Domestic Violence: True or False?

Malcom's Chicken, "Against the Grain", MAD Museum, NYC

I gave a presentation on Domestic Violence to our medical students today.

I received feedback that some of the information I presented was not widely known, even by experienced clinicians....Hence today's blog.

True or False:

1-Domestic violence, also called Intimate Partner Violence or IPV, is  not the first cause of serious battering for US women 

This is False. An estimated 3 to 4 million US women are battered every year by either a former or a current partner. Perpetrators of violence are very typically known to victims as either family members or current/former intimate partners. This is true for violence along the entire spectrum: emotional, verbal, stalking, physical, or sexual.

2-Marital or relational satisfaction is inversely related to domestic violence.

This is true. Relationships with high levels of marital or relational dissatisfaction are at far higher risk for IPV; IPV can be conceptualized (often) as a more extreme/dangerous form of relational dissatisfaction. For clinicians, and ideally for people in general, it is important to appreciate that there are specific risk factors for being in highly dysfunctional relationships. This is not meant to "blame the victim" but to encourage self-care or care recommendations by clinicians for risk factors that can be moderated (e.g., untreated depression, alcoholism, life experiences that would benefit from psychotherapy).

3-Most violence perpetrators are highly controlling individuals with a tendency towards violence and sociopathy.

This is false. Individuals who do fall in that particular category are the most dangerous, in general and are perhaps more likely to be vividly portrayed in movies. Nevertheless, they are not the most common perpetrators. Those fall into two other categories: individuals with negative affect/poor emotional regulation and individuals who only perpetuate violence towards family members but not towards others. Individuals in those two latter categories are more likely to benefit from therapeutic intervention.

4-Domestic Violence is overwhelmingly a problem perpetuated by men on women.

This is a trick statement. It is false. However, the problem has a much greater adverse public health impact on women because women tend to be more frequently severely injured. The more common pattern nevertheless is for bi-directional violence in which both men and women engage. But I repeat: in that engagement, women fare worse.

5-Most battered women never leave their batterers.

Many medical students today were under the impression that this was true. It is false, most battered women eventually leave eventhough leaving is difficult for multiple reasons ranging from attachment to partner, financial concerns, safety concerns for themselves and/or children. Related to that, we talked about research showing that eventhough the act of leaving is often seen as a precipitant for more serious violence, in reality, the natural history of violence is such that it often gets worse and that leaving is overall safer. Also exposure to a parent being battered is an adverse environmental exposure for children, even when they themselves are not being physically battered. Clinicians need to better conceptualize the phenomenon of behavior change and learn to facilitate it without trying to force it for individuals who are not yet ready.


If you want to read more about this, here is a useful reference: Langhinrichsen-Rohling, J. Top 10 Greatest "Hits": Important Findings and Future Directions for Intimate Partner Violence Research. Journal of Interpersonal Violence. 2005; 20; 108-118.

Till Later,

Anne