Interpartner violence
Interpartner violence (IPV) refers to abusive behaviors between intimate partners, encompassing four primary subcategories: physical violence, sexual violence, threats of violence, and psychological/emotional abuse. Physical violence includes actions that may cause harm or injury, while sexual violence involves coercive sexual acts. Threats can manifest through words or gestures aimed at instilling fear, and psychological abuse pertains to emotional harm perceived by the victim.
Epidemiologically, IPV predominantly affects women, with significant lifetime prevalence rates reported—approximately 35.6% of women and 28.5% of men experiencing physical violence in the U.S. Women are particularly vulnerable to sexual violence, with 9.4% reporting experiences of rape. The health effects of IPV are profound, leading to a range of physical and mental health issues, including chronic pain, gastrointestinal disorders, and increased rates of psychological conditions like PTSD.
Preventing IPV involves a multifaceted approach that includes promoting healthy relationships, ensuring access to support services, and training healthcare providers to recognize and intervene in cases of violence. Effective prevention and intervention strategies are essential to address the immediate dangers victims face and to mitigate the long-term health consequences associated with interpartner violence.
Interpartner violence
Disease/Disorder
Also known as: Intimate partner violence
Anatomy or system affected: Psychic-emotional system, all bodily systems
Definition: Psychological, physical, or sexual harm from a current or former partner, which can be actual or threatened within heterosexual or homosexual partnerships.
Key terms:
Danger Assessment Tool: An instrument that helps determine the level of danger an abused woman has of being killed by her intimate partner.
mandatory reporting requirements: laws designating groups of professionals that are required to report specific types of violence, abuse, and neglect. In the United States these laws vary by state.
Post-traumatic Stress Disorder: A maladaptive condition resulting from exposure to events beyond the realm of normal human experience and characterized by persistent difficulties involving emotional numbing, intense fear, helplessness, horror, reexperiencing of trauma, avoidance, and arousal.
The US Center for Disease Control (CDC) has developed standardized definitions for the four subcategories of interpartner violence:
- • Physical is the use of physical force, possibly causing disability, injury, or death.
- • Sexual includes the use of physical aggression to force a person to engage in a sex act, when a sex act is attempted or completed with a person who is unable to understand or communicate their unwillingness to be complicit in the act, and abusive sexual contact.
- • Threats of physical or sexual violence are when words, gestures, or weapons are used to threaten bodily harm.
- • Psychological/emotional abuse describes harm caused by acts, threats of acts, or coercive tactics, and are acts largely defined based on the victim's perception of an act being abusive.
Epidemiology
Interpartner violence affects women at a higher rate than men. It is likely that incidents are underreported, so prevalence data are estimates. In the United States, 35.6 percent of women and 28.5 percent of men report physical violence, stalking, or rape during their lifetimes. Women are more often victims of sexual violence, with 9.4 percent of women in the United States experiencing rape in their lifetimes. Nearly 17 percent of women and 8 percent of men report being victims of sexual violence other than rape during their lifetimes. On the other hand, rates of psychological abuse by an intimate partner are almost equal among genders, with 48.4 percent of men and 48.8 percent of women reporting psychological abuse in their lifetimes.
Worldwide, rates of interpartner sexual and physical violence against women were measured in a World Health Organization (WHO) multicountry study. Among fifteen study sites, rates of women reporting they had experienced either sexual or physical violence in their lifetimes ranged from 15 to 71 percent. The rate of participants who reported that they experienced either form of violence in the past year ranged among sites from 4 to 53 percent.
Health Effects of Interpartner Violence
Interpartner violence may lead to direct physical harm. It has also been associated with higher rates of other physical symptoms and comorbid conditions that may persist long after the violent episode has ended. These conditions include headaches; back, musculoskeletal, or chest pain; gynecological disorders; gastrointestinal disorders; sexually transmitted infections; and respiratory infections.
Studies have found a correlation between incidence of interpartner violence and pregnancy. The effects of violence for the year prior to pregnancy have been observed to be far-reaching, and include poor physical outcomes for the mother and fetus, as well as increased risk for postpartum depression in the mother.
Victims of interpartner violence also exhibit increased levels of psychological conditions, especially post-traumatic stress disorder and major depressive disorder. Victims are also more likely to engage in negative health behaviors, such as substance abuse and high-risk sexual behaviors (Roberts, 2003). These comorbidities can equate to long-term health consequences and disability across the lifespan for those who suffer from interpartner violence.
Prevention
The approach to preventing interpartner violence is multifaceted. Prevention efforts must begin by encouraging healthy relationships and emotionally supportive environments. Services must be readily available for victims, including healthcare, legal assistance, and mental health counseling to enable intervention and prevent reoccurrence. Healthcare providers should be trained to intervene when a victim of interpartner violence is identified. WHO and the Family Violence Prevention Fund have both outlined approaches to addressing patients who are victims of interpartner violence. First and foremost, the patient's immediate risk for danger should be assessed, followed by support and possible referral for counseling. The Danger Assessment Tool is one instrument that can be used to assess how at-risk a female patient is for being murdered by her intimate partner. Some states require clinicians to report acts of violence communicated by patients. Clinicians should be familiar with the mandatory reporting requirements in their state of practice.
Bibliography
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Campbell, J.Q. “Danger Risk Assessment Tool.” Johns Hopkins University, School of Nursing, 2004. Print.
Devries, K. M., et al. “Intimate Partner Violence and Incident Depressive Symptoms and Suicide Attempts: A Systematic Review of Longitudinal Studies.” PLoS Medicine 10.5 (2013): e1001439. Print.
Garcia-Moreno, C., et al. “Prevalence of Intimate Partner Violence: Findings from the WHO Multi-Country Study on Women's Health and Domestic Violence.” Lancet 368.9543 (2006): 1260–269. Print.
Gazmararian, J. A., et al. “Prevalence of Violence against Pregnant Women.” JAMA: The Journal of the American Medical Association 275.24 (1996): 1915–920. Print.
Ludermir, A. B., et al. “Violence against Women by Their Intimate Partner during Pregnancy and Postnatal Depression: A Prospective Cohort Study.” Lancet 376.9744 (2010): 903–10. Print.
Motz, Anna. Toxic Couples: The Psychology of Domestic Violence. New York: Routledge, 2014. Print.
Roberts, T. A., J. D. Klein, and S. Fisher. “Longitudinal Effect of Intimate Partner Abuse on High-risk Behavior among Adolescents.” Archives of Pediatrics & Adolescent Medicine 157.9 (2003): 875. Print.
Saltzman, L. E., et al. Intimate Partner Violence Surveillance: Uniform Definitions and Recommended Data Elements: Version 1.0. Atlanta: Centers for Disease Control and Prevention, Natl. Center for Injury Prevention and Control, 2002. Print.
Sorenson, Susan, and Paula Lundberg Love. Violence and Sexual Abuse at Home: Current Issues in Spousal Battering and Child Maltreatment. Hoboken: Taylor, 2014. Print.