Intimate Partner Violence

Adverse Health Conditions and Health Risk Behaviors Associated with Intimate Partner Violence

Intimate partner violence (IPV) is defined as threatened, attempted, or completed physical or sexual violence or emotional abuse by a current or former intimate partner. IPV can be committed by a spouse, an ex-spouse, a current or former boyfriend or girlfriend, or a dating partner.

In addition to the risk for death and injury, IPV has been associated with certain adverse health conditions and health risk behaviours

According to the 2005 Behavioral Risk Factor Surveillance System (BRFSS) survey, Reported by: MC Black, PhD, MJ Breiding, PhD, National Center for Injury Prevention and Control, CDC, persons who report having experienced IPV during their lifetimes also are more likely to report current adverse health conditions and health risk behaviors. Although a causal link between IPV and adverse health conditions cannot be inferred from these results, they underscore the need for IPV assessment in health-care settings. In addition, the results indicate a need for secondary intervention strategies to address the health-related needs of IPV victims and reduce their risk for subsequent adverse health conditions and health risk behaviors.

This report describes the results of that survey, which indicated that persons who report having experienced IPV during their lifetimes also are more likely to report current adverse health conditions and health risk behaviors. Although a causal link between IPV and adverse health conditions cannot be inferred from these results, they underscore the need for IPV assessment in health-care settings. In addition, the results indicate a need for secondary intervention strategies to address the health-related needs of IPV victims and reduce their risk for subsequent adverse health conditions and health risk behaviors.

Domestic violence

Domestic violence (also known as domestic abuse, spousal abuse, or intimate partner violence) occurs when a family member, partner or ex-partner attempts to physically or psychologically dominate another. Domestic violence often refers to violence between spouses, or spousal abuse but can also include cohabitants and non-married intimate partners. Domestic violence occurs in all cultures; people of all races, ethnicities, religions, sexes and classes can be perpetrators of domestic violence. Domestic violence is perpetrated by both men and women.

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

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

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

Forms of Abuse:

Domestic violence can take the form of:

• Physical violence
• Indirect physical violence may include destruction of objects, striking or throwing objects near the victim, or harm to pets.

In addition to physical violence, spousal abuse often includes mental or emotional abuse:

• Verbal threats of physical violence to the victim, the self, or others including children, and verbal violence, including threats, insults, put-downs, and attacks.
• Nonverbal threats may include gestures, facial expressions, and body postures.
• Psychological abuse may also involve economic and/or social control, such as controlling the victim's money and other economic resources, preventing the victim from seeing friends and relatives, actively sabotaging the victim's social relationships, and isolating the victim from social contacts.

Causes:

There are many different theories as to the causes of domestic violence.
These include:

• Psychological theories that consider personality traits and mental characteristics of the offender
• Social theories which consider external factors in the offender's environment, such as family structure, stress, social learning

Power and control:

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

• Abusers' efforts to dominate their partners have been attributed to:
• Low self-esteem or feelings of inadequacy
• Unresolved childhood conflicts
• Stress of poverty
• Hostility and resentment toward women
• Hostility and resentment toward men
• Personality disorders
• Genetic tendencies

Questions of power and control are integral to the widely utilized Duluth Domestic Abuse Intervention Project. They developed the "Power and Control Wheel" to illustrate this: it has power and control at the center, surrounded by spokes (techniques used), the titles of which include:

• Coercion and threats
• Intimidation
• Emotional abuse
• Isolation
• Minimizing, denying and blaming
• Using children
• Economic abuse
• Male privilege

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

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

Cycle of violence

Advocates and counsellors will refer to domestic violence as a pattern of behaviours:

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

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

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

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

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

Many victims leave their abusers, only to return. Research has shown that a major factor in helping a victim to establish lasting independence from the abusive partner is her or his ability to get legal assistance. Economists at the Brennan Center for Justice analyzed Bureau of Justice Statistics data to determine what accounted for the nationwide reduction in reported abuse. Their findings revealed that one significant factor was the availability of legal services to assist abuse victims. Another major study by economists at Colgate University and the University of Arkansas flatly stated that the only public service that reduces domestic violence in the long term is legal aid.

Legal assistance can provide essential safety planning, buttress a family’s economic position through child or spousal support, allay fears planted by the batterer about loss of custody, and help victims to secure needed government benefits.