rape.

The incidence of intimate partner violence has declined by over 60%, from about ten victimizations per 1000 persons age 12 or older to approximately 4 per 1000.

Due to underreporting and difficulty sampling, obtaining accurate incidence information on elder abuse and neglect is difficult. Elderly abuse is thought to occur in 3% to 10% of the population of elders.

Elderly patients may not report due to fear, guilt, ignorance, or shame. Clinicians underreport elder abuse due to poor recognition of the problem, lack of understanding of reporting methods and requirements, and concerns about physician-patient confidentiality.

Pathophysiology

There may be some pathologic findings in both the victims and perpetrators of domestic violence. Certain medical conditions and lifestyles make family and domestic violence more likely. [13] [14] [15]

Perpetrators

While the research is not definitive, a number of characteristics are thought to be present in perpetrators of domestic violence. Abusers tend to:

Have a higher consumption of alcohol and illicit drugs and assessment should include questions that explore drinking habits and violence
Be possessive, jealous, suspicious, and paranoid.
Be controlling of everyday family activity, including control of finances and social activities.
Suffer low self-esteem
Have emotional dependence, which tends to occur in both partners, but more so in the abuser

Domestic violence at home results in emotional damage, which exerts continued effects as the victim matures.

Approximately 45 million children will be exposed to violence during childhood.
Approximately 10% of children are exposed to domestic violence annually, and 25% are exposed to at least 1 event during their childhood.
Ninety percent are direct eyewitnesses of violence.
Males who batter their wives batter the children 30% to 60% of the time.
Children who witness domestic violence are at increased risk of dating violence and have a more difficult time with partnerships and parenting.
Children who witness domestic violence are at an increased risk for post-traumatic stress disorder, aggressive behavior, anxiety, impaired development, difficulty interacting with peers, academic problems, and they have a higher incidence of substance abuse.
Children exposed to domestic violence often become victims of violence.
Children who witness and experience domestic violence are at a greater risk for adverse psychosocial outcomes.
Eighty to 90% of domestic violence victims abuse or neglect their children.
Abused teens may not report abuse. Individuals 12 to 19 years of age report only about one-third of crimes against them, compared with one-half in older age groups

Pregnant and Females

The American College of Obstetricians and Gynecologists (ACOG) recommends all women be assessed for signs and symptoms of domestic violence during regular and prenatal visits. Providers should offer support and referral information.

Domestic violence affects approximately 325,000 pregnant women each year.
The average reported prevalence during pregnancy is approximately 30% emotional abuse, 15% physical abuse, and 8% sexual abuse.
Domestic violence is more common among pregnant women than preeclampsia and gestational diabetes.
Reproductive abuse may occur and includes impregnating against a partner's wishes by stopping a partner from using birth control.
Since most pregnant women receive prenatal care, this is an excellent time to assess for domestic violence.

The danger of domestic violence is particularly acute as both mother and fetus are at risk. Healthcare professionals should be aware of the psychological consequences of domestic abuse during pregnancy. There is more stress, depression, and addiction to alcohol in abused pregnant women. These conditions may harm the fetus.

Gay, Lesbian, Bisexual, and Transgender

Domestic violence occurs in gay, lesbian, bisexual, and transgender couples, and the rates are thought to be similar to a heterosexual woman, approximately 25%.

There are more cases of domestic violence among males living with male partners than among males who live with female partners.
Females living with female partners experience less domestic violence than females living with males.
Transgender individuals have a higher risk of domestic violence. Transgender victims are approximately two times more likely to experience physical violence.

Gay, lesbian, bisexual, and transgender victims may be reticent to report domestic violence. Part of the challenge may be that support services such as shelters, support groups, and hotlines are not regularly available. This results in isolated and unsupported victims. Healthcare professionals should strive to be helpful when working with gay, lesbian, bisexual, and transgender patients.

Usually, domestic violence is perpetrated by men against women; however, females may exhibit violent behavior against their male partners.

Approximately 5% of males are killed by their intimate partners.
Each year, approximately 500,000 women are physically assaulted or raped by an intimate partner compared to 100,000 men.
Three out of 10 women at some point are stalked, physically assaulted, or raped by an intimate partner, compared to 1 out of every 10 men.
Rape is primarily perpetrated by other men, while women engage in other forms of violence against men.

Although women are the most common victims of domestic violence, healthcare professionals should remember that men may also be victims and should be evaluated if there are indications present.

The elderly are often mistreated by their spouses, children, or relatives.

Annually, approximately 2% of the elderly experience physical abuse, 1% sexual abuse, 5% neglect, 5% financial abuse, and 5% suffer emotional abuse.
The annual incidence of elder abuse is estimated to be 2% to 10%, with only about 1 in 15 cases reported to the authorities.
Approximately one-third of nursing homes disclosed at least 1 incident of physical abuse per year.
Ten percent of nursing home staff self-report physical abuse against an elderly resident.

Elder domestic violence may be financial or physical. The elderly may be controlled financially. Elders are often hesitant to report this abuse if it is their only available caregiver. Victims are often dependent, infirm, isolated, or mentally impaired. Healthcare professionals should be aware of the high incidence of abuse in this population.

History and Physical

The history and physical exam should be tailored to the age of the victim.

The most common injuries are fractures, contusions, bruises, and internal bleeding. Unexpected injuries to pre-walking infants should be investigated. The caregiver should explain unusual injuries to the ears, neck, or torso; otherwise, these injuries should be investigated.

Children who are abused may be unkempt and/or malnourished. They may display inappropriate behavior such as aggression, or maybe shy, withdrawn, and have poor communication skills. Others may be disruptive or hyperactive. School attendance is usually poor.

Intimate Partner Abuse

Approximately one-third of women and one-fifth of men will be victims of abuse. The most common sites of injuries are the head, neck, and face. Clothes may cover injuries to the body, breasts, genitals, rectum, and buttocks. One should be suspicious if the history is not consistent with the injury. Defensive injuries may be present on the forearms and hands. The patient may have psychological signs and symptoms such as anxiety, depression, and fatigue.

Medical complaints may be specific or vague such as headaches, palpitations, chest pain, painful intercourse, or chronic pain.

Intimate Partner Abuse: Pregnancy and Female

Abuse during pregnancy may cause as much as 10% of pregnant hospital admissions. There are a number of historical and physical findings that may help the provider identify individuals at risk.

If the examiner encounters signs or symptoms, she should make every effort to examine the patient in private, explaining confidentiality to the patient. Be sure to ask caring, empathetic questions and listen politely without interruption to answers.

Intimate Partner Abuse: Same-Sex

Same-sex partner abuse is common and may be difficult to identify. Over 35% of heterosexual women, 40% of lesbians, 60% of bisexual women experience domestic violence. For men, the incidence is slightly lower. In addition to common findings of abuse, perpetrators may try to control their partners by threatening to make their sexual preferences public.

The provider should be aware there are fewer resources available to help victims; further, the perpetrator and victim may have the same friends or support groups.

Intimate Partner Abuse: Men

Men represent as much as 15% of all cases of domestic partner violence. Male victims are also less likely to seek medical care, so that the incidence may be underreported. These victims may have a history of child abuse.

Elderly Abuse

Health professionals should ask geriatric patients about abuse, even if signs are absent.

Pathologic characteristics of perpetrators including dementia, mental illness, and drug and alcohol abuse
A shared living situation with the abuser
Social isolation

Establishing that injuries are related to domestic abuse is a challenging task. Life and limb-threatening injuries are the priority. After stabilization and physical evaluation, laboratory tests, x-rays, CT, or MRI may be indicated. It is important that healthcare professionals first attend to the underlying issue that brought the victim to the emergency department. [1] [16] [17] [18]

The evaluation should start with a detailed history and physical examination. Clinicians should screen all females for domestic violence and refer females who screen positive. This includes females who do not have signs or symptoms of abuse. All healthcare facilities should have a plan in place that provides for assessing, screening, and referring patients for intimate partner violence. Protocols should include referral, documentation, and follow-up.
Health professionals and administrators should be aware of challenges such as barriers to screening for domestic violence: lack of training, time constraints, the sensitive nature of issues, and a lack of privacy to address the issues.
Although professional and public awareness has increased, many patients and providers are still hesitant to discuss abuse.
Patients with signs and symptoms of domestic violence should be evaluated. The obvious cues are physical: bruises, bites, cuts, broken bones, concussions, burns, knife or gunshot wounds.
Typical domestic injury patterns include contusions to the head, face, neck, breast, chest, abdomen, and musculoskeletal injuries. Accidental injuries more commonly involve the extremities of the body. Abuse victims tend to have multiple injuries in various stages of healing, from acute to chronic.
Domestic violence victims may have emotional and psychological issues such as anxiety and depression. Complaints may include backaches, stomachaches, headaches, fatigue, restlessness, decreased appetite, and insomnia. Women are more likely to experience asthma, irritable bowel syndrome, and diabetes.

Assuming the patient is stable and not in pain, a detailed assessment of victims should occur after disclosure of abuse. Assessing safety is the priority. A list of standard prepared questions can help alleviate the uncertainty in the patient's evaluation. If there are signs of immediate danger, refer to advocate support, shelter, a hotline for victims, or legal authorities.

If there is no immediate danger, the assessment should focus on mental and physical health and establish the history of current or past abuse. These responses determine the appropriate intervention.
During the initial assessment, a practitioner must be sensitive to the patient’s cultural beliefs. Incorporating a cultural sensitivity assessment with a history of being victims of domestic violence may allow more effective treatment.
Patients that have suffered domestic violence may or may not want a referral. Many are fearful of their lives and financial well-being. They hence may be weighing the tradeoff in leaving the abuser leading to loss of support and perhaps the responsibility of caring for children alone. The healthcare provider needs to assure the patient that the decision is voluntary and that the provider will help regardless of the decision. The goal is to make resources accessible, safe, and enhance support.
If the patient elects to leave their current situation, information for referral to a local domestic violence shelter to assist the victim should be given.
If there is a risk to life or limb, or evidence of injury, the patient should be referred to local law enforcement officials.
Counselors often include social workers, psychiatrists, and psychologists that specialize in the care of battered partners and children.

A detailed history and careful physical exam should be performed. If head trauma is suspected, consider an ophthalmology consultation to obtain indirect ophthalmoscopy.

Laboratory studies are often important for forensic evaluation and criminal prosecution. On occasion, certain diseases may mimic findings similar to child abuse. As a consequence, they must be ruled out.

A urine test may be used as a screen for sexually transmitted disease, bladder or kidney trauma, and toxicology screening.

If bruises or contusions are present, there is no need to evaluate for a bleeding disorder if the injuries are consistent with an abuse history. Some tests can be falsely elevated, so a child abuse-specialist pediatrician or hematologist should review or follow-up these tests.

Gastrointestinal and Chest Trauma

Consider liver and pancreas screening tests such as AST, ALT, and lipase. If the AST or ALT is greater than 80 IU/L, or lipase greater than 100 IU/L, consider an abdomen and pelvis CT with intravenous contrast.
The highest-risk are those with abusive head trauma, fractures, nausea, vomiting, or an abnormal Glasgow Coma Scale score of less than 15.

The evaluation of the pediatric skeleton can prove challenging for a non-specialist as there are subtle differences from adults, such as cranial sutures and incomplete bone growth. A fracture can be misinterpreted. If there is a concern for abuse, consider consulting a radiologist.

Imaging: Skeletal Survey

A skeletal survey is indicated in children younger than 2 years with suspected physical abuse. The incidence of occult fractures is as high as 1 in 4 in physically abused children younger than 2 years. The clinician should consider screening all siblings younger than 2 years.

The skeletal survey should include 2 views of each extremity; anteroposterior and lateral skull; and lateral chest, spine, abdomen, pelvis, hands, and feet. A radiologist should review the films for classic metaphyseal lesions and healing fractures, most often involving the posterior ribs. A “babygram” that includes only 1 film of the entire body is not an adequate skeletal survey.

Skeletal fractures will remodel at different rates, which are dependent on the age, location, and nutritional status of the patient.

Imaging: CT

If abuse or head trauma is suspected, a CT scan of the head should be performed on all children aged six months or younger or children younger than 24 months if intracranial trauma is suspected. Clinicians should have a low threshold to obtain a CT scan of the head when abuse is suspected, especially in an infant younger than 12 months.

CT of the abdomen and pelvis with intravenous contrast is indicated in unconscious children, have traumatic abdominal findings such as abrasions, bruises, tenderness, absent or decreased bowel sounds, abdominal pain, nausea, or vomiting, or have elevation of the AST, an ALT greater than 80 IU/L, or lipase greater than 100 IU/L.

Special Documentation

Photographs should be taken before treatment of injuries.

Intimate Partner and Elder

Evaluate for evidence of dehydration, electrolyte abnormalities, infection, substance abuse, improper medication administration, and malnutrition.

X-rays of bruised of tender body parts to detect fractures
Head CT scan to evaluate for intracranial bleeding as a result of abuse or the causes of altered mental status
Pelvic examination with evidence collection if sexual assault

Evidence Collection

Domestic and family violence commonly results in the legal prosecution of the perpetrator. Preferably, a team specializing in domestic violence is called in to assist with evidence collection.

Each health facility should have a written procedure for how to package and label specimens and maintain a chain of custody. Law enforcement personnel will often assist with evidence collection and provide specific kits.

It is important to avoid destroying evidence. Evidence includes tissue specimens, blood, urine, saliva, and vaginal and rectal specimens. Saliva from bites can be collected; the bite mark is swabbed with a water-moistened cotton-tipped swab.

Clothing stained with blood, saliva, semen, and vomit should be retained for forensic analysis.

Treatment / Management

The priority is the ABCs and appropriate treatment of the presenting complaints. However, once the patient is stabilized, emergency medical services personnel may identify problems associated with violence. [19] [20] [21]

Emergency Department and Office Care

Interventions to consider include:

Make sure a safe environment is provided.
Diagnose physical injuries and other medical or surgical problems.
Treat acute physical or life-threatening injuries.
Identify possible sources of domestic violence.
Establish domestic violence as a diagnosis.
Reassure the patient that he is not at fault.
Evaluate the emotional status and treat.
Document the history, physical, and interventions.
Determine the risks to the victim and assess safety options.
Counsel the patient that violence may escalate.
Determine if legal intervention is needed and report abuse when appropriate or mandated.
Develop a follow-up plan.
Offer shelter options, legal services, counseling, and facilitate such referral.

Medical Record

The medical record is often evidence used to convict an abuser. A poorly document chart may result in an abuser going free and assaulting again.

Charting should include detailed documentation of evaluation, treatment, and referrals.

Describe the abusive event and current complaints using the patient's own words.
Include the behavior of the patient in the record.
Include health problems related to the abuse.
Include the alleged perpetrator's name, relationship, and address.
The physical exam should include a description of the patient's injuries including location, color, size, amount, and degree of age bruises and contusions.
Document injuries with anatomical diagrams and photographs.
Include the name of the patient, medical record number, date, and time of the photograph, and witnesses on the back of each photograph.
Torn and damaged clothing should also be photographed.
Document injuries not shown clearly by photographs with line drawings.
With sexual assault, follow protocols for physical examination and evidence collection.

Disposition

If the patient does not want to go to a shelter, provide telephone numbers for domestic violence or crisis hotlines and support services for potential later use. Provide the patient with instructions but be mindful that written materials may pose a danger once the patient returns home.

A referral should be made to primary care or another appropriate resource.
Advise the patient to have a safety plan and provide examples.
Forty percent of domestic violence victims never contact the police.
Of female victims of domestic homicide, 44% had visited a hospital emergency department within 2 years of their murder.
Health professionals provide an opportunity for victims of domestic violence to obtain help.
Differential Diagnosis

The differential diagnosis varies with the injury type of injury and age.

Head Traum a

Accidental injury
Arteriovenous malformations
Bacterial meningitis
Birth trauma
Cerebral sinovenous thrombosis
Solid brain tumors

Bruises and Contusions

Accidental bruises
Bleeding disorder
Congenital dermal melanocytosis (Mongolian spots)
Erythema multiforme
Accidental burns
Atopic dermatitis
Contact dermatitis
Inflammatory skin conditions
Congenital syphilis
Osteogenesis imperfecta
Osteomyelitis
Toddler’s fracture

Without proper social service and mental health intervention, all forms of abuse can be recurrent and escalating problems, and the prognosis for recovery is poor. Without treatment, domestic and family violence usually recurs and escalates in both frequency and severity. [3] [22] [23]

Of those injured by domestic violence, over 75% continue to experience abuse.
Over half of battered women who attempt suicide will try again; often they are successful with the second attempt.

In children, the potential for poor outcomes is particularly high as abuse inflicts lifelong effects. In addition to dealing with the sequelae of physical injury, the mental consequences may be catastrophic. Studies indicate a significant association between child sexual abuse and increased risk of psychiatric disorders in later life. The potential for the cycle of violence to continued from childhood is very high.

Children raised in families of sexual abuse may develop:

Attention deficit hyperactivity disorder (ADHD)
Conduct disorder
Bipolar disorder
Panic disorder
Sleep disorders
Suicide attempts
Post-traumatic stress disorder (PTSD)

Health Outcomes

There are multiple known and suspected negative health outcomes of family and domestic violence. There are long-term consequences to broken bones, traumatic brain injuries, and internal injuries.

Patients may also develop multiple comorbidities such as:

Fibromyalgia
High blood pressure
Chronic pain
Gastrointestinal disorders
Gynecologic disorders
Panic attacks
Pearls and Other Issues

Screening: Tools

The American Academy of Pediatricians has free guides for the history, physical, diagnostic testing, documentation, treatment, and legal issues in cases of suspected child abuse.
The Center for Disease Control and Prevention (CDC) provides several scales assessing family relationships, including child abuse risks.
The physical examination is still the most significant diagnostic tool to detect abuse. A child or adult with suspected abuse should be undressed, and a comprehensive physical exam should be performed. The skin should be examined for bruises, bites, burns, and injuries in different stages of healing. Examine for retinal hemorrhages, subdural hemorrhages, tympanic membrane rupture, soft tissue swelling, oral bruising, fractured teeth, and organ injury.

Screening: Recommendations

Evaluate for organic conditions and medications that mimic abuse.
Evaluate patients and caregivers separately
Clinicians should regularly screen for family and domestic violence and elder abuse
The Elder Abuse Suspicion Index can be used to assess for elder abuse
Screen for cognitive impairment before screening for abuse in the elderly
Pattern injury is more suspicious
Failure to report child abuse is illegal in most states.
Failure to report intimate partner and elder abuse is illegal in many states.

It is important to be aware of federal and state statutes governing domestic and family abuse. Remember that reporting domestic and family violence to law enforcement does not obviate detailed documentation in the medical record.

Battering is a crime, and the patient should be made aware that help is available. If the patient wants legal help, the local police should be called.
In some jurisdictions, domestic violence reporting is mandated. The legal obligation to report abuse should be explained to the patient.
The patient should be informed how local authorities typically respond to such reports and provide follow-up procedures. Address the risk of reprisal, need for shelter, and possibly an emergency protective order (available in every state and the District of Columbia).
If there is a possibility the patient’s safety will be jeopardized, the clinician should work with the patient and authorities to best protect the patient while meeting legal reporting obligations.
The clinical role in managing an abused patient goes beyond obeying the laws that mandate reporting; there is a primary obligation to protect the life of the patient.
The clinician must help mitigate the potential harm that results from reporting, provide appropriate ongoing care, and preserve the safety of the patient.
If the patient desires, and it is acceptable to the police, a health professional should remain during the interview.
The medical record should reflect the incident as described by the patient and any physical exam findings. Include the date and time the report was taken and the officer's name and badge number.

National Statutes

Federal Child Abuse Prevention and Treatment Act (CAPTA)

Each state has specific child abuse statutes. Federal legislation provides guidelines for defining acts that constitute child abuse. The guidelines suggest that child abuse includes an act or failure recent act that presents an imminent risk of serious harm. This includes any recent act or failure to act on the part of a parent or caretaker that results in death, physical or emotional harm, sexual abuse, or exploitation.

Elder Justice Act

The Elder Justice Act provides strategies to decrease the likelihood of elder abuse, neglect, and exploitation. The Act utilizes three significant approaches:

Patient Safety and Abuse Act

The Violence Against Woman Act makes it a federal crime to cross state lines to stalk, harass, or physically injure a partner; or enter or leave the country violating a protective order. It is a violation to possess a firearm or ammunition while subject to a protective order or if convicted of a qualifying crime of domestic violence.

Enhancing Healthcare Team Outcomes

Domestic violence may be difficult to uncover when the victim is frightened, especially when he or she presents to an emergency department or healthcare practitioner's office. The key is to establish an assessment protocol and maintain an awareness of the possibility that domestic and family violence may be the cause of the patient’s signs and symptoms.

Over 80% of victims of domestic and family violence seek care in a hospital; others may seek care in health professional offices, including dentists, therapists, and other medical offices. Routine screening should be conducted by all healthcare practitioners including nurses, physicians, physician assistants, dentists, nurse practitioners, and pharmacists. Interprofessional coordination of screening is a critical component of protecting victims and minimizing negative health outcomes. Health professional team interventions reduce the incidence of morbidity and mortality associated with domestic violence. Documentation is vital and a legal obligation.

Healthcare professionals including the nurse should document all findings and recommendations in the medical record, including statements made denying abuse
If domestic violence is admitted, documentation should include the history, physical examination findings, laboratory and radiographic finds, any interventions, and the referrals made.
If there are significant findings that can be recorded, pictures should be included.
The medical record may become a court document; be objective and accurate.
Healthcare professionals should provide a follow-up appointment.
Reassurance that additional assistance is available at any time is critical to protect the patient from harm and break the cycle of abuse.
Involve the social worker early
Do not discharge the patient until a safe haven has been established.

The following agencies provide national assistance for victims of domestic and family violence:

Centers for Disease Control and Prevention (800-CDC-INFO (232-4636)/TTY: 888-232-6348
Childhelp: National Child Abuse Hotline: (800-4-A-CHILD (2-24453))
The coalition of Labor Union Women (cluw.org): 202-466-4615
Corporate Alliance to End Partner Violence: 309-664-0667
Employers Against Domestic Violence: 508-894-6322
Futures without Violence: 415-678-5500/TTY 800-595-4889
Love Is Respect: National Teen Dating Abuse Helpline: 866-331-9474 /TTY: 866-331-8453
National Center on Domestic and Sexual Violence
National Center on Elder Abuse
National Coalition Against Domestic Violence (www.ncadv.org)
National Network to End Domestic Violence: 202-543-5566
National Organization for Victim Assistance
National Resource Center on Domestic Violence: 800-537-2238
National Sexual Violence Resource Center: 717-909-0710
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Disclosure: Martin Huecker declares no relevant financial relationships with ineligible companies.

Disclosure: Kevin King declares no relevant financial relationships with ineligible companies.

Disclosure: Gary Jordan declares no relevant financial relationships with ineligible companies.

Disclosure: William Smock declares no relevant financial relationships with ineligible companies.

This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.

Cite this Page Huecker MR, King KC, Jordan GA, et al. Domestic Violence. [Updated 2023 Apr 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

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CHAPTER ONE INTRODUCTION AND STATEMENT OF THE PROBLEM

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Magnitude and determinants of intimate partner violence against women in East Africa: multilevel analysis of recent demographic and health survey

Study period and setting

Data source

Measurements of variable and operational definitions

Physical violence

Sexual violence

Emotional violence

Explanatory variable

Attitude towards wife-beating

Husband controlling behavior

Data management and analysis

Socio-demographic characteristics

Magnitude of intimate partner violence

Determinants of intimate partner violence

Strength and limitation

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Domestic Violence: A Q & A With Trauma Researcher Maja Bergman

What is domestic violence? In what forms does it present itself?

Are women its primary victims?

What percentage of people are victims of domestic abuse?

New York City recently amended its definition of domestic violence to include economic abuse and extended protections to victims. How does this invisible form of domestic violence typically present itself? What effects can it have on victims?

What sort of challenges do domestic violence survivors face?

What types of therapy are helpful to work through the trauma of domestic abuse?

Are there any warning signs that someone may be an abuser?

What can we do to stop domestic abuse and promote domestic violence awareness?

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