2006 DOMESTIC VIOLENCE UPDATE  (1hour)

Objectives
Upon completion of this course the student will be able to:
A. Demonstrate knowledge about domestic violence statistics.
B. Understand what domestic violence is.
C. Describe types of abuse.
D. Recognize characteristics of the victim and the abuser.

HISTORY

It is now recognized that for generations, behind a portrait of marital bliss all-too- often lurked men with short tempers and violent tendencies. Americans did not invent violence against women, but they took to it like avengers. In puritan New England women were routinely whipped and publicly humiliated. Married women were little more than the property of their husbands. For generations Americans have reported more domestic abuse than any other Industrial nation. Alcohol has been the catalyst for much of the violence. In the early 1900’s there was no law to prevent abusive alcoholic husbands from abusing their wives. Well in to the late 1800’s a legal formula known as the "rule of thumb" allowed men to beat their wives as long as the sticks they used were no larger than their thumbs.

The 1864 North Carolina Law allowed a husband to use the degree of force necessary to control an unruly temper and make a wife behave herself. If no permanent injury has been inflicted, it is better to shut out the public gaze and leave the parties to forgive and forget. Historically the legal point of view was one ranging from apathy to complete endorsement.

In 1874 in the state of New York one story became the turning point for child and domestic abuse in the United States. Her name was Mary Alec McCormick. For years this small child was a prisoner in a closet. She was a pale, sickly child covered with marks of abuse made over long periods of time. On the table next to Mary lay a whip and a broken pair of scissors which her mother used to injure her. In the 1870’s no organization existed to help children so they turned to the Society for the Prevention of Cruelty to Animals (SPCA). They took Mary to a local judge. This was where the first chapter of Children’s Rights was written. The judge stated that "the sight of this little girl would make grown men weep." Since then, the laws have slowly changed in favor of children’s rights. As for women’s rights, the United States did not abolish the legal right of men to beat their wives until 1871.

What is domestic violence?  

Many people think of it as the deliberate physical assault of a woman by intimate partner such as a spouse, ex-spouse, boyfriend, or ex-boyfriend. But in recent years, the term "domestic violence" has begun to include other forms of violence including abuse of elders, children, and siblings. The term "domestic violence" also tends to overlook male victims and violence between same-sex partners. Therefore, we prefer using the more specific term "intimate partner violence," which we define as the intentional emotional and/or physical abuse by a spouse, ex-spouse, boyfriend/girlfriend, ex-boyfriend/ex-girlfriend, or date.

. The following facts provide a small picture of just how serious this problem is in the United States:

Between November, 1995 and May, 1996, according to data collected on men and women in the United States over the age of 18 by the National Violence Against Women Survey:

Recent research in Minnesota found that women who are victims of intimate partner violence have an annual health care cost of $1775 more than that of women who are not victims of intimate partner violence.

 

Family violence, which includes intimate partner violence, involves elements of control and abuse of power by the person committing the violence.

 

Intimate Partner Violence Fact Sheet
 

Problem Definition

Intimate partner violence (IPV) is a substantial public health problem for Americans that has serious consequences and costs for individuals, families, communities, and society. Recent efforts have been made to increase resources to address gaps in knowledge and to improve services for victims, perpetrators, and child witnesses.

IPV is actual or threatened physical or sexual violence, or psychological/emotional abuse. Some of the common terms that are used to describe intimate partner violence are domestic abuse, spouse abuse, domestic violence, courtship violence, battering, marital rape, and date rape. Intimate partners include current or former spouses, boyfriends, or girlfriends (including heterosexual or same-sex partners). Readers should consult the references cited here for their exact definitions of IPV, which may vary from that described above.

Many experts consider the following figures to be underestimates of IPV, because victims may underreport IPV on surveys and because data sources may lack information identifying victim-perpetrator relationships. Further, definitions and research methods vary across studies, leading to different estimates of IPV.

Non-lethal intimate violence: Data from a household survey on criminal victimization, the National Crime Victimization Survey, between 1992 and 1996 indicate:

  • Nearly 1 million incidents of non-lethal IPV occurred each year from 1992 to 1996; 85% of victims were women.

  • On average each year from 1992 to 1996, approximately 8 in 1,000 women and 1 in 1,000 men age 12 or older experienced a violent victimization perpetrated by a current or former spouse, boyfriend, or girlfriend.

  • On average each year between 1992 and 1996, approximately 12 per 1,000 black women experienced violence by an intimate partner, compared with about 8 per 1,000 white women. These rates are not adjusted for socioeconomic status, which may account for the higher rates in black women.

  • The number of violent victimization's by an intimate partner has been declining for women. In 1996, women reported 840,000 violent victimization's by an intimate partner, down from 1.1 million in 1993.

  • For years 1992-1993, 92% of rapes of women were committed by known assailants. About half of all rapes and sexual assaults against women are committed by friends or acquaintances; 26% are by intimate partners.

Lethal intimate violence: Data from FBI Uniform Crime Reports between 1992 and 1996 indicate:

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For men and for blacks, murders by intimate partners have decreased
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In 1996 about 2,000 murders were attributed to intimate partners, down from 3,000 two decades earlier.
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In 1996, 30% of all female murders were perpetrated by husbands, ex-husbands, or boyfriends. Three percent of all male murder victims were killed by wives, ex-wives, or girlfriends.

Pregnancy: A 1996 review of the literature indicated that estimated proportions of women experiencing IPV during pregnancy ranged between 0.9% and 20.1%. The proportion of pregnant women who had experienced IPV at any time in the past ranged between 9.7% and 29.7%.

Stalking: A term that generally refers to repeated harassing or threatening behavior, stalking is more prevalent in the U.S. than previously thought. In a national study in which the definition of stalking required the victim to report a high level of fear, an estimated 1 million women and 370,000 men were stalked annually. Most victims were women (78%) and most perpetrators were men (87%).

Health Effects

Studies of emergency department (ED) visits by women have found:

  • Women account for nearly 40% of all ED visits for violent victimization in 1994.

  • In 36% of all ED visits by women for violent victimization's, intimate partners were identified as the perpetrators.

  • Women account for 84% of those treated for injuries by intimate partner, which includes spouses, ex-spouses, boyfriends, girlfriends.

  • In one study of ED visits by women, over half of all women in the study had experienced IPV at some time in their lives, while 11% of those with current husbands or boyfriends gave IPV as the reason for the visit.

As a consequence of severe intimate partner violence, female victims are more likely than male victims to need medical attention, take time off from work, spend more days in bed, and suffer more from stress and depression.

Psychological consequences for victims of intimate partner violence can include depression, suicidal thoughts and attempts, lowered self-esteem, alcohol and other drug abuse, and post- traumatic stress disorder.

Risk Factors

Income: Women in families with incomes below $10,000 are more likely than other women to be victims of violence by an intimate partner.

Age: Women age 19 to 29 are more likely than other women to be victims of violence by an intimate partner.

Children:

  • Women whose children have been abused by a parent or other caretaker are at increased risk for IPV.

  • Increased frequency of violence toward a spouse is associated with increased risk of the violent spouse (particularly a husband) also being abusive to the child.

  • Each year more than ten million American children witness IPV within their families.

  • Witnessing violence is stressful and it is a risk factor for long-term physical and mental health problems such as alcohol and substance abuse, child abuse and IPV.

Alcohol and other drugs: Data from the National Crime Victimization Survey indicate an association between IPV and alcohol or other drug use. Among IPV victims who were able to describe alcohol or drug use by the perpetrator, 75% reported offender alcohol or other drug use at the time of the crime.

The nature of the relationship between IPV and substance abuse is not yet clear. Many assaults against intimate partners do not occur in the context of substance abuse, and many substance abusers are not violent with their intimate partners.

Stalking and other forms of violence: Data from the National Violence Against Women Survey of 1995-96 indicate a strong association between stalking and other forms of violence in intimate relationships: 81% of women who were stalked by a current or former husband or cohabiting partner were also physically assaulted by that partner; 31% were also sexually assaulted by that partner.

Costs

Data from the National Crime Victimization Survey between 1992 and 1996 indicate:

  • Non-lethal intimate violence results in financial losses to women victims that are conservatively estimated to be $150 million per year.

  • Medical expenses accounted for at least 40% of these costs, property losses for another 44%, and lost pay for the remainder.

Prevention and Intervention
Increasing access to services for victims and perpetrators of IPV and their children is a priority.

One promising strategy, the use of coordinated community initiatives, may strengthen safety networks for high-risk individuals and families.

School-based prevention programs for IPV have focused both on teen dating violence and on IPV among adult partners. Topics addressed have included exploration of gender roles and expectations, personal safety, legal statutes, and social norms that tolerate violence.

Home visitation services and interventions with child witnesses to violence have shown some promise in prevention of IPV among high-risk families.

Practice guidelines for health care providers include recommendations to ask all women patients if they have experienced IPV. Health care providers may also provide information to women at risk for IPV about community resources, such as shelters for battered women and legal resources.
 
Dating Violence
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Dating violence may be defined as the perpetration or threat of an act of violence by at least one member of an unmarried couple on the other member within the context of dating or courtship. This violence encompasses any form of sexual assault, physical violence, and verbal or emotional abuse.

Scope of the Problem

Violent behavior that takes place in a context of dating or courtship is not a rare event. Estimates vary because studies and surveys use different methods and definitions of the problem.

  • A review of dating violence research found that prevalence rates of nonsexual, courtship violence range from 9% to 65%, depending on whether threats and emotional or verbal aggression were included in the definition.
  • Data from a study of 8th and 9th grade male and female students indicated that 25% had been victims of nonsexual dating violence and 8% had been victims of sexual dating violence.
  • Summarizing many studies, the average prevalence rate for nonsexual dating violence is 22% among male and female high school students and 32% among college students. Females are somewhat more likely than males to report being victims of violence.
  • In a national study of college students, 27.5% of the women surveyed said that they had suffered rape or attempted rape at least once since age 14.3 Only 5% of those experiences were reported to the police. The term "hidden rape" has emerged because this survey and many other studies found that sexual assaults are seldom reported to the police.
  • Over half of a representative sample of more than 1,000 female students at a large urban university had experienced some form of unwanted sex. Twelve percent of these acts were perpetrated by casual dates and 43% by steady dating partners.
  • Studies of college students and high school student suggest that both males and females inflict and receive dating violence in equal proportion, but the motivation for violence by women is more often for defensive purposes. Other studies have found that women and girls were victims of dating violence twice as often as men and boys, and that females suffer significantly more injuries than males.
  • A recent National Crime Victimization survey found that women were 6 times more likely than men to experience violence at the hands of an intimate partner. Intimate partners include current or former spouses, boyfriends, girlfriends, dating partners, regardless of whether they are cohabiting or not.
  • Nearly half of the 500,000 rapes and sexual assaults reported to the police by women of all ages were committed by friends or acquaintances. From 80% to 95% of the rapes that occur on college campuses are committed by someone known to the victim.

Risk Factors

Characteristics of Victims

  • Young women aged 12-18 who are victims of violence are more likely than older women to report that their offenders were acquaintances, friends, or intimate partners.
  • The likelihood of becoming a victim of dating violence is associated with having female peers who have been sexually victimized, lower church attendance, greater number of past dating partners, acceptance of dating violence, and personally having experienced a previous sexual assault.

Characteristics of Perpetrators

  • Studies have found the following to be associated with sexual assault perpetration: the male having sexually aggressive peers;  heavy alcohol or drug use; and the man's acceptance of dating violence, the male's assumption of key roles in dating such as initiating the date, being the driver, and paying dating expenses; miscommunication about sex; previous sexual intimacy with the victim; interpersonal violence, traditional sex roles, adversarial attitudes about relationships, and rape myths.
  • Men who have a family history of observing or experiencing abuse are more likely to inflict abuse, violence, and sexual aggression.
  • As the consumption of alcohol by either the victim or perpetrator increases, the rate of serious injuries associated with dating violence also increases.

 

Male Batterers
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Incidence

Estimates from survey research conducted in 1985 indicate that at least three out of every 100, or 1.8 million, men severely assaulted their female partner or cohabitant during the preceding 12 months. These assaults included punching, kicking, choking, threats with a knife or gun, or use of a knife or gun.

Characteristics Associated With Batterers

Witnessing intimate partner violence (IPV) as a child or adolescent, or experiencing violence from caregivers as a child are the risk factors which have been most consistently identified with the perpetration of IPV.2

Men who are physically violent towards their partners are also likely to be sexually violent towards their partners, and are likely to use violence towards children.

Chronic alcohol abuse by the male batterer may be more strongly associated with IPV than acute intoxication.

High levels of marital conflict and lower socioeconomic status have been consistently associated with the occurrence and persistence of IPV. However, findings from studies with representative samples indicate that IPV is not exclusive to those with lower SES.

Perpetrators of IPV may have interpersonal skills deficits (such as lack of communication skills, poor spouse-specific assertion) in comparison with nonviolent men, particularly in the context of problematic marital situations.

Research findings are mixed on the association between anger and the perpetration of IPV. Some research reports that men who perpetrate violence towards their partners have higher levels of general anger/hostility than the men who are non-violent. Others report that anger and hostility felt towards a partner is associated with perpetration of violence, while generalized feelings of anger and aggression are not.

A high proportion of batterers identified through court-ordered or other clinical populations have been found to have traits consistent with diagnoses of personality disorders, such as schizoidal/borderline, personality, antisocial or narcissistic, passive dependent/compulsive disorders. As these data come from clinical populations, however, it is not clear that psychopathology causes battering.

Comment: Further theory-driven consensus on the variables which may distinguish batterers from nonbatterers would be helpful for guiding future research.

 

Batterer Types

A number of researchers have suggested that batters are a heterogenous group. Clarification of the variables which distinguish violent from non-violent men, or type-specific treatment effectiveness might be explored if different types of batterer could reliably be identified.  A review of typology research on batterers suggest that three types can be distinguished on the basis of: severity of IPV perpetrated, generality of the violence (toward the woman and toward others), and psychopathology/personality disorders. The three types proposed are:

The family-only batterer: may perpetrate less severe violence, use relatively little psychological or sexual abuse, and display few or no symptoms of psychopathology.

The dysphoric/borderline batterer: may perpetrate moderate to severe violence, mostly confined to the family, and be generally distressed, dysphoric, or emotionally volatile.

The generally violent/antisocial batterer: may engage in moderate to severe IPV, the most extrafamilial violence, and have the most extensive history of criminal involvement, alcohol and drug abuse, and antisocial personality disorder or psychopathology.

Further research is necessary to: 1) replicate and establish the validity of these proposed types, 2) to develop simple and efficient assessment tools which can reliably distinguish among batterer types, 3) determine how these subtypes differ from nonviolent men, and 4) identify the developmental and situational factors associated with individuals and society which may contribute to the development of different batterer types.

 

Criminal Justice Interventions

Arrest

Research findings are mixed regarding the effectiveness of police arrest policies as a deterrent to IPV. Some studies have reported deterrence effects from arrest policies when compared with strategies such as counseling or short separation. Other studies, however, have failed to replicate these findings.  Additional studies have suggested that the deterrent effects of arrest may vary depending on factors such as length of time in police custody and the characteristics of the individual arrested.

Comment: While arrest in and of itself may not act as a deterrent to the perpetration of IPV for all individuals, it is important that arrest policies and practices be evaluated in the context of an integrated criminal justice response, in which arrest for IPV is followed by the laying of charges, and the appropriate administration of sanctions by other criminal justice agencies.

Prosecution policies

To date, there has been little investigation of the deterrent effects of prosecution for IPV. One study, which compared reassault rates for prosecution versus alternative interventions (police only or social service contacts) reported that prosecution lead to no overall preventive effects on reassault.  Later analyses suggested that criminal justice interventions may be most effective at reducing chances of re-assault by perpetrators with a history of less severe violence.

Another study assessed rates of reassault for men randomly assigned to one of three court outcomes (pretrial diversion to counseling for perpetrators of IPV, prosecution to conviction with a recommendation of counseling as a condition of probation, or prosecution to conviction with presumptive sentencing). Findings indicated that all conditions showed a drop in the rates of reassault in the six months following arrest. Under conditions of victim initiated complaints, permitting victims to drop charges significantly reduced their risk of future violence. This reduced risk was attributed to the increased empowerment which the victim may have gained by having the criminal justice system in alliance to maintain her safety, although actually dropping the charges may not have increased the woman's safety.

Batterer Intervention Programs

Batterer intervention programs, which seek to educate or rehabilitate known perpetrators of IPV to be nonviolent, have proliferated since the 1980s, under the auspices of both the criminal justice system and mental health system. Three theoretical approaches to the conduct of these programs have been consistently documented. These theories influence the content and delivery of interventions:

Society and culture: attributes battering to social and cultural norms and values that endorse or tolerate the use of violence by men against their women partners. The feminist model of intervention educates men concerning the impact of these social norms and values, and attempts to resocialize men through education, emphasizing nonviolence and equality in relationships.

The Family: family-based theories of IPV focus on the structure and social isolation of families. The family systems model of intervention focuses on communication skills, with the goal of family preservation and may use couples counseling/conjoint therapy.

The Individual: psychological theories attribute perpetration of IPV to personality disorders, the batterer's social environment during childhood or biological predispositions. Psychotherapeutic interventions target individual problems and/or build cognitive skills to help the batterer control violent behaviors.

Many programs adopt components of each approach. Currently there is little evidence to suggest the effectiveness of one approach over another, or of the differential effectiveness of different programs with different "types" of batterers, although one study has suggested that process-psychodynamic groups may function better for men with dependent personalities, while cognitive-behavioral groups may be more effective for those with antisocial traits.

The most widely evaluated intervention model for men who batter are group interventions using cognitive-behavioral techniques, often in combination with feminist content. One review of these studies reported that percentages of successful outcomes (i.e., reduced or no reassault) from these programs varied from 53% to 85% However, other reviews have pointed out that methodological problems in the studies limit conclusions about the effectiveness of such programs.

Comment: At present, several large evaluation studies of batterer intervention programs are underway which compare a variety of treatment modalities. These studies may clarify our understanding of the effectiveness of these programs.

Attrition

The majority of intervention or education groups for men who batter report high attrition rates, with as many as 50% - 75% of men failing to complete the mandated program. Factors which have been found to be associated with attrition include: lifestyle instability (e.g., youth, low education, unstable work histories) and incongruence between the batterer's self-identified problems and the treatment provided.

Evidence of the efficacy of court-mandating men to treatment as a means of increasing program completion are mixed. Some studies report increased completion, while others suggest reduced completion.31

Comment: Further research on the interaction effects between the characteristics of the offender, the treatment program, and the criminal justice system in relation to treatment completion is needed.

Standards

Despite the limited evidence for the effectiveness of batterer intervention programs, many states have or are in the process of developing standards for the conduct of these programs. At the present time, 25 states have county and/or state standards; five states have drafted standards and 13 states and the District of Columbia are developing standards. These standards vary in how they are implemented, and may be voluntary or mandatory. However, the majority support the use of progams based on cognitive-behavioral principals, some to the exclusion of other approaches.

Comment: It is possible that the legislation of standards at this time may restrict necessary enquiry into alternative approaches.

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Tjaden, P., & Thoennes, N. Prevalence, incidence, and consequences of violence against women: Findings from the National Violence Against Women Survey. Institute of Justice, Research in Brief. November, 1998.

Wisner, C.L., Gilmer, T.P., Saltzman, L.E., & Zink, T.M. Intimate partner violence against women: Do victims cost health plans more? Journal of Family Practice 48(6) 1999.

Violence and the family: Report of the American Psychological Association Presidential Task Force on Violence and the Family, 1996.

Bosworth K, Espelage DL, Simon TR. Factors Associated With Bullying Behavior in Middle School Students. Journal of Early Adolescence 1999;19(3):341-362.

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What can you do if you are a victim? Contact your local battered women’s shelter or the National Domestic Violence Hotline at 1-800-799-SAFE(7233) or 1-800-787-3224 (TDD). They can provide you with helpful information and advice.

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