research paper on domestic abuse

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• April 01, 2024 | VOL. 181, NO. 4 CURRENT ISSUE pp.255-346
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Domestic Violence Awareness

• Anna Chapman , M.D. ,
• Catherine Monk , Ph.D.

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Domestic or intimate partner violence is alarmingly prevalent, and, for victims, a major contributor to depression, anxiety, and other forms of mental illness. Psychological problems and psychiatric syndromes often are the antecedents of domestic violence for the perpetrator and also can be risk factors for becoming a victim. Remarkably, the two dominant mental health fields, psychiatry and clinical psychology—the ones charged with investigating and attending to the mind, brain, and behavior—are largely absent from domestic violence research and intervention.

More than one in three women and at least one in four men have been the victim of rape, physical violence, or stalking by an intimate partner ( 1 ). However, women are far more likely than men to experience severe sexual and physical violence from a partner or to be killed by one ( 1 , 2 ). In the United States, intimate partner homicides make up between 40% and 50% of all murders of women ( 3 ). Domestic violence crosses geographic and socioeconomic stratification, although studies indicate that lower-income women in rural communities experience higher rates of violence and, specifically, sexual abuse ( 4 , 5 ). Victims suffer from dramatic rates of depression, anxiety, and posttraumatic stress disorder, as well as substance abuse and suicidality ( 6 – 8 ). A recent study based on a representative U.S. sample of more than 25,000 adults indicated that new onsets of major mental health problems were more than twice as common among those exposed to domestic violence in the past year than among nonvictims ( 9 ). Millions of children—as many as 15 million, according to some estimates—witness domestic violence each year ( 10 ). For male children there is a 1,000% greater risk of reproducing this violence in their own spousal relationships ( 11 ). A recent epidemiologic study found prior domestic violence victimization to be more strongly associated with domestic violence perpetration than any other factor ( 12 ).

Despite its prevalence in the general population, domestic violence is underrepresented in our consulting rooms in part because victims, and especially perpetrators, rarely voluntarily self-identify or seek treatment ( 8 , 13 , 14 ). Shame, guilt, and denial are obvious deterrents. These factors are often compounded by a sense of futility resulting from learned helplessness, and a profound unraveling of self-esteem ( 15 ). More practical considerations include fears for personal security, economic codependence, and the concerns that disclosure will trigger social services engagement, particularly child protection ( 8 ). Finally, disclosure represents a potential threat to the continuance of a romantic relationship, which, though abusive, involves emotional investment. Without experience handling domestic violence situations, clinicians can feel ill-prepared and deskilled, lacking knowledge about referral sources, emergent threats of bodily harm, and the accompanying legal and ethical obligations. This lack of presentation in clinical settings contributes to a “don’t ask” scenario ( 8 ). Since 1986, numerous medical institutions have advocated for domestic violence screening in routine medical care ( 16 , 17 ); in 2001, the American Psychiatric Association followed suit. That same year, the American Psychological Association’s Intimate Partner Abuse and Relationship Violence Working Group launched a curriculum on domestic violence but appears to have done little to foster relevant training in clinical interventions.

Domestic violence is an exceptionally challenging clinical situation. Those in domestic violence relationships are at risk for repeating this experience, and likely have abuse or exposure to it in their backgrounds ( 11 , 18 ), adding immense complexity to treatment. The work presents unique challenges, including safety planning and patients’ minimization of abuse, which may induce feelings of helplessness in the context of significant urgency and danger ( 19 – 21 ). There now are targeted treatments for domestic violence intervention, such as Seeking Safety ( 22 ) and Child-Parent Psychotherapy ( 23 ), though few psychologists and psychiatrists are trained in them. Of course the question of how clinically to respond to perpetrators is a complicated one, independent of the necessary legal consequences. However, treatment and prevention programs are emerging, such as the Melissa Institute for Violence Prevention and Treatment.

Beyond the “professional counter-transference” is possibly a more personal one. Aggression is a fundamental human impulse, and violence a socially unacceptable manifestation of it. Underlying any violent interaction is the universal human struggle with aggression and its myriad complex antecedents: family and developmental history; self-esteem; power dynamics; fear of abandonment and humiliation; emotional regulation; impulse control; and the capacity for empathy, guilt, and remorse. The possibility that domestic violence exists at the far end of a continuum of aggression that includes our own moments of intense anger is difficult to accept. That we all may have something in common with perpetrators encourages our disengagement.

Our counter-transference to victimization is similar; it is threatening to empathize with the shattering paradox of domestic violence victims, experiencing violence at the hands of someone they love and whom they are unable to leave. And yet this paradox—experiencing a depth of attachment that supersedes most basic self-preservative drives—is consistent with what John Bowlby theorized, what recent child development research has demonstrated ( 24 ), and what data from rodent models have characterized on a neurobiological level ( 25 ).

Evoking deep, psychological concerns, we retreat from domestic violence, drawing a line in the sand between “our” behaviors and “theirs.” With this dichotomizing orientation, moral judgment replaces a psychological perspective. We tend to pity and disdain the victim, and vilify the abuser, abdicating our roles as clinicians and researchers. It is the mandate of the criminal justice system to punish people for violent actions, and of social services to support victims. As the leading fields in mind, brain, and behavior, it is our mandate to understand and rehabilitate all human behavior, without prejudice.

The authors report no financial relationships with commercial interests.

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Domestic Violence

Affiliations.

• 1 University of Louisville
• 2 University of Tennessee
• PMID: 29763066
• Bookshelf ID: NBK499891

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.

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.

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.

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• Continuing Education Activity
• Introduction
• Epidemiology
• Pathophysiology
• History and Physical
• Treatment / Management
• Differential Diagnosis
• Pearls and Other Issues
• Enhancing Healthcare Team Outcomes
• Review Questions

Publication types

• Study Guide

• Open access
• Published: 20 June 2023

A qualitative quantitative mixed methods study of domestic violence against women

• Mina Shayestefar 1 ,
• Mohadese Saffari 1 ,
• Razieh Gholamhosseinzadeh 2 ,
• Monir Nobahar 3 , 4 ,
• Majid Mirmohammadkhani 4 ,
• Seyed Hossein Shahcheragh 5 &
• Zahra Khosravi 6  

BMC Women's Health volume  23 , Article number:  322 ( 2023 ) Cite this article

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Violence against women is one of the most widespread, persistent and detrimental violations of human rights in today’s world, which has not been reported in most cases due to impunity, silence, stigma and shame, even in the age of social communication. Domestic violence against women harms individuals, families, and society. The objective of this study was to investigate the prevalence and experiences of domestic violence against women in Semnan.

This study was conducted as mixed research (cross-sectional descriptive and phenomenological qualitative methods) to investigate domestic violence against women, and some related factors (quantitative) and experiences of such violence (qualitative) simultaneously in Semnan. In quantitative study, cluster sampling was conducted based on the areas covered by health centers from married women living in Semnan since March 2021 to March 2022 using Domestic Violence Questionnaire. Then, the obtained data were analyzed by descriptive and inferential statistics. In qualitative study by phenomenological approach and purposive sampling until data saturation, 9 women were selected who had referred to the counseling units of Semnan health centers due to domestic violence, since March 2021 to March 2022 and in-depth and semi-structured interviews were conducted. The conducted interviews were analyzed using Colaizzi’s 7-step method.

In qualitative study, seven themes were found including “Facilitators”, “Role failure”, “Repressors”, “Efforts to preserve the family”, “Inappropriate solving of family conflicts”, “Consequences”, and “Inefficient supportive systems”. In quantitative study, the variables of age, age difference and number of years of marriage had a positive and significant relationship, and the variable of the number of children had a negative and significant relationship with the total score and all fields of the questionnaire (p < 0.05). Also, increasing the level of female education and income both independently showed a significant relationship with increasing the score of violence.

Conclusions

Some of the variables of violence against women are known and the need for prevention and plans to take action before their occurrence is well felt. Also, supportive mechanisms with objective and taboo-breaking results should be implemented to minimize harm to women, and their children and families seriously.

Peer Review reports

Violence against women by husbands (physical, sexual and psychological violence) is one of the basic problems of public health and violation of women’s human rights. It is estimated that 35% of women and almost one out of every three women aged 15–49 experience physical or sexual violence by their spouse or non-spouse sexual violence in their lifetime [ 1 ]. This is a nationwide public health issue, and nearly every healthcare worker will encounter a patient who has suffered from some type of domestic or family violence. Unfortunately, different forms of family violence are often interconnected. The “cycle of abuse” frequently persists from children who witness it to their adult relationships, and ultimately to the care of the elderly [ 2 ]. This violence includes a range of physical, sexual and psychological actions, control, threats, aggression, abuse, and rape [ 3 ].

Violence against women is one of the most widespread, persistent, and detrimental violations of human rights in today’s world, which has not been reported in most cases due to impunity, silence, stigma and shame, even in the age of social communication [ 3 ]. In the United States of America, more than one in three women (35.6%) experience rape, physical violence, and intimate partner violence (IPV) during their lifetime. Compared to men, women are nearly twice as likely (13.8% vs. 24.3%) to experience severe physical violence such as choking, burns, and threats with knives or guns [ 4 ]. The higher prevalence of violence against women can be due to the situational deprivation of women in patriarchal societies [ 5 ]. The prevalence of domestic violence in Iran reported 22.9%. The maximum of prevalence estimated in Tehran and Zahedan, respectively [ 6 ]. Currently, Iran has high levels of violence against women, and the provinces with the highest rates of unemployment and poverty also have the highest levels of violence against women [ 7 ].

Domestic violence against women harms individuals, families, and society [ 8 ]. Violence against women leads to physical, sexual, psychological harm or suffering, including threats, coercion and arbitrary deprivation of their freedom in public and private life. Also, such violence is associated with harmful effects on women’s sexual reproductive health, including sexually transmitted infection such as Human Immunodeficiency Virus (HIV), abortion, unsafe childbirth, and risky sexual behaviors [ 9 ]. There are high levels of psychological, sexual and physical domestic abuse among pregnant women [ 10 ]. Also, women with postpartum depression are significantly more likely to experience domestic violence during pregnancy [ 11 ].

Prompt attention to women’s health and rights at all levels is necessary, which reduces this problem and its risk factors [ 12 ]. Because women prefer to remain silent about domestic violence and there is a need to introduce immediate prevention programs to end domestic violence [ 13 ]. violence against women, which is an important public health problem, and concerns about human rights require careful study and the application of appropriate policies [ 14 ]. Also, the efforts to change the circumstances in which women face domestic violence remain significantly insufficient [ 15 ]. Given that few clear studies on violence against women and at the same time interviews with these people regarding their life experiences are available, the authors attempted to planning this research aims to investigate the prevalence and experiences of domestic violence against women in Semnan with the research question of “What is the prevalence of domestic violence against women in Semnan, and what are their experiences of such violence?”, so that their results can be used in part of the future planning in the health system of the society.

This study is a combination of cross-sectional and phenomenology studies in order to investigate the amount of domestic violence against women and some related factors (quantitative) and their experience of this violence (qualitative) simultaneously in the Semnan city. This study has been approved by the ethics committee of Semnan University of Medical Sciences with ethic code of IR.SEMUMS.REC.1397.182. The researcher introduced herself to the research participants, explained the purpose of the study, and then obtained informed written consent. It was assured to the research units that the collected information will be anonymous and kept confidential. The participants were informed that participation in the study was entirely voluntary, so they can withdraw from the study at any time with confidence. The participants were notified that more than one interview session may be necessary. To increase the trustworthiness of the study, Guba and Lincoln’s criteria for rigor, including credibility, transferability, dependability, and confirmability [ 16 ], were applied throughout the research process. The COREQ checklist was used to assess the present study quality. The researchers used observational notes for reflexivity and it preserved in all phases of this qualitative research process.

Qualitative method

Based on the phenomenological approach and with the purposeful sampling method, nine women who had referred to the counseling units of healthcare centers in Semnan city due to domestic violence in February 2021 to March 2022 were participated in the present study. The inclusion criteria for the study included marriage, a history of visiting a health center consultant due to domestic violence, and consent to participate in the study and unwillingness to participate in the study was the exclusion criteria. Each participant invited to the study by a telephone conversation about study aims and researcher information. The interviews place selected through agreement of the participant and the researcher and a place with the least environmental disturbance. Before starting each interview, the informed consent and all of the ethical considerations, including the purpose of the research, voluntary participation, confidentiality of the information were completely explained and they were asked to sign the written consent form. The participants were interviewed by depth, semi-structured and face-to-face interviews based on the main research question. Interviews were conducted by a female health services researcher with a background in nursing (M.Sh.). Data collection was continued until the data saturation and no new data appeared. Only the participants and the researcher were present during the interviews. All interviews were recorded by a MP3 Player by permission of the participants before starting. Interviews were not repeated. No additional field notes were taken during or after the interview.

The age range of the participants was from 38 to 55 years and their average age was 40 years. The sociodemographic characteristics of the participants are summarized in table below (Table  1 ).

Five interviews in the courtyards of healthcare centers, 2 interviews in the park, and 2 interviews at the participants’ homes were conducted. The duration of the interviews varied from 45 min to one hour. The main research question was “What is your experience about domestic violence?“. According to the research progress some other questions were asked in line with the main question of the research.

The conducted interviews were analyzed by using the 7 steps Colizzi’s method [ 17 ]. In order to empathize with the participants, each interview was read several times and transcribed. Then two researchers (M.Sh. and M.N.) extracted the phrases that were directly related to the phenomenon of domestic violence against women independently and distinguished from other sentences by underlining them. Then these codes were organized into thematic clusters and the formulated concepts were sorted into specific thematic categories.

In the final stage, in order to make the data reliable, the researcher again referred to 2 participants and checked their agreement with their perceptions of the content. Also, possible important contents were discussed and clarified, and in this way, agreement and approval of the samples was obtained.

Quantitative method

The cross-sectional study was implemented from February 2021 to March 2022 with cluster sampling of married women in areas of 3 healthcare centers in Semnan city. Those participants who were married and agreed with the written and verbal informed consent about the ethical considerations were included to the study. The questionnaire was completed by the participants in paper and online form.

The instrument was the standard questionnaire of domestic violence against women by Mohseni Tabrizi et al. [ 18 ]. In the questionnaire, questions 1–10, 11–36, 37–65 and 66–71 related to sociodemographic information, types of spousal abuse (psychological, economical, physical and sexual violence), patriarchal beliefs and traditions and family upbringing and learning violence, respectively. In total, this questionnaire has 71 items.

The scoring of the questionnaire has two parts and the answers to them are based on the Likert scale. Questions 11–36 and 66–71 are answered with always [ 4 ] to never (0) and questions 37–65 with completely agree [ 4 ] to completely disagree (0). The minimum and maximum score is 0 and 300, respectively. The total score of 0–60, 61–120 and higher than 121 demonstrates low, moderate and severe domestic violence against women, respectively [ 18 ].

In the study by Tabrizi et al., to evaluate the validity and reliability of this questionnaire, researchers tried to measure the face validity of the scale by the previous research. Those items and questions which their accuracies were confirmed by social science professors and experts used in the research, finally. The total Cronbach’s alpha coefficient was 0.183, which confirmed that the reliability of the questions and items of the questionnaire is sufficient [ 18 ].

Descriptive data were reported using mean, standard deviation, frequency and percentage. Then, to measure the relationship between the variables, χ2 and Pearson tests also variance and regression analysis were performed. All analysis were performed by using SPSS version 26 and the significance level was considered as p < 0.05.

Qualitative results

According to the third step of Colaizzi’s 7-step method, the researcher attempted to conceptualize and formulate the extracted meanings. In this step, the primary codes were extracted from the important sentences related to the phenomenon of violence against women, which were marked by underlining, which are shown below as examples of this stage and coding.

The primary code of indifference to the father’s role was extracted from the following sentences. This is indifference in the role of the father in front of the children.

“Some time ago, I told him that our daughter is single-sided deaf. She has a doctor’s appointment; I have to take her to the doctor. He said that I don’t have money to give you. He doesn’t force himself to make money anyway” (p 2, 33 yrs).

“He didn’t value his own children. He didn’t think about his older children” (p 4, 54 yrs).

The primary code extracted here included lack of commitment in the role of head of the household. This is irresponsibility towards the family and meeting their needs.

“My husband was fired from work after 10 years due to disorder and laziness. Since then, he has not found a suitable job. Every time he went to work, he was fired after a month because of laziness” (p 7, 55 yrs).

“In the evening, he used to get dressed and go out, and he didn’t come back until late. Some nights, I was so afraid of being alone that I put a knife under my pillow when I slept” (p 2, 33 yrs).

A total of 246 primary codes were extracted from the interviews in the third step. In the fourth step, the researchers put the formulated concepts (primary codes) into 85 specific sub-categories.

Twenty-three categories were extracted from 85 sub-categories. In the sixth step, the concepts of the fifth step were integrated and formed seven themes (Table  2 ).

These themes included “Facilitators”, “Role failure”, “Repressors”, “Efforts to preserve the family”, “Inappropriate solving of family conflicts”, “Consequences”, and “Inefficient supportive systems” (Fig.  1 ).

Themes of domestic violence against women

Some of the statements of the participants on the theme of “ Facilitators” are listed below:

Husband’s criminal record

“He got his death sentence for drugs. But, at last it was ended for 10 years” (p 4, 54 yrs).

Inappropriate age for marriage

“At the age of thirteen, I married a boy who was 25 years old” (p 8, 25 yrs).

“My first husband obeyed her parents. I was 12–13 years old” (p 3, 32 yrs).

“I couldn’t do anything. I was humiliated” (p 1, 38 yrs).

“A bridegroom came. The mother was against. She said, I am young. My older sister is not married yet, but I was eager to get married. I don’t know, maybe my father’s house was boring for me” (p 2, 33 yrs).

“My parents used to argue badly. They blamed each other and I always wanted to run away from these arguments. I didn’t have the patience to talk to mom or dad and calm them down” (p 5, 39 yrs).

Overdependence

“My husband’s parents don’t stop interfering, but my husband doesn’t say anything because he is a student of his father. My husband is self-employed and works with his father on a truck” (p 8, 25 yrs).

“Every time I argue with my husband because of lack of money, my mother-in-law supported her son and brought him up very spoiled and lazy” (p 7, 55 yrs).

Bitter memories

“After three years, my mother married her friend with my uncle’s insistence and went to Shiraz. But, his condition was that she did not have the right to bring his daughter with her. In fact, my mother also got married out of necessity” (p 8, 25 yrs).

Some of their other statements related to “ Role failure” are mentioned below:

Lack of commitment to different roles

“I got angry several times and went to my father’s house because of my husband’s bad financial status and the fact that he doesn’t feel responsible to work and always says that he cannot find a job” (p 6, 48 yrs).

“I saw that he does not want to change in any way” (p 4, 54 yrs).

“No matter how kind I am, it does not work” (p 1, 38 yrs).

Some of their other statements regarding “ Repressors” are listed below:

Fear and silence

“My mother always forced me to continue living with my husband. Finally, my father had been poor. She all said that you didn’t listen to me when you wanted to get married, so you don’t have the right to get angry and come to me, I’m miserable enough” (p 2, 33 yrs).

“Because I suffered a lot in my first marital life. I was very humiliated. I said I would be fine with that. To be kind” (p1, 38 yrs).

“Well, I tell myself that he gets angry sometimes” (p 3, 32 yrs).

Shame from society

“I don’t want my daughter-in-law to know. She is not a relative” (p 4, 54 yrs).

Some of the statements of the participants regarding the theme of “ Efforts to preserve the family” are listed below:

Hope and trust

“I always hope in God and I am patient” (p 2, 33 yrs).

Efforts for children

“My divorce took a month. We got a divorce. I forgave my dowry and took my children instead” (p 2, 33 yrs).

Some of their other statements regarding the “ Inappropriate solving of family conflicts” are listed below:

Child-bearing thoughts

“My husband wanted to take me to a doctor to treat me. But my father-in-law refused and said that instead of doing this and spending money, marry again. Marriage in the clans was much easier than any other work” (p 8, 25 yrs).

Lack of effective communication

“I was nervous about him, but I didn’t say anything” (p 5, 39 yrs).

“Now I am satisfied with my life and thank God it is better to listen to people’s words. Now there is someone above me so that people don’t talk behind me” (p 2, 33 yrs).

Some of their other statements regarding the “ Consequences” are listed below:

Harm to children

“My eldest daughter, who was about 7–8 years old, behaved differently. Oh, I was angry. My children are mentally depressed and argue” (p 5, 39 yrs).

After divorce

“Even though I got a divorce, my mother and I came to a remote area due to the fear of what my family would say” (p 2, 33 yrs).

Social harm

“I work at a retirement center for living expenses” (p 2, 33 yrs).

“I had to go to clean the houses” (p 5, 39 yrs).

Non-acceptance in the family

“The children’s relationship with their father became bad. Because every time they saw their father sitting at home smoking, they got angry” (p 7, 55 yrs).

Emotional harm

“When I look back, I regret why I was not careful in my choice” (p 7, 55 yrs).

“I felt very bad. For being married to a man who is not bound by the family and is capricious” (p 9, 36 yrs).

Some of their other statements regarding “ Inefficient supportive systems” are listed below:

Inappropriate family support

“We didn’t have children. I was at my father’s house for about a month. After a month, when I came home, I saw that my husband had married again. I cried a lot that day. He said, God, I had to. I love you. My heart is broken, I have no one to share my words” (p 8, 25 yrs).

“My brother-in-law was like himself. His parents had also died. His sister did not listen at all” (p 4, 54 yrs).

“I didn’t have anyone and I was alone” (p 1, 38 yrs).

Inefficiency of social systems

“That day he argued with me, picked me up and threw me down some stairs in the middle of the yard. He came closer, sat on my stomach, grabbed my neck with both of his hands and wanted to strangle me. Until a long time later, I had kidney problems and my neck was bruised by her hand. Given that my aunt and her family were with us in a building, but she had no desire to testify and was afraid” (p 3, 32 yrs).

Undesired training and advice

“I told my mother, you just said no, how old I was? You never insisted on me and you didn’t listen to me that this man is not good for you” (p 9, 36 yrs).

Quantitative results

In the present study, 376 married women living in Semnan city participated in this study. The mean age of participants was 38.52 ± 10.38 years. The youngest participant was 18 and the oldest was 73 years old. The maximum age difference was 16 years. The years of marriage varied from one year to 40 years. Also, the number of children varied from no children to 7. The majority of them had 2 children (109, 29%). The sociodemographic characteristics of the participants are summarized in the table below (Table  3 ).

The frequency distribution (number and percentage) of the participants in terms of the level of violence was as follows. 89 participants (23.7%) had experienced low violence, 59 participants (15.7%) had experienced moderate violence, and 228 participants (60.6%) had experienced severe violence.

Cronbach’s alpha for the reliability of the questionnaire was 0.988. The mean and standard deviation of the total score of the questionnaire was 143.60 ± 74.70 with a range of 3-244. The relationship between the total score of the questionnaire and its fields, and some demographic variables is summarized in the table below (Table  4 ).

As shown in the table above, the variables of age, age difference and number of years of marriage have a positive and significant relationship, and the variable of number of children has a negative and significant relationship with the total score and all fields of the questionnaire (p < 0.05). However, the variable of education level difference showed no significant relationship with the total score and any of the fields. Also, the highest average score is related to patriarchal beliefs compared to other fields.

The comparison of the average total scores separately according to each variable showed the significant average difference in the variables of the previous marriage history of the woman, the result of the previous marriage of the woman, the education of the woman, the education of the man, the income of the woman, the income of the man, and the physical disease of the man (p < 0.05).

In the regression model, two variables remained in the final model, indicating the relationship between the variables and violence score and the importance of these two variables. An increase in women’s education and income level both independently show a significant relationship with an increase in violence score (Table  5 ).

The results of analysis of variance to compare the scores of each field of violence in the subgroups of the participants also showed that the experience and result of the woman’s previous marriage has a significant relationship with physical violence and tradition and family upbringing, the experience of the man’s previous marriage has a significant relationship with patriarchal belief, the education level of the woman has a significant relationship with all fields and the level of education of the man has a significant relationship with all fields except tradition and family upbringing (p < 0.05).

According to the results of both quantitative and qualitative studies, variables such as the young age of the woman and a large age difference are very important factors leading to an increase in violence. At a younger age, girls are afraid of the stigma of society and family, and being forced to remain silent can lead to an increase in domestic violence. As Gandhi et al. (2021) stated in their study in the same field, a lower marriage age leads to many vulnerabilities in women. Early marriage is a global problem associated with a wide range of health and social consequences, including violence for adolescent girls and women [ 12 ]. Also, Ahmadi et al. (2017) found similar findings, reporting a significant association among IPV and women age ≤ 40 years [ 19 ].

Two others categories of “Facilitators” in the present study were “Husband’s criminal record” and “Overdependence” which had a sub-category of “Forced cohabitation”. Ahmadi et al. (2017) reported in their population-based study in Iran that husband’s addiction and rented-householders have a significant association with IPV [ 19 ].

The patriarchal beliefs, which are rooted in the tradition and culture of society and family upbringing, scored the highest in relation to domestic violence in this study. On the other hand, in qualitative study, “Normalcy” of men’s anger and harassment of women in society is one of the “Repressors” of women to express violence. In the quantitative study, the increase in the women’s education and income level were predictors of the increase in violence. Although domestic violence is more common in some sections of society, women with a wide range of ages, different levels of education, and at different levels of society face this problem, most of which are not reported. Bukuluki et al. (2021) showed that women who agreed that it is good for a man to control his partner were more likely to experience physical violence [ 20 ].

Domestic violence leads to “Consequences” such as “Harm to children”, “Emotional harm”, “Social harm” to women and even “Non-acceptance in their own family”. Because divorce is a taboo in Iranian culture and the fear of humiliating women forces them to remain silent against domestic violence. Balsarkar (2021) stated that the fear of violence can prevent women from continuing their studies, working or exercising their political rights [ 8 ]. Also, Walker-Descarte et al. (2021) recognized domestic violence as a type of child maltreatment, and these abusive behaviors are associated with mental and physical health consequences [ 21 ].

On the other hand and based on the “Lack of effective communication” category, ignoring the role of the counselor in solving family conflicts and challenges in the life of couples in the present study was expressed by women with reasons such as lack of knowledge and family resistance to counseling. Several pathologies are needed to investigate increased domestic violence in situations such as during women’s pregnancy or infertility. Because the use of counseling for couples as a suitable solution should be considered along with their life challenges. Lin et al. (2022) stated that pregnant women were exposed to domestic violence for low birth weight in full term delivery. Spouse violence screening in the perinatal health care system should be considered important, especially for women who have had full-term low birth weight infants [ 22 ].

Also, lack of knowledge and low level of education have been found as other factors of violence in this study, which is very prominent in both qualitative and quantitative studies. Because the social systems and information about the existing laws should be followed properly in society to act as a deterrent. Psychological training and especially anger control and resilience skills during education at a younger age for girls and boys should be included in educational materials to determine the positive results in society in the long term. Manouchehri et al. (2022) stated that it seems necessary to train men about the negative impact of domestic violence on the current and future status of the family [ 23 ]. Balsarkar (2021) also stated that men and women who have not had the opportunity to question gender roles, attitudes and beliefs cannot change such things. Women who are unaware of their rights cannot claim. Governments and organizations cannot adequately address these issues without access to standards, guidelines and tools [ 8 ]. Machado et al. (2021) also stated that gender socialization reinforces gender inequalities and affects the behavior of men and women. So, highlighting this problem in different fields, especially in primary health care services, is a way to prevent IPV against women [ 24 ].

There was a sub-category of “Inefficiency of social systems” in the participants experiences. Perhaps the reason for this is due to insufficient education and knowledge, or fear of seeking help. Holmes et al. (2022) suggested the importance of ascertaining strategies to improve victims’ experiences with the court, especially when victims’ requests are not met, to increase future engagement with the system [ 25 ]. Sigurdsson (2019) revealed that despite high prevalence numbers, IPV is still a hidden and underdiagnosed problem and neither general practitioner nor our communities are as well prepared as they should be [ 26 ]. Moreira and Pinto da Costa (2021) found that while victims of domestic violence often agree with mandatory reporting, various concerns are still expressed by both victims and healthcare professionals that require further attention and resolution [ 27 ]. It appears that legal and ethical issues in this regard require comprehensive evaluation from the perspectives of victims, their families, healthcare workers, and legal experts. By doing so, better practical solutions can be found to address domestic violence, leading to a downward trend in its occurrence.

Some of the variables of violence against women have been identified and emphasized in many studies, highlighting the necessity of policymaking and social pathology in society to prevent and use operational plans to take action before their occurrence. Breaking the taboo of domestic violence and promoting divorce as a viable solution after counseling to receive objective results should be implemented seriously to minimize harm to women, children, and their families.

Limitations

Domestic violence against women is an important issue in Iranian society that women resist showing and expressing, making researchers take a long-term process of sampling in both qualitative and quantitative studies. The location of the interview and the women’s fear of their husbands finding out about their participation in this study have been other challenges of the researchers, which, of course, they attempted to minimize by fully respecting ethical considerations. Despite the researchers’ efforts, their personal and professional experiences, as well as the studies reviewed in the literature review section, may have influenced the study results.

Data Availability

Data and materials will be available upon email to the corresponding author.

Abbreviations

Intimate Partner Violence

Human Immunodeficiency Virus

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Acknowledgements

The authors of this study appreciate the Deputy for Research and Technology of Semnan University of Medical Sciences, Social Determinants of Health Research Center of Semnan University of Medical Sciences and all the participants in this study.

Research deputy of Semnan University of Medical Sciences financially supported this project.

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M.Sh. contributed to the first conception and design of this research; M.Sh., Z.Kh., M.S., R.Gh. and S.H.Sh. contributed to collect data; M.N. and M.Sh. contributed to the analysis of the qualitative data; M.M. and M.Sh. contributed to the analysis of the quantitative data; M.SH., M.N. and M.M. contributed to the interpretation of the data; M.Sh., M.S. and S.H.Sh. wrote the manuscript. M.Sh. prepared the final version of manuscript for submission. All authors reviewed the manuscript meticulously and approved it. All names of the authors were listed in the title page.

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Shayestefar, M., Saffari, M., Gholamhosseinzadeh, R. et al. A qualitative quantitative mixed methods study of domestic violence against women. BMC Women's Health 23 , 322 (2023). https://doi.org/10.1186/s12905-023-02483-0

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EDITORIAL article

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

• 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]

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Domestic Violence in Health Contexts: A Guide for Healthcare Professions pp 17–33 Cite as

Domestic Violence and Abuse: Theoretical Explanation and Perspectives

• Parveen Ali 3 ,
• Julie McGarry 4 &
• Caroline Bradbury-Jones 5  
• First Online: 17 November 2019

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Domestic violence and abuse (DVA) is a complex issue and it is important to understand how and why this happens. Such understanding can help find strategies to minimise DVA. Over past decades, many explanations have been proposed to explain DVA from various perspectives. This chapter aims to present an aggregated overview of that information to help healthcare professionals understand the phenomenon from a theoretical perspective. The chapter provides information about various perspectives including biological, psychological, sociological, and ecological frameworks.

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Domestic violence and abusive relationships: Research review

Research review of data and studies relating to intimate partner violence and abusive relationships.

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This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License .

by John Wihbey, The Journalist's Resource August 17, 2015

This <a target="_blank" href="https://journalistsresource.org/criminal-justice/domestic-violence-abusive-relationships-research-review/">article</a> first appeared on <a target="_blank" href="https://journalistsresource.org">The Journalist's Resource</a> and is republished here under a Creative Commons license.<img src="https://journalistsresource.org/wp-content/uploads/2020/11/cropped-jr-favicon-150x150.png" style="width:1em;height:1em;margin-left:10px;">

The controversy over NFL star Ray Rice and the instance of domestic violence he perpetrated, which was caught on video camera, stirred wide discussion about sports culture, domestic violence and even the psychology of victims and their complex responses to abuse . In 2015, domestic violence drew a national spotlight again when the South Carolina newspaper, the Post and Courier , won a Pulitzer Prize for its investigation of women who were abused by men and had been dying at a rate of one every 12 days.

The research on domestic violence, referred to more precisely in academic literature as “intimate partner violence” (IPV), has grown substantially over the past few decades. Although knowledge of the problem and its scope have deepened, the issue remains a major health and social problem afflicting women. In November 2014 the World Health Organization estimated that 35% of all women have experienced either intimate partner violence or sexual violence by a non-partner during their lifetimes. This figure is supported by the findings of a 2013 peer-reviewed metastudy — the most rigorous form of research analysis — published in the leading academic journal Science . That metastudy found that “in 2010, 30.0% [95% confidence interval (CI) 27.8 to 32.2%] of women aged 15 and over have experienced, during their lifetime, physical and/or sexual intimate partner violence.” The prevalence found among high-income regions in North America was 21.3%. Of course, under-reporting remains a substantial problem in this research area.

In 2010, the National Intimate Partner and Sexual Violence Survey, conducted by the U.S. Centers for Disease Control and Prevention, found that “more than 1 in 3 women (35.6%) … in the United States have experienced rape, physical violence, and/or stalking by an intimate partner in their lifetime.” That survey was subsequently updated in September 2014. The findings, based on telephone surveys with more than 12,000 people in 2011, include:

The lifetime prevalence of physical violence by an intimate partner was an estimated 31.5% among women and in the 12 months before taking the survey, an estimated 4.0% of women experienced some form of physical violence by an intimate partner. An estimated 22.3% of women experienced at least one act of severe physical violence by an intimate partner during their lifetimes. With respect to individual severe physical violence behaviors, being slammed against something was experienced by an estimated 15.4% of women, and being hit with a fist or something hard was experienced by 13.2% of women. In the 12 months before taking the survey, an estimated 2.3% of women experienced at least one form of severe physical violence by an intimate partner.

Still, the overall rates of IPV in the United States have been generally falling over the past two decades, and in 2013 the federal government reauthorized an enhanced Violence Against Women Act , adding further legal protections and broadening the groups covered to include LGBT persons and Native American women. (For research on the relatively higher violence rates among gay men, see the 2012 study “Intimate Partner Violence and Social Pressure among Gay Men in Six Countries.” )

A 2013 study published in the Journal of Marriage and Family , “Women’s Education, Marital Violence, and Divorce: A Social Exchange Perspective,” analyzes a nationally representative sample of more than 900 young U.S. women to look at factors that make females more likely to leave abusive relationships. The researchers, Derek A. Kreager, Richard B. Felson, Cody Warner and Marin R. Wenger, are all at Pennsylvania State University. They note that traditional “social exchange theory” would suggest that as women have more resources, they become less dependent on men and have more opportunities outside relationships, and therefore have more ability to divorce. The study sets out to “determine whether the relationship between a woman’s education and divorce is different in violent marriages.” The researchers also hypothesize that women who have higher levels of education are less likely to get divorced in general — prior academic work they cite supports this — but they aim to see how the introduction of intimate partner violence changes this dynamic.

The study’s findings include:

• The data provide “support for our primary hypotheses that women’s education typically protects against divorce but that this association weakens in abusive marriages. In addition, we found a similar pattern for wives’ proportional income, net of education. Together, these patterns suggest that educational and financial resources benefit women by increasing marital stability in nonabusive marriages and promoting divorce in abusive marriages.”
• Further, the “greater tendency for educated women to leave abusive marriages was substantial. For example, in highly violent marriages, women with a college degree had over a 10% greater probability of divorce in the observed time period than women without a college degree.”
• The study also finds that “women with economic resources were likely to leave unhappy marriages, regardless of whether they involve abuse. Similarly, degree-earning women were more likely than less educated women to leave violent marriages, regardless of their feelings of dissatisfaction.”

The researchers note that, across the U.S. population, more women are attaining college degrees, and given the study’s findings, this suggests “increases in women’s education should reduce rates of domestic violence. In a population with many educated women, violent marriages are likely to break up.” They caution that it is also possible “that our observed patterns reflect husbands’ perceptions and decisions. Perhaps abusive men feel threatened by successful wives, which then increases divorce risk. Nonabusive men may not feel threatened and thus stay with successful women.” On this point, more research is required.

Related research: A 2015 study titled “When War Comes Home: The Effect of Combat Service on Domestic Violence” suggests that multiple deployments and longer deployment lengths may increase the chance of family violence. A June 2014 study published in the  Journal of Interpersonal Violence , “Intimate Partner Violence Before and During Pregnancy: Related Demographic and Psychosocial Factors and Postpartum Depressive Symptoms Among Mexican American Women,”  provides a snapshot of domestic violence in a community sample of low-income Hispanic women. A March 2013 report from the U.S. Department of Justice’s Bureau of Justice Statistics, “Female Victims of Sexual Violence, 1994-2010,” provides a broad picture of such crimes across American society, examining the demographics of both victims and offenders. Regarding the issue of IPV prevention, a 2003 metastudy published in the Journal of the American Medical Association (JAMA) , “Interventions for Violence Against Women: Scientific Review,” found that “information about evidence-based approaches in the primary care setting for preventing IPV is seriously lacking…. Specifically, the effectiveness of routine primary care screening remains unclear, since screening studies have not evaluated outcomes beyond the ability of the screening test to identify abused women. Similarly, specific treatment interventions for women exposed to violence, including women’s shelters, have not been adequately evaluated.” Subsequent research continues to find problems with current techniques for screening and detection.

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Introduction, correlations and typologies, complex interdependencies, group 1 exemplar. victim was never substance dependent, group 2 exemplar. victim was desisting from substance use, group 3 exemplar. victim was substance dependent, discussion and conclusion.

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The Dynamics of Domestic Abuse and Drug and Alcohol Dependency

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David Gadd, Juliet Henderson, Polly Radcliffe, Danielle Stephens-Lewis, Amy Johnson, Gail Gilchrist, The Dynamics of Domestic Abuse and Drug and Alcohol Dependency, The British Journal of Criminology , Volume 59, Issue 5, September 2019, Pages 1035–1053, https://doi.org/10.1093/bjc/azz011

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This article elucidates the dynamics that occur in relationships where there have been both substance use and domestic abuse. It draws interpretively on in-depth qualitative interviews with male perpetrators and their current and former partners. These interviews were undertaken for the National Institute for Health Research-funded ADVANCE programme. The article’s analysis highlights the diverse ways in which domestic abuse by substance-using male partners is compounded for women who have never been substance dependent, women who have formerly been substance dependent and women who are currently substance dependent. The criminological implications of the competing models of change deployed in drug treatment and domestic violence intervention are discussed alongside the policy and practice challenges entailed in reconciling them within intervention contexts where specialist service provision has been scaled back and victims navigate pressures to stay with perpetrators while they undergo treatment alongside the threat of sanction should they seek protection from the police and courts.

The 2019 Domestic Abuse Bill proposes to establish a statutory definition of domestic abuse that includes ‘controlling, coercive, threatening behaviour, violence or abuse’ encompassing ‘psychological, physical, sexual, economic and emotional forms of abuse’ ( HM Government, 2019 : 5). It proposes to widen the scope of Domestic Abuse Protection Orders so that suspected perpetrators of domestic abuse can be compelled to attend ‘drug or alcohol treatment’, as well as ‘behavioural change’ programmes by the family courts (if petitioned by victims or other relevant third parties, such as non-governmental organizations) and magistrates courts (where the police would normally petition) (ibid. Explanatory Note Clause 3: 128). It is proposed that compliance with such orders will be secured in part through electronic monitoring. Breaches of such orders will be a criminal offence, punishable by up to ‘five years’ imprisonment, unlimited fine or both’ (ibid. 30).

The Bill is informed by a prolonged consultation in which over 3,200 responses were received by government and expert opinion—primarily from organizations representing victims and survivors of domestic abuse and stalking—was submitted to two Home Affairs Committees ( House of Commons, 2018 ). Cross-party support for the Bill was secured: as politicians registered the volume of domestic abuse cases raised with them by constituents; amidst news that the daughter of an MP had committed suicide following a relationship in which she suffered psychological—but not physical—torment that caused her to fear that she was mentally ill ( Elgot, 2018 ); and during a campaign by David Challen to enable his mother to appeal her conviction for murdering his coercively controlling father ( Moore, 2018 ). In strengthening the prohibition of ‘coercive control’ ( Home Office, 2015 : 2)—a concept advanced by Stark (2007 : i) to explain ‘how men entrap women in personal life’ through ‘intimate terrorism’—the Bill can be read as a logical extension of three decades of Conservative party policy that conceives the criminalization of a dangerous minority of men who abuse ‘very vulnerable women and girls’ to be a key part of the solution to domestic abuse ( Heidensohn, 1995 ; Gadd, 2012 ). But this Bill was conceived within a more nuanced policy agenda than its predecessors. In the initial consultation document Transforming the Response to Domestic Abuse, which sought views on a raft of new measures, the then-Home Secretary, Amber Rudd, and Justice Secretary, David Gauke, called for policy that (1) recognizes that both ‘women and men are victims of domestic abuse’, though ‘a disproportionate number of victims are women, especially in the most severe cases’ ( HM Government, 2018 : 3); (2) ‘actively empowers victims, communities and professionals to confront and challenge’ domestic abuse; and (3) reduces regional variation in the quality of ‘services to help victims’ and ‘punish and rehabilitate offenders’ (ibid, our emphases). This receptivity to the rehabilitative ambitions of health and social care professionals derived principally from the findings of domestic homicide and serious case reviews (ibid, p21), which reveal the pertinence of a ‘toxic trio’ of domestic abuse, mental health issues and drug and alcohol problems in cases where women or children are killed ( Brandon et al., 2010 ; Robinson et al., 2018 ), and how substance use features in around half of intimate partners homicides in the United Kingdom ( Home Office, 2016 ). Transforming the Response to Domestic Abuse followed suit, highlighting the ‘complex needs’ of those living with ‘drug and alcohol misuse, offending, mental illness and poverty’ ( HM Government, 2018 : 10); domestic abuse ‘victims’ with ‘problematic drug use’ (p24); ‘survivors… who have children on child protection plans’ (p28); ‘women at risk of having their children removed’ (p28); ‘female offenders’ who have also ‘experienced domestic abuse’ (p31); and male ‘perpetrators’, who are too often depicted in terms of the ‘stereotype’ of a ‘drunk… who… loses control and assaults their partner’ (p11). Such ‘simplistic’ depictions were debunked for failing to ‘reflect… the complex reality and lived experience of victims’ and impervious to the ‘dynamics of power and control which are present in many abusive relationships’ (ibid. pp11 and 12). They had previously been challenged by official drugs policy that committed to supporting the disproportionate number of ‘intimate partner violence’ victims and perpetrators accessing substance misuse services ( HM Government, 2017 ).

This article responds to this call to redress the dynamics of power that occur in relationships where substance use and domestic abuse co-occur. We contribute to such an understanding through the presentation of three couple dyads—each comprising a male perpetrator and his female partner—interviewed in-depth for the UK National Institute for Health Research funded Advancing theory and treatment approaches for males in substance use treatment who perpetrate intimate partner violence (ADVANCE) programme 1 . Our conclusion returns to the challenges the 2019 Domestic Abuse Bill poses to policy, practice and criminological theorizing.

Evidence for the relationship between domestic abuse and drug and alcohol intoxication is plentiful in crime surveys but tends to focus, peculiarly, on the behaviour of victims more often than offenders. For example, the 2016 Crime Survey for England and Wales revealed that ‘adults aged between 16 and 59 who had taken illicit drugs in the last year’ were three times more likely to report ‘being a victim of partner abuse’ than those who had not done so ( ONS, 2016 : 25). However, using illicit drugs does not invite assault and the identification of such ‘risk factors’ in the absence of explanation of their relevance accentuates the victim-blaming some perpetrators deploy to control their victims ( Gadd et al., 2014 ). The international evidence reveals that men, but not women, tend to perpetrate more severe assaults when they have been drinking ( Graham et al., 2011 ; Reno et al., 2010 ). Women are more vulnerable to assault when they too are intoxicated, but this is at least partly because those living with abusers are less diligent at pursuing safety strategies when they have been drinking ( Iverson et al., 2013 ). Substance use features in around half of all UK domestic homicides. Since 2011, substance use has been detected among domestic homicide perpetrators more than four times as often as it has among those killed by them ( Home Office, 2016 )

In sum, the relationship between substance use and domestic abuse is not straightforward. Moreover, Different substances have different pharmacological properties. They are used in variable quantities and combinations fostering a range of effects—including docility as much as aggression—that are contingent upon the user’s experience of them, prehistory of use, mood and the context in which the consumption takes place ( Zinberg, 1984 ; Gilchrist et al., 2019 ). Laboratory research reveals that those with low levels of inhibition, empathy and self-regulation and elevated levels of sensitivity to threats and insults (‘instigative cues’) are more prone to violence when they have consumed alcohol up to four hours ahead of a perceived threat or ‘provocation’ ( Leonard and Quiqley, 2017 ). Cocaine consumption can induce similar reactions. Like cannabinoids and opiates—the effects of which are rarely studied in the context of aggression or violence—cocaine can also alleviate anxiety and exacerbate underlying problems with depression, paranoia and hallucinations ( Sacks et al., 2009 ). Consequently, regular use of such drugs, like the consumption of excessive alcohol, can impinge upon mental well-being and intimacy, generating indirect and belated relationships between victimization and substance use that extend far beyond periods of intoxication.

Feminist scholarship on domestic abuse has tended not to engage with the pharmacological impacts of substance use and has focussed instead on how some abusive men retain power over women by attributing their violence to intoxication, by insisting that their drinking caused them to act out of character, or by denying any memory of assaults perpetrated when intoxicated ( Hearn, 1998 ; MacKay, 1996 ). Evaluations of interventions for perpetrators have thus needed to be alert to the ways in which substance use is invoked to minimize violence. Women’s accounts of victimization have had to take precedence over men’s self-reported offending as measure of changes given the potential for such minimization ( Dobash et al., 1999 ). But as Stark’s (2007) review of officially reported ‘intimate terrorism’ cases illustrates, substance can also be implicated in the perpetration of ‘coercive control’ and victims’ responses to it. His analyses reveal that some victims do self-medicate to manage the depression the daily anticipation of violence engenders and that some perpetrators control victims by increasing their dependence on substances before restricting their access to them. Finally, Stark highlights that some women who have been terrorized over many years take matters into their own hands after the law has failed to protect them, mounting grievous attacks on perpetrators when they are too intoxicated to retaliate.

Typological research on men’s domestic abuse perpetration has also addressed the role of drugs and alcohol anecdotally. For example, Holtzworth-Munroe and Stuart (1994) suggest that there are three distinct types of male domestic abuse perpetrator, one of which—the ‘antisocial batterer’—is defined by their dependence on drugs and alcohol, engagement in crime and paternalistic values. The other two groups, they propose, include ‘family only batterers’ who are seemingly ‘normal’ men who are violent at home and conventional in their sexism; and ‘emotionally dysphoric batterers’ with clinically diagnosable ‘borderline personality disorders’ who tend to be overtly misogynistic, especially when their relationships are failing, or they distrust the fidelity of their partners. Yet, what the relationship is between substance use and violence for the antisocial batterer remains untheorized in Holzworth and colleagues’ tests of their typology ( Holtzworth-Munroe et al., 2000 ). This is despite clinical evidence suggesting that drug use and violence co-occur most among men with diagnosed mental health issues, poor concentration and problems understanding and remembering their pasts ( Sacks et al., 2009 ). In relation to ‘family only’ perpetrators, Johnson et al. (2014 : 65) suggest that this group is more likely to be involved in ‘situational couple’ and ‘separation-instigated’ violence that is more ‘gender-symmetrical’, and derivative of arguments over domestic matters, finances, childcare or ‘objections to the other partner’s excessive drinking’ that evolve into ‘fights’. For this subgroup of ‘family only perpetrators’, the link between alcohol consumption and domestic abuse may have more to do with everyday conflicts than personality traits, though the difference between them and intimate terrorists can be overdrawn ( Gadd and Corr, 2017 ). Sociologically speaking, control ‘is a continuum. Everyone controls their partner to some extent’ ( Johnson, 2008 : 87), begging the question as to when and why the desire to control becomes pertinent.

Answers to this question can be found in the few qualitative studies that explore how drugs and alcohol feature in the relationships of couples living with domestic abuse. These reveal that some perpetrators pose greater risks to their partners, not when they are high, but when they are irritable, withdrawing or are struggling to finance alcohol or drug purchases ( Gilchrist et al., 2019 ). One exemplar is Hydén’s (1994) study of middle-class Swedish couples reported to the police for domestic abuse. Follow-up interviews with 20 couples where alcohol consumption was noted by the police revealed that, although drunkenness and its expense were the source of many arguments that led to violence, social drinking, especially at parties, was also what held some relationships together. Afterwards, some couples reconciled on the basis that it was the alcohol that caused the conflict. They asserted that the perpetrator was normally a ‘good person’ who could be helped. Men who had caused injuries when intoxicated often claimed they could only recall feeling hurt—sometimes in ways that reminded them of painful experiences in their pasts—by female partners who criticized them or acted aggressively towards them and not the assaults they themselves had perpetrated.

Evidence of the relevance of emotional pain can also be found in Motz’s (2014) case analyses of couples in therapy. This reveals how some women who had been abused or neglected as children attempted to cope with feelings of vulnerability ‘through the creation of highly dependent relationships with men who… offer… protection, and through getting into states of mind where these feelings can be pushed away… through drugs or alcohol’ (p69). Motz depicts the emotionally impoverished lives of abusive men with whom some drug-using women cohabit, many of whom feared abandonment because of experiences of abuse, neglect or institutional care. Some of these men had ‘little capacity to tolerate emotional intimacy’ (p93) and thus found it ‘impossible to relate’ to their families or sexual partners unless ‘high on drugs’ (p93). Over time, Motz suggests, these couples became ‘doubly dangerous’, leaving their children uncared for when intoxicated, withdrawing or fighting, and unable to ‘come together safely’ in an emotionally connected way to ‘manage and contain distress’ afterwards (p158). ‘Toxic couples’, Motz argues, deny their own dependencies and instead project them onto each other, leading them to view their partners as more out of control than they are. For some men such projection amounted to ‘a fantasized attempt at creating a state of invulnerability and absolute control’ (ibid) when their own lives are in disarray.

Evidence of this kind of ‘splitting’—where good and bad, safe and dangerous, vulnerable and invulnerable, qualities in the self or other are imagined as irreconcilably polarized—upon which such projective processes rely, can also be found in Gilbert and colleagues’ (2001) focus-group study of women enrolled in North American methadone programmes. Participants described how altercations materialized rapidly when high on crack cocaine or when drunk, as intoxication induced paranoid sexual jealousy that led to hostile accusations by men who became like ‘Jekyll and Hyde’. When withdrawing from heroin, some men attacked their partners for failing to provide money for drugs, some women cited ‘irritability’ as explanations for their own use of violence towards their partners when intoxicated or withdrawing, meanwhile others emphasized that drunkenness intensified their male partners’ criticism of them for failing to fulfill household tasks. Some women described engaging in prostitution to raise money for drugs as evidence of their love and care for male partners. When the women subsequently refused to raise funds in this way or sought support from professionals to reduce their own drug use, some male perpetrators threatened further violence whereas others encouraged them to relapse back onto heroin or crack, thus entrapping stigmatized and socially isolated women in relationships with them.

In what follows, we expand the argument for a more relationally sensitive analysis of the dynamics of power that pertain in the lives of couples where domestic abuse towards a partner occurs alongside substance use. Such analyses, we argue, need to be attuned to the gendered power dynamics of drug use and domestic abuse: dynamics that may be reciprocal even while unequal; financial, emotional and pharmacological; involve violence that is perceived as ‘situational’ by one partner and ‘coercively controlling’ by the other; and recalled as involving movements between intimacy and distance among the exchange of insults and assaults, craving for drink and drugs, intoxication and withdrawal. We seek to illustrate these points by drawing on dyad interviews—with male perpetrators in treatment for substance use problems together with their current and former female partners—undertaken for the ADVANCE programme.

The ADVANCE programme seeks to develop and test an integrated intimate partner violence and substance use group intervention that will reduce intimate partner abuse perpetrated by men receiving substance misuse treatment. We report here on the programme’s preparatory workstream. This involved interviewing male domestic abuse perpetrators receiving treatment for substance use and their current or former partners about their relationships and support needs. Adult men were recruited from six community-based substance use treatment services in London and the West Midlands. The treatment services were for people who regarded themselves as ‘substance dependent’, typically because they regarded their drug and alcohol usage as ‘compulsive’, necessary to deal with problems, taking up a lot of time and energy, costing more than they could legitimately afford, and/or very difficult to stop 2 .

Seventy men were screened for lifetime domestic abuse against a partner. Men who currently had court orders preventing contact with their (ex)partners were excluded. Forty-seven of the 70 men screened were eligible, and 37 of these 47 men were then interviewed. Male interviewees were asked to provide contact details of their current or former female partners, and in 14 cases these women were interviewed. All participants were advised that there were limits to the confidentiality that could be afforded where unaddressed risks of harm and safeguarding issues were disclosed. Women and men were always interviewed by different researchers to ensure no information was inadvertently shared between participants. Participants were paid £20 to compensate for their time.

Interviews were undertaken using reflective techniques derived from the Free Association Narrative Interview Method ( Hollway and Jefferson, 2000 ), with participants being supported through active listening to tell the stories of their drug use, relationships, domestic abuse and intervention experiences. Digital recordings of the interviews were transcribed verbatim and transcriptions were checked twice for errors. Timelines were created to track the sequence of events through the life of each participant. Case studies were then written-up as ‘pen portraits’, which sought to capture the complexity revealed in each interview, including apparent contradictions, avoidances and implausible claims. In the 14 cases where both partners were interviewed, men’s and women’s accounts were compared with each other. Although all of the perpetrators interviewed could have been coded as ‘antisocial’ in Holtzworth-Munroe’s (2000) terms, given their drug use and criminal histories, such categorization would oversimplify matters. All but two of the men depicted their violence as situational and/or a product of some form of mutual combat, whereas all but one of their partners depicted coercively controlling abuse, to which around half the women responded with some degree of violent resistance. In terms of their drug use, the 14 men who were interviewed with their partners appeared to be broadly comparable with the other 23 whose partners were not interviewed ( Table 1 ). The majority used heroin with other illicit substances, notably crack cocaine and/or powder cocaine, though some also mixed benzodiazepines with alcohol. Nine out of the 14 were also heavy drinkers. Five of the 14 men also described medical or psychological diagnosis consistent with emotional dysphoria. Eight males disclosed perpetrating violence that was extra-familial in addition to their abuse of partners. Contact with children had, at some point or other, been restricted for all the men in the study.

Self-reported substance use within the sample

Given the high degree of similarity among the men on key variables, we explored if more meaningful distinctions could be drawn by distinguishing the dyads in terms of whether victims had ever used drugs and, if they had, whether they were desisting from substance use or still using. Only four of the women described themselves as substance dependent at the time of the interviews. Five had never been substance dependent, and another five were desisting from substance use, either having become completely abstinent from using or having only had temporary relapses. A three-fold distinction could thus be drawn across the dyads that revealed some important variations in terms of how domestic abuse and substance use manifested themselves.

Group 1. Victim had never been substance dependent ( n = 5)

Within the sample, there were five couples where the female partner had never been substance dependent, though all the women interviewed drank alcohol socially, and one smoked cannabis occasionally. Women in this group had almost no involvement in crime. Four of these women had never been separated from their children, but one woman had children who had been required to live with their grandfather as she would not leave her abusive partner. These non-substance dependent women were typically confused as to why relationships that had started out well had suddenly deteriorated; why their partners engaged in unexplained and peculiar behaviours; and why they had accused them of unfounded infidelities while lying about their own substance use and/or the criminal activity that generally supported it.

Group 2. Victim was desisting from substance use ( n = 5)

Within the sample, there were five couples where the female partner had abstained from using drugs or alcohol, having previously been substance dependent. None of these women had criminal convictions. The stories these desisting women told tended to be of intimacy lost. Sharing feelings and traumas that motivated drug use, and about what made it difficult to give up, had generated understanding and closeness when they had first met their partners. Conflicts had then developed when the men resumed drug use or drinking whereas the women were trying to reduce their own or abstain. Only two of the women in this group had children of their own. In both cases, these women had raised their own children, but with some intermittent professional oversight.

Group 3. Victim was substance dependent ( n = 4)

Within the sample, there were four couples where both the male perpetrator and the female victim were both currently substance dependent. All the women in this group used crack cocaine and heroin to varying degrees. Though they sometimes mentioned love, they often explained their persistence with relationships that had become abusive in terms of daily needs for protection, somewhere to live and the sharing of drugs. The women in this group had much more frequent and entrenched patterns of criminal involvement than the other 10 in the sample. Their criminal involvement activities included shoplifting, petty frauds and prostitution to finance their drug use, typically with encouragement from male partners who relied, to some extent, upon the income the women generated. All four women in this group had been separated from their children when these children were young, though two women had re-established relationships with their children in adulthood.

In what follows, we present one couple from each of these groups to further illustrate the different power dynamics that can pertain in relationships where domestic abuse and substance use co-occur. Italics are used to highlight points where the participants emphasized a relationship between substance use and domestic abuse.

Wayne (early thirties) and Rhian (late twenties) met while she was managing a pub where he drank, sometimes ‘heavily’, during the ‘daytime’. She had never cohabited with a partner before, but he already had a child with another woman and had served at least six prison sentences, two for ‘kidnap’ of his own child. By Rhian’s account, when they first met three years before, the relationship ‘progressed really quickly’: ‘within a couple of weeks’ Wayne was staying in her flat. By Wayne’s account, he and Rhian visited the grave of his grandfather before spending the night together. After that, Wayne said, he ‘couldn’t get rid’ of Rhian: he ‘loved her to bits’ and their relationship was ‘proper good’ for 18 months until he began to ‘blag’ money from her to buy heroin. Rhian’s account, by contrast, was recollected more as an unfolding nightmare, in which she did not know why Wayne was being so controlling until after their baby was born when he revealed he was getting treatment for heroin dependency.

Rhian recalled that Wayne first assaulted her within a couple of months of moving in. After a drink with friends and not knowing that she was already pregnant, Rhian felt ill and went to bed. When Wayne returned home, he became ‘very argumentative’, ‘coming right’ in her ‘face’, accusing her, without foundation, of sleeping with someone else. Rhian wanted to end the relationship then, but Wayne was profusely apologetic, convincing her to keep the baby and get their ‘own place’, explaining his life was ‘empty’ before they met. Wayne provided a detailed account of the emptiness he felt. His mother, who was separated from his father, had worked nights in a pub, leaving her children ‘home alone’ to run ‘wild’. In her absence, Wayne began smoking ‘weed’ regularly. He had ‘weird thoughts’ and would pick fights with anybody , feeling no ‘remorse’ afterwards. Wayne’s mother sought help but did not receive any. Instead, Wayne became abusive to her, ‘calling her a slag’, threatening to hit her when she took his brother’s side, and constantly ‘smashing her house up’. Invited by his cousin to ‘smoke’ heroin to ‘forget’ his grief’ after his grandmother’s funeral, Wayne claimed his clandestine usage escalated from there, Rhian erroneously assuming he was cheating on her, doing nothing to ‘help’ him come to terms with his loss, and causing him to cheat on her. As a ‘druggie’, Wayne said, he became unable to show Rhian ‘affection’ or ‘love anybody’ , including himself.

Wayne’s accusations of infidelity caused Rhian much distress while his behaviour became more erratic and threatening, ‘his jaw… going and his eyes’ being ‘wired’ . He smashed Rhian’s phone because he was ‘convinced’ that he had ‘seen someone’s name’ on the screen. Though their relationship was ‘over’ during most of her pregnancy, Rhian ‘literally couldn’t go anywhere’ without Wayne constantly ‘phoning’ and ‘texting’ her, questioning her about what money she had spent, and sometimes barricading her in the house until she asked his mother to come and get him. After a nurse overheard Wayne discussing drugs on his phone during one of the few antenatal appointments he attended, Rhian took the opportunity to ask him what it was about because she was concerned that social services would see a child protection risk for her baby. Wayne responded by calling Rhian a ‘sick’ ‘liar’ and insisted that it was she, not drugs, that was ‘driving’ him ‘crazy’ .

Wayne apologized after their son was born and claimed that holding the baby inspired him to ‘change’. He and Rhian then took, what she recalled was, a ‘perfect’ family holiday together in which he explained that he had been prescribed Subutex (buprenorphine), a semi-synthetic opioid used to treat heroin dependence . Wanting her son to be raised by two parents, Rhian agreed to let Wayne move back in, but when his drug use resumed, he became ‘physically aggressive again’ . Rhian recounted three occasions when Wayne throttled her, once asking her to put the baby in another room so the child would not see, and on another occasion putting a knife to Rhian’s throat and rationalizing, ‘You’re killing me… So, I should … make it look like you killed yourself’. Sometimes Wayne would speed off, with their baby in the back of the car, in a hurry to buy drugs. Other times, he locked Rhian in the flat for days because he suspected she was ‘cheating’ and feared she would leave him. The violence only ceased, Rhian said, when Wayne called the police on himself after pinning her down and grabbing her by the neck. Rhian said she was pressurized by the police to make a statement against Wayne, but that the case was withdrawn when he made a fraudulent counter-accusation and a friend of his posted content on Rhian’s Facebook page, as if by her, purportedly confessing. Wayne, by contrast, only recalled one assault explaining they ‘didn’t argue a lot’ partly because his ‘mind wasn’t there’ . He admitted driving off with the baby because he was in a ‘rush’ to get drugs but insisted the argument occurred only on his return when Rhian, who thought ‘she was more powerful than everybody else’, punched him ‘in the chest’ to stop him leaving again. In response, Wayne claimed, he had ‘moved’ Rhian by the ‘face’ because she ‘wouldn’t let’ him leave and was ‘kicking’ his ‘legs’ and because he knew he ‘would have ended up battering’ her as he did not always know what he was doing when ‘on heroin’ . Wayne was thus surprised to later be awoken by ‘two police officers’ who arrested him, but relieved when the courts concluded that Rhian had lied, and pleased that, post the break-up, he had been able to access some support for the mental health problems that had been troubling him since his childhood.

Mitchel (early fifties) and June (mid-forties) were in a relationship for over 15 years. They met while in residential rehabilitation for heroin dependence when they both were ‘emotionally raw’. Mitchel felt the ‘deepest love’ for June when they met. June thought she had ‘met her soulmate’: an ‘affectionate’ man with whom she had much ‘empathy’ given his ‘horrendous’ experiences of ‘child abuse’; a man who helped her overcome the death of her son’s (also heroin-using) father. As a teenager, Mitchel too had found ‘comfort’ in heroin use after he was sexually abused by his brother and his brother’s friends while their mother, was out ‘trying to find somebody to love her’ . As a child, June was repeatedly coerced into having sex by a man who threatened to report her to social services for caring for her siblings while her mother received hospital treatment. June said that as a university student, she lacked the social skills to say ‘no’ when she was introduced to heroin. When she became pregnant, she weaned herself off it but relapsed when her mother accused her of inviting the sexual abuse she was subjected to as a child. Having taken heroin to ‘bury’ the ‘hurt’ this accusation inflicted, June self-referred into drug rehabilitation for two years so she could raise her son in an environment in which her desistance from drugs was effectively managed . From Mitchel’s perspective, problems in their relationship emerged after they left the residential rehabilitation. June, he said, was ‘damaged goods’: ‘although the love was there’ she was ‘frigid’. He pursued sex with a woman called Rose and hoped that ‘the three of’ them ‘could love each other’, introducing both women to crack cocaine to facilitate this. But, according to Mitchel, the ‘resentments grew’, until June became pregnant and began ‘hounding’ him to commit to her, even though she knew he ‘loved’ Rose ‘more’, trapping him, paradoxically, in a sexless relationship by becoming pregnant. Owing money to a crack cocaine dealer, Mitchel said, he and June fled to his mother’s house for a ‘fresh start’, during which they could cease using drugs and get their own place.

June, by contrast, made no mention of a polyamorous relationship and said that she had remained ‘clean’ of drugs for a decade after leaving the rehabilitation centre while Mitchel’s drug use resumed . Thereafter, she said, Mitchel would constantly ‘put’ her ‘down and compare’ her to another woman. She said that while the heroin would ‘subdue’ Mitchel, when drunk he became ‘aggressive and arrogant, looking for a problem’ . This abusiveness heightened during her pregnancy; a time when she felt increasingly ‘isolated’ and ‘insecure’. The ‘fresh start’ she had been promised never materialized though this was partly because she started drinking heavily, blurring the line between his ‘put downs’ and her responses to them . Drinking, June said, helped her tolerate Mitchel’s ‘screaming’, but sometimes he was determined to escalate arguments, once pouring a bucket of water over her while in bed. When Mitchell returned from university, where his relationship with Rose had resumed, June said he ‘was drinking pints of vodka’ as well as using heroin while undertaking odd jobs for cash, and that she would come home from work to find him ‘asleep’ in front of ‘a plate full of heroin and needles’ while the children played unsupervised . June said that when she ‘confronted’ Mitchel, he ‘cleared’ out her bank account, leaving her reliant on money borrowed from her mother to provide food for the family. Feeling ‘depressed’, ‘trapped’ and defeated’, June began using heroin again.

Mitchel made no mention of these incidents but said June had become domineering about domestic matters when he returned from university. ‘ Violence’ became their ‘means’ of ‘communication’ at this time with him threatening to hit her ‘back’ when she ‘lashed out’. June explained that she had once hit Mitchel in retaliation, whacking him ‘with a folder’ when he lent her car to an unqualified driver and the police questioned her about it. Mitchel responded, she said, by ‘kicking’ her ‘from the head up’, breaking her jaw, causing her unforgettable pain. June said she lay on top of her son to protect him when Mitchel went ‘ballistic’ because the boy had failed to clear up the kitchen after making his own lunch. June conceded that she ‘hit’ Mitchel ‘right back’. Mitchel said he regretted hitting June ‘like a man’, clarifying that normally he would ‘just’ hit her back with an ‘open hand slap’, but that on this occasion she ‘came at’ him, creating an ‘explosion’ before having a ‘breakdown’, perplexingly ‘terrified’ of him.

The police attended but arrested neither of them as they had both been drinking . So, June said, she tried to leave for a friend’s house with the children and eyes that were too swollen to open, but Mitchel kicked and beat her again. After a period in hospital, June said June contacted a drugs and alcohol dependency team who put her on a methadone programme, but Mitchel started taking the methadone because he feared he would lose the house and his children if June recovered. June’s version was that she only succeeded in leaving Mitchel after she awoke to find him ‘forcing’ tablets down her ‘throat’, to make it look as if she had killed herself by overdose. Mitchel made no mention of this attempted murder but explained how bitter he was that June secured a court order that prohibited him from seeing the children merely because he had made the ‘ mistake’ of buying a very large ‘bag’ of heroin and despite always having done the hoovering and cooking ‘for them’.

Joe (mid-thirties) and Kate (late twenties) had been together for six years. A week after having met in the streets and gone out for a drink , Kate arrived at Joe’s house with just a suitcase and never left. Kate had been sexually assaulted both as a child and as a teenager and was estranged from her family. Joe, whose parents were both deceased, was sexually abused while in care and was estranged from his siblings. Kate’s children lived exclusively with her previous partner, their father, because of Kate’s alcoholism. Joe had been a heavy drinker since his molestation and had served multiple prison sentences: two for attacking men he had seen ‘touch up’ women without their consent and one for assaulting Kate. All but one of Joe’s many previous relationships had involved violence, some grievous and directed at him, but for which he had often been arrested, leading him to the conclusion that ‘it is really sexist out there’: ‘there’s one rule for blokes and one rule for women’.

Despite being ‘frightened of men’, Kate initially found Joe ‘really nice’. She said he ‘spoilt’ her and did ‘sweet’ things, taking her to restaurants and bringing her flowers. They both emphasized that they had loved each other, though Kate said she struggled to ‘handle’ Joe’s attention and was sometimes ‘mouthy’ and ‘hateful’ towards him when drunk, merely to elicit a different ‘reaction’ . From Joe’s perspective, however, ‘every argument’ was ‘about drugs and money’ . He understood that Kate was using drugs —something she barely disclosed in her interview—‘ to block out the pain’ of her past, but the drug use had affected their sex life , while chronic pancreatitis had left her with ‘only… a few years left to live’. Joe did not like Kate ‘clipping’ —‘robbing’ men she deceived into believing they would have sex with her—to fund their drug use and wanted her to steal from supermarkets instead. He said he worried that Kate would be raped or killed by men she had clipped and that he had lost teeth defending her from men she had tricked. Joe admitted being ‘jealous’ and afraid that Kate was ‘cheating on’ on him, though he knew she was not ‘a slag’ despite ‘acting’ like ‘one’. Joe considered himself to be no longer ‘alcohol reliant’, having given up spirits, but claimed that he became ‘addicted’ to heroin a year ago, trying it to show Kate he could ‘understand’ what it was like for her . Heroin withdrawal had been the real ‘devil’ for Joe, leaving him unable to ‘walk’ at times, ‘depressed’ and vulnerable to a descending ‘red mist’ that he claimed rendered his temper uncontrollable . Joe commenced a Subutex prescription during his most recent prison sentence which, since his release, he had shared with Kate to ‘make sure that she ain’t sick’ (i.e., suffering withdrawal symptoms), sometimes also using heroin or crack cocaine in addition to his prescription.

From Kate’s perspective, however, Joe’s protectiveness could be ‘suffocating’. She explained that although Joe initially ‘understood’ how her childhood experiences of the sexual violence affected her, his capacity for understanding was now contingent on whether she had sex with him. He now treated her like a ‘child’ and ‘as his’ property and feared he ‘could kill’ her in an ‘accidental angry’ moment. When coming down from being high or drunk, Joe was often ‘controlling’ and could ‘switch very easily with anyone’. Kate explained that previously, when Joe had been smoking crack, he assaulted a ‘pervert’ who had touched Kate ‘in an inappropriate way’. After he had finished assaulting the ‘pervert’ Joe proceeded to strangle and batter Kate, breaking some of her ribs. Hence, Kate avoided doing anything ‘sudden’ that would make Joe ‘paranoid’, despite having invited him to ‘just fucking kill’ her rather than keep ‘terrifying’ her. After ‘days’ of ‘not sleeping and just drinking’, Joe tried to provoke an argument . When Kate walked away, he mimed ‘putting bullets’ in her head, so she ‘pushed him away’ and he ‘punched’ her. While Joe was in prison for this assault, Kate twice attempted suicide. She continued to blame herself for his violence and drank alcohol ‘to feel happy’ while questioning whether it was ‘really’ her ‘fault’ that Joe was so ‘messed up’, as he has claimed. Joe, by contrast, claimed Kate had hit him ‘over the head with a hammer’ because he ‘wouldn’t buy her drugs’ and explained that the assault on her, for which he went to prison, occurred after she ‘slapped’ him ‘round the head’ because he did not ‘have… money for drugs’. It was unfortunate, he said, that the police drove past just as he was hitting ‘her back’ in ‘self-defence’. Though Kate said she ‘loves’ Joe ‘to death’ she doubted whether the ‘damage’ to their relationship could be ‘mended’. He , by contrast, was desperate ‘to get her clean’, as he imagined this would enable him to get his own ‘life back’. Joe assumed that if Kate became sober enough to see her children again, it would save his relationship with her from ‘ruin’.

In this article, we have presented three relationship scenarios where domestic abuse pertained alongside drug or alcohol dependency. These relationships diverged primarily in terms of the female partners’ histories of drug and alcohol consumption as all men were in treatment for substance dependence. All three men—like the majority of those interviewed in the ADVANCE project—considered ‘drugs’, their own and/or their partner’s use of them to have damaged or ruined their relationships. Their depictions of violence as ‘isolated incidents’ in which they were only partially culpable were consistent with perpetrators’ accounts more generally ( Stark, 2007 ; Women’s Aid, 2018 ; Gilchrist et al., 2019 ). Wayne, Mitchel and Joe all described discrete, regrettable and unplanned assaults that derived from everyday conflicts over alcohol and drug use, financial pressures, sexual jealousies and domestic chores: conflicts that were sometimes accentuated by being intoxicated. Nevertheless, the stories these men told suggested that their need to control became increasingly acute when their relationships were in crisis, when they had secrets to keep, when they felt dependent on drugs or alcohol, were afraid of losing their minds, their partners and their children, when money was scarce, and when homelessness and criminalization were distinct possibilities. As these men projected this sense of being in disarray onto their partners, the women began to feel like they were being driven crazy, in part because they did not have full knowledge of the drug and alcohol use that was consuming the men’s time and minds. As the women began to question what was happening, the men’s attempts to coercively control became more dangerous and desperate, e.g., in the refusal to let partners leave their homes or in their efforts to tempt or coerce the women into consuming drugs. Despite their unhappiness, these men, like their partners, often lacked the emotional strength and economic resources required to separate ( Walby and Towers, 2018 ). Instead, the men often blamed discrete incidents of violence, as they construed them, on drugs and/or money-related issues that could be fixed if they entered treatment and their partners were prepared to fight for the relationship, for the sake of children whose well-being had not been paramount (to the men) previously.

By contrast, Rhian, June and Kate, described steadily accumulating patterns of abuse, forgiven initially as promises of fresh starts, either in new places or after drug treatment, were made. The women’s reasons for enduring domestic abuse or for giving the men another chance began with this hope for change but often mutated as they encountered the financial and emotional difficulties of leaving homes, the prospect of losing their children (forever in Kate’s case) and the concomitant risk of criminalization when the men threatened to report them for hitting back or for using drugs. Hence, the reasons these women stayed were complexly configured around drug and alcohol use. Wayne’s abusive behaviour had proved confusing to Rhian, who knew only that he was a heavy drinker until his heroin use was confirmed after their baby was born. Then, as someone with little experience of either drugs or relationships, Rhian was persuaded to give Wayne another chance while he sought drug treatment, assuming mistakenly that this would redress his violence. June, by contrast, had some empathy with Mitchel, having relapsed with heroin herself and recognizing that her own drinking contributed to their arguments. June had been persuaded that moving might facilitate a fresh start, without drug use. However, when June sought opioid substitution treatment for herself, Mitchel found a new way of controlling her, diminishing her capacity to leave by controlling her access to her prescription and then trying to administer an overdose. The challenges for Kate were different again. She had a long history of heavy alcohol consumption and illicit drug use, the latter of which Joe had joined in with, compounding their mutual dependence on shoplifting and pseudo-sex work to maintain their supplies. Joe construed his heroin use as an attempt to empathize with Kate, though it appeared that he persisted with drug treatment partly because it legitimized his management of her drug use. Joe hoped he would get his ‘life back’ if he could facilitate a reconciliation between Kate and her children. In the interim, Kate suffered grievous violence, while living in Joe’s home: violence that was construed as part of the protection he afforded her against men she had clipped.

For the women in these relationships, criminal justice intervention was often greeted with trepidation, for it rarely provided the protection it promised. Instead, they had often concluded that it was simpler to suffer difficulties within their relationships, attribute violence to drugs use and attribute drug use to earlier traumas, of which there were many in our participants’ lives. For June and Kate, the pains of child abuse, mental health problems and bereavement were partly responsible for the solace they had sought in alcohol and heroin consumption, as well as in their relationships with men. However, as their drug and alcohol usage became complicated by domestic abuse, a range of different strategies were pursued by each couple, typically to avoid attracting the attention of social services or the police. These strategies included taking prescribed medications to minimize their need to commit crime to fund illicit drug use (Joe), moving away while also severing ties with friends and family (Mitchel, June), switching substances (Mitchel, Joe), pursuing relationships with others who use illicit drugs to avoid feeling ‘trapped’ (Mitchel, Kate), consuming drugs or alcohol to cope with the aftermath of conflict (Wayne, Mitchel and June), engaging in crime together (Joe, Kate) and tacitly encouraging partners to participate in drug use (Mitchel, Joe), compounding the risks faced by women who wished to abstain or keep their use moderate. Although drug and alcohol use could increase sociability and enhance feelings of closeness between partners, the fear of dependency also induced feelings of worthlessness—evidenced most vociferously in Wayne’s belief that he could not love anyone and the paranoid accusations this engendered, but also hinted at in Joe’s jealousy and Mitchel’s infidelity.

These cases reveal how the projective dynamics that impart blame, often through men’s claims that their female partners are ‘driving’ them ‘mad’, are easily facilitated by the nuances of sexism and reinforced by the perennial threat of violence. These dynamics were compounded as drinking and drug use generated financial pressures, which intensified conflicts that left the women, as well as some of the men, feeling that their partners regarded sustaining their substance use as more important than their relationship, avoiding criminalization and social services intervention, and the threats posed by those from whom money and drugs had been borrowed or defrauded.

For time-pressured police officers, social workers and magistrates faced with partial evidence and counterclaims, discerning the ‘truth’ of who had done what to whom in which circumstances would have been particularly difficult. Evidently, some abusive men tell highly convoluted stories to exonerate themselves. But some women who are the primary victims in such relationships do not and cannot always tell the whole truth either, not only because they fear further violence and abuse but also because of the stigma of their own drinking and drug use, the fear of child protection proceedings being instigated and the risk of being incriminated by perpetrators they have hit in self-defence or retaliated against ( Wolf et al., 2003 ; Felson and Paul-Phillipe, 2005 ). What is under-acknowledged in many serious cases of domestic abuse is that both perpetrators and victims often share in the shame associated with being abused as adults and children, of failing to protect their own children, anticipate their partner’s needs, having hit back, gotten drunk or engaged in illicit drug use.

Like many of the men in the ADVANCE programme study, the perpetrators we have depicted here dealt with feelings of trauma and grief from their pasts through drug use and by scaring their partners in ways that the women experienced as acutely controlling. While frequently terrifying, such behaviour was not only instrumental and controlling but also expressive of how painful some aspects of their pasts were and how unwilling they were to concede their dependency on both substances and partners who provided care, funds, a place to live and the support needed to maintain precarious relationships with children. Similar experiences of child abuse, mental health problems and drug dependency were sometimes part of the story of intimacy that held these couples together despite grievous domestic abuse. Then, when the risk of criminalization or estrangement presented, men who were coercively controlling sometimes used such prehistories against their partners by threatening to expose them for raising children in contexts that were unsafe. Hence, the ‘madness’ that the women in these relationships often felt was not simply symptomatic of their own mental health problems but projected onto them by men who had become desperate to impose their own versions of reality.

This imposition of the perpetrator’s reality sometimes became more forceful when the criminal justice system intervened. The risk of ‘legal systems abuse’ occurs when perpetrators adept at coercive control harness the powers of the police or the courts to further intimidate their partners ( Douglas, 2018 ). It has, to some extent, been be amplified by the advent of gender-neutral policy, which recognizes that men can be victims too, alongside incident-focussed approaches to policing that direct attention to what has just happened—such as a man being hit—rather than the history of the relationship—such as a woman being terrified or controlled by the same man over a prolonged period ( Walklate et al., 2018 ). The 2019 Domestic Abuse Bill attempts to counter this risk by prohibiting perpetrators from cross-examining victims in the family courts and providing greater recognition of the impact of the ways in which economic abuse makes it harder for many victims to leave. But compelling alcohol and drug-using perpetrators to receive treatment may introduce unforeseen possibilities for coercive use of the law. Some women will consider themselves too culpable to seek support and will ultimately be let down within a criminal justice process calibrated to identify the perpetrator of assaults at the scene and/or whether they were intoxicated, and hence be easily blindsided by the mutualizing discourses some serial offenders offer in their defence ( Tolmie, 2018 ). Others will stay under the misapprehension that the domestic abuse will cease once treatment for substance use begins. This is an unlikely outcome, though intervention is nonetheless worthwhile. There is tentative evidence to suggest that reducing drinking among perpetrators can diminish resort to violence ( Wilson et al., 2014 ) and that opiate substitution treatment can help alleviate dependence on illicitly purchased drugs and acquisitive crime and improve mental, physical and sexual health among heroin-dependent polydrug users ( Gossop et al., 2000 ; Strang et al., 2010 ; MacArthur et al., 2014 ). But, although treatment interventions can reduce the harms of substance use, where drug and alcohol use and domestic abuse co-occur, treatment needs to be part of a range of measures that include support in changes in thinking and modes of relating, securing the housing and economic resources couples need to be able to contemplate living apart, the support and empowerment of survivors, the safeguarding of children and professional help with mental health problems. These skilled forms of intervention are critical to deescalating the dynamics that sustain substance use in the lives of people enduring the worst forms of domestic abuse but are often in short supply.

By contrast, the evidence that domestic abuse perpetrator programmes—as currently commissioned by the UK government—‘work’ remains mixed ( Vigurs et al., 2017 ). Although the best interventions risk encouraging men who have been physically violent to adopt more emotionally abusive tactics ( Kelly and Westmarland, 2016 ), the UK’s Probation Inspectorate is doubtful as to whether the private Community Rehabilitation Companies currently delivering such interventions provide adequate practice in terms of safeguarding victims and their children ( House of Commons, 2018 ). Both the domestic abuse and substance use treatment sectors in the United Kingdom have suffered sustained funding cuts over the last 10 years ( Women’s Aid, 2016 ; ACMD, 2017 ), often secured through the non-renewal of local procurement contracts via competitive tendering processes that favour cheaper and less specialist provision. One danger with compelling drug or alcohol treatment is that it will place clinicians and health practitioners in the ethically compromising position of having to report those who relapse, together with those whose prescriptions have proved insufficient, or who have decided that they would be better trying to reduce their substance use gradually, to the courts where they may face further criminalization ( Seddon, 2007 ; Werb et al., 2016 ).

More generally, models of treatment for alcohol and drug use that acknowledge that ‘relapse’ is common are hard to reconcile with domestic abuse policy founded on compliance with court orders that insist upon ‘zero tolerance’ of reoffending ( Benitez et al., 2010 ). Criminalizing responses are rarely challenged in domestic abuse policy, where academic research has tended to extol the benefits of naming ‘perpetrators’ as such and victims, though sometimes recognized as ‘survivors’, are usually cast as their opposites. Such an approach runs contrary to academic conventions in substance use research where a concerted effort has been used to avoid stigmatizing terminology that reduces individuals’ identities to their drug consumption ( Broyles et al., 2014 ).

Hence, acknowledgement of complexities in the power dynamics of domestic abuse that co-occurs with drug, alcohol and mental health problems raises acute challenges, not only for the delivery of policy that attempts to reconcile safety, justice and rehabilitation but also for academics who have framed the problem of domestic abuse primarily as one of either gender or psychology. Not only do criminologists need to reconceptualize domestic abuse more dynamically but they must also ask why some men choose to secure control in coercive ways when so many other aspects of their lives appear out of control. There is a need to recognize how the interdependencies—including the prospect of economic abuse—involved in intimate relationships are intensified by poverty, stigma, co-dependency, child abuse and neglect, poor mental health and the fear of police and social services intervention. In theory and in practice, we must ensure that shorthand explanations derivative of personality disorders do not obscure what can be learnt from the more complex descriptions both survivors and perpetrators can offer of their relationships. Policymakers need also to ensure that evaluations of treatment options for substance-using perpetrators extend beyond the longstanding fixation with acquisitive crime to include measures that take stock of their impact on children and partners, whether current and former, and to recognize that establishing effective practice will require the reestablishment of expertize and service provision that is increasingly scarce.

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Domestic violence research topics.

The list of domestic violence research paper topics below will show that domestic violence takes on many forms. Through recent scientific study, it is now known that domestic violence occurs within different types of households. The purpose of creating this list is for students to have available a comprehensive, state-of-the-research, easy-to-read compilation of a wide variety of domestic violence topics and provide research paper examples on those topics.

Domestic violence research paper topics can be divided into seven categories:

• Victims of domestic violence,
• Theoretical perspectives and correlates to domestic violence,
• Cross-cultural and religious perspectives,
• Understudied areas within domestic violence research,
• Domestic violence and the law,
• Child abuse and elder abuse, and
• Special topics in domestic violence.

100+ Domestic Violence Research Topics

Victims of domestic violence.

Initial research recognized wives as victims of domestic violence. Thereafter, it was acknowledged that unmarried women were also falling victim to violence at the hands of their boyfriends. Subsequently, the term ‘‘battered women’’ became synonymous with ‘‘battered wives.’’ Legitimizing female victimization served as the catalyst in introducing other types of intimate partner violence.

• Battered Husbands
• Battered Wives
• Battered Women: Held in Captivity
• Battered Women Who Kill: An Examination
• Cohabiting Violence
• Dating Violence
• Domestic Violence in Workplace
• Intimate Partner Homicide
• Intimate Partner Violence, Forms of
• Marital Rape
• Mutual Battering
• Spousal Prostitution

Read more about victims of domestic violence .

Part 2: Research Paper Topics on

Theoretical Perspectives and Correlates to Domestic Violence

There is no single causal factor related to domestic violence. Rather, scholars have concluded that there are numerous factors that contribute to domestic violence. Feminists found that women were beaten at the hands of their partners. Drawing on feminist theory, they helped explain the relationship between patriarchy and domestic violence. Researchers have examined other theoretical perspectives such as attachment theory, exchange theory, identity theory, the cycle of violence, social learning theory, and victim-blaming theory in explaining domestic violence. However, factors exist that may not fall into a single theoretical perspective. Correlates have shown that certain factors such as pregnancy, social class, level of education, animal abuse, and substance abuse may influence the likelihood for victimization.

• Animal Abuse: The Link to Family Violence
• Assessing Risk in Domestic Violence Cases
• Attachment Theory and Domestic Violence
• Battered Woman Syndrome
• Batterer Typology
• Bullying and the Family
• Coercive Control
• Control Balance Theory and Domestic Violence
• Cycle of Violence
• Depression and Domestic Violence
• Education as a Risk Factor for Domestic Violence
• Exchange Theory
• Feminist Theory
• Identity Theory and Domestic Violence
• Intergenerational Transfer of Intimate Partner Violence
• Popular Culture and Domestic Violence
• Post-Incest Syndrome
• Pregnancy-Related Violence
• Social Class and Domestic Violence
• Social Learning Theory and Family Violence
• Stockholm Syndrome in Battered Women
• Substance Use/Abuse and Intimate Partner Violence
• The Impact of Homelessness on Family Violence
• Victim-Blaming Theory

Read more about domestic violence theories .

Part 3: Research Paper Topics on

Cross-Cultural and Religious Perspectives on Domestic Violence

It was essential to acknowledge that domestic violence crosses cultural boundaries and religious affiliations. There is no one particular society or religious group exempt from victimization. A variety of developed and developing countries were examined in understanding the prevalence of domestic violence within their societies as well as their coping strategies in handling these volatile issues. It is often misunderstood that one religious group is more tolerant of family violence than another. As Christianity, Islam, and Judaism represent the three major religions of the world, their ideologies were explored in relation to the acceptance and prevalence of domestic violence.

• Africa: Domestic Violence and the Law
• Africa: The Criminal Justice System and the Problem of Domestic Violence in West Africa
• Asian Americans and Domestic Violence: Cultural Dimensions
• Child Abuse: A Global Perspective
• Christianity and Domestic Violence
• Cross-Cultural Examination of Domestic Violence in China and Pakistan
• Cross-Cultural Examination of Domestic Violence in Latin America
• Cross-Cultural Perspectives on Domestic Violence
• Cross-Cultural Perspectives on How to Deal with Batterers
• Dating Violence among African American Couples
• Domestic Violence among Native Americans
• Domestic Violence in African American Community
• Domestic Violence in Greece
• Domestic Violence in Rural Communities
• Domestic Violence in South Africa
• Domestic Violence in Spain
• Domestic Violence in Trinidad and Tobago
• Domestic Violence within the Jewish Community
• Human Rights, Refugee Laws, and Asylum Protection for People Fleeing Domestic Violence
• Introduction to Minorities and Families in America
• Medical Neglect Related to Religion and Culture
• Multicultural Programs for Domestic Batterers
• Qur’anic Perspectives on Wife Abuse
• Religious Attitudes toward Corporal Punishment
• Rule of Thumb
• Same-Sex Domestic Violence: Comparing Venezuela and the United States
• Worldwide Sociolegal Precedents Supporting Domestic Violence from Ancient to Modern Times

Part 4: Research Paper Topics on

Understudied Areas within Domestic Violence Research

Domestic violence has typically examined traditional relationships, such as husband–wife, boyfriend–girlfriend, and parent–child. Consequently, scholars have historically ignored non-traditional relationships. In fact, certain entries have limited cross-references based on the fact that there were limited, if any, scholarly publications on that topic. Only since the 1990s have scholars admitted that violence exists among lesbians and gay males. There are other ignored populations that are addressed within this encyclopedia including violence within military and police families, violence within pseudo-family environments, and violence against women and children with disabilities.

• Caregiver Violence against People with Disabilities
• Community Response to Gay and Lesbian Domestic Violence
• Compassionate Homicide and Spousal Violence
• Domestic Violence against Women with Disabilities
• Domestic Violence by Law Enforcement Officers
• Domestic Violence within Military Families
• Factors Influencing Reporting Behavior by Male Domestic Violence Victims
• Gay and Bisexual Male Domestic Violence
• Gender Socialization and Gay Male Domestic Violence
• Inmate Mothers: Treatment and Policy Implications
• Intimate Partner Violence and Mental Retardation
• Intimate Partner Violence in Queer, Transgender, and Bisexual Communities
• Lesbian Battering
• Male Victims of Domestic Violence and Reasons They Stay with Their Abusers
• Medicalization of Domestic Violence
• Police Attitudes and Behaviors toward Gay Domestic Violence
• Pseudo-Family Abuse
• Sexual Aggression Perpetrated by Females
• Sexual Orientation and Gender Identity: The Need for Education in Servicing Victims of Trauma

Part 5: Research Paper Topics on

Domestic Violence and the Law

The Violence against Women Act (VAWA) of 1994 helped pave domestic violence concerns into legislative matters. Historically, family violence was handled through informal measures often resulting in mishandling of cases. Through VAWA, victims were given the opportunity to have their cases legally remedied. This legitimized the separation of specialized domestic and family violence courts from criminal courts. The law has recognized that victims of domestic violence deserve recognition and resolution. Law enforcement agencies may be held civilly accountable for their actions in domestic violence incidents. Mandatory arrest policies have been initiated helping reduce discretionary power of police officers. Courts have also begun to focus on the offenders of domestic violence. Currently, there are batterer intervention programs and mediation programs available for offenders within certain jurisdictions. Its goals are to reduce the rate of recidivism among batterers.

• Battered Woman Syndrome as a Legal Defense in Cases of Spousal Homicide
• Batterer Intervention Programs
• Clemency for Battered Women
• Divorce, Child Custody, and Domestic Violence
• Domestic Violence Courts
• Electronic Monitoring of Abusers
• Expert Testimony in Domestic Violence Cases
• Judicial Perspectives on Domestic Violence
• Lautenberg Law
• Legal Issues for Battered Women
• Mandatory Arrest Policies
• Mediation in Domestic Violence
• Police Civil Liability in Domestic Violence Incidents
• Police Decision-Making Factors in Domestic Violence Cases
• Police Response to Domestic Violence Incidents
• Prosecution of Child Abuse and Neglect
• Protective and Restraining Orders
• Shelter Movement
• Training Practices for Law Enforcement in Domestic Violence Cases
• Violence against Women Act

Read more about Domestic Violence Law .

Part 6: Research Paper Topics on

Child Abuse and Elder Abuse

Scholars began to address child abuse over the last third of the twentieth century. It is now recognized that child abuse falls within a wide spectrum. In the past, it was based on visible bruises and scars. Today, researchers have acknowledged that psychological abuse, where there are no visible injuries, is just as damaging as its counterpart. One of the greatest controversies in child abuse literature is that of Munchausen by Proxy. Some scholars have recognized that it is a syndrome while others would deny a syndrome exists. Regardless of the term ‘‘syndrome,’’ Munchausen by Proxy does exist and needs to be further examined. Another form of violence that needs to be further examined is elder abuse. Elder abuse literature typically focused on abuse perpetrated by children and caregivers. With increased life expectancies, it is now understood that there is greater probability for violence among elderly intimate couples. Shelters and hospitals need to better understand this unique population in order to better serve its victims.

• Assessing the Risks of Elder Abuse
• Child Abuse and Juvenile Delinquency
• Child Abuse and Neglect in the United States: An Overview
• Child Maltreatment, Interviewing Suspected Victims of
• Child Neglect
• Child Sexual Abuse
• Children Witnessing Parental Violence
• Consequences of Elder Abuse
• Elder Abuse and Neglect: Training Issues for Professionals
• Elder Abuse by Intimate Partners
• Elder Abuse Perpetrated by Adult Children
• Filicide and Children with Disabilities
• Mothers Who Kill
• Munchausen by Proxy Syndrome
• Parental Abduction
• Postpartum Depression, Psychosis, and Infanticide
• Ritual Abuse–Torture in Families
• Shaken Baby Syndrome
• Sibling Abuse

Part 7: Research Paper Topics on

Special Topics  in Domestic Violence

Within this list, there are topics that may not fit clearly into one of the aforementioned categories. Therefore, they are be listed in a separate special topics designation. Analyzing Incidents of Domestic Violence: The National Incident-Based Reporting System

• Community Response to Domestic Violence
• Conflict Tactics Scales
• Dissociation in Domestic Violence, The Role of
• Domestic Homicide in Urban Centers: New York City
• Fatality Reviews in Cases of Adult Domestic Homicide and Suicide
• Female Suicide and Domestic Violence
• Healthcare Professionals’ Roles in Identifying and Responding to Domestic Violence
• Measuring Domestic Violence
• Neurological and Physiological Impact of Abuse
• Social, Economic, and Psychological Costs of Violence
• Stages of Leaving Abusive Relationships
• The Physical and Psychological Impact of Spousal Abuse

Domestic violence remains a relatively new field of study among social scientists but it is already a popular research paper subject within college and university students. Only within the past 4 decades have scholars recognized domestic violence as a social problem. Initially, domestic violence research focused on child abuse. Thereafter, researchers focused on wife abuse and used this concept interchangeably with domestic violence. Within the past 20 years, researchers have acknowledged that other forms of violent relationships exist, including dating violence, battered males, and gay domestic violence. Moreover, academicians have recognized a subcategory within the field of criminal justice: victimology (the scientific study of victims). Throughout the United States, colleges and universities have been creating victimology courses, and even more specifically, family violence and interpersonal violence courses.

The media have informed us that domestic violence is so commonplace that the public has unfortunately grown accustomed to reading and hearing about husbands killing their wives, mothers killing their children, or parents neglecting their children. While it is understood that these offenses take place, the explanations as to what factors contributed to them remain unclear. In order to prevent future violence, it is imperative to understand its roots. There is no one causal explanation for domestic violence; however, there are numerous factors which may help explain these unjustified acts of violence. Highly publicized cases such as the O.J. Simpson and Scott Peterson trials have shown the world that alleged murderers may not resemble the deranged sociopath depicted in horror films. Rather, they can be handsome, charming, and well-liked by society. In addition, court-centered programming on television continuously publicizes cases of violence within the home informing the public that we are potentially at risk by our caregivers and other loved ones. There is the case of the au pair Elizabeth Woodward convicted of shaking and killing Matthew Eappen, the child entrusted to her care. Some of the most highly publicized cases have also focused on mothers who kill. America was stunned as it heard the cases of Susan Smith and Andrea Yates. Both women were convicted of brutally killing their own children. Many asked how loving mothers could turn into cold-blooded killers.

Browse other criminal justice research topics .

Domestic violence survivors seek homeless services from a system that often leaves them homeless

Associate Professor of Community Psychology, University of Maryland, Baltimore County

Associate Professor of Clinical Psychology, George Mason University

Disclosure statement

Nkiru Nnawulezi has received from the National Institute of Health, Office of Family Violence Prevention and Services, and the Center for Victim Research.

Lauren Cattaneo has received funding from the Spencer Foundation New Civics Initiative, and the Center for Victim Research, Office of Victims of Crime, US Department of Justice.

University of Maryland, Baltimore County provides funding as a member of The Conversation US.

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About 1 in every 3 women, and 1 in 4 men, will experience domestic violence over their lifetime. Since domestic violence can escalate to the point of serious injury or murder, survivors must take action to increase their safety – potentially even fleeing their homes.

Of the total homicides that occurred in the U.S. in 2020, 34% of women and 6% of men were murdered by their intimate partners .

Research has clearly shown the connection between domestic violence and homelessness. For example, a California study found that domestic violence survivors were four times more likely to experience housing instability compared with those who hadn’t experienced domestic violence.

We are two psychologists based in Washington D.C., who study the experiences, struggles and strengths of domestic violence survivors.

In Washington, 1 in 4 people experiencing homelessness report a history of domestic violence, with nearly half citing it as the direct reason for their homelessness .

Domestic violence and housing instability

Housing instability brings its own set of problems for survivors, including poor health , economic insecurity and the risk of future violence . These stresses can lead survivors back to the abusive relationship or into other unsafe housing situations.

Because the vicious cycle between domestic violence and housing instability is well known, domestic violence experts have argued for policies to provide quick, specialized assistance for survivors who seek emergency housing support .

Too often, however, these policies fall flat. Our 2018-2019 study of domestic violence survivors in the city’s services for homelessness found that out of 41 participants, only four received immediate housing , with either a bed in a shelter or a hotel.

We collaborate with domestic violence advocates and attorneys as members of the Domestic Violence Action Research Collective , a project of the DC Coalition Against Domestic Violence . This group collectively decides on research questions through discussions about what hinders community practitioners’ ability to support domestic violence survivors.

Domestic violence advocates and attorneys in our group alerted us to repeated stories about how the district government’s homelessness services system was failing survivors. The group designed a study to find out why.

Survivors’ access to homelessness services

From May 2018 to May 2019, our team recruited study participants in the waiting room of the Virginia Williams Family Resource Center , which is the gateway for families needing emergency housing in Washington.

Of 779 clients we screened, 183 responded that domestic violence was the reason for their housing instability; 41 of those agreed to interviews about their experiences accessing homelessness services.

A Washington law states that survivors of domestic violence do not have to prove their residency in the district in order to be eligible for homeless services. Policy also dictates that survivors should be asked questions to sensitively assess their circumstances and should meet with an on-site domestic violence housing coordinator to connect them with resources.

Instead of receiving this specialized assistance, many of our participants said they found the intake process confusing and unpredictable. Almost half said they waited more than three hours to meet with staff, sometimes only to find out they needed different information to prove eligibility and would have to restart the process another day.

Participants told us that they hesitated to disclose their domestic violence experiences to staff and described inconsistent responses when they did. Of 20 participants who said they did disclose experiences with domestic violence during their intake, only 11 said they were asked about their experiences by staff, and only two met with the domestic violence specialist at the facility. Several participants shared that when they revealed experiences of domestic violence, staff members simply moved on without asking for further details.

The lack of assistance in response to the disclosure of domestic violence left many participants in distress. As one participant described it: “I left feeling discouraged and embarrassed that I told all of these people I did not know my business, just for them to say it wasn’t good enough.”

The impact of homelessness services on survivors

Many participants felt that staff ignored their safety concerns, especially when staff insisted that survivors stay with friends, family or their abusive partner, rather than using public resources. Participants said that staff sometimes even contacted those individuals without survivors’ knowledge.

Only 22 of our 41 participants were deemed eligible for services. Four received immediate shelter. Eighteen participants received referrals to public or private sources of housing assistance, or both, but too often these resources were also dead ends. Participants were put on long waitlists, landlords didn’t accept vouchers, or referral options were not responsive to participants’ immediate needs.

For example, a frequent referral was “rapid rehousing” – a program that provides governmental rental subsidies for up to one year, after which people must pay their own rent. Survivors who are eligible for rapid rehousing must find affordable housing in the district, which is a formidable obstacle to program effectiveness.

As one survivor put it: “Where am I going to be able to rent at, that’s not a slumlord, or not in certain dangerous neighborhoods? I’m looking for safety. Running to safety doesn’t mean that I’m trying to run into harm.”

The 19 survivors ineligible for services were given varied reasons, often involving their inability to prove they were homeless. Ten participants told us that at the time they left Virginia Williams, they and their children had nowhere to go. Leaving without assistance prompted difficult choices, including maxing out credit cards to stay in hotels or begging to stay with family and friends in conditions that created new problems.

Some of the people we interviewed believed that the denial of assistance was due to racist and classist stereotypes of Black women seeking to “exploit the system.” Given that 39 of the 41 participants in this study were Black, as was the majority of the clientele at the center, we believe the possibility that racial bias influenced the frequent denial of services is significant.

Underserving domestic violence survivors

If we focus just on the interaction between staff and participants, the simplest interpretation of these results could be that staff are uninformed, unfeeling or both. Or one might wonder whether something is amiss with the survivors seeking assistance – that they are being turned away because they are not following the right steps to receive help.

We believe those interpretations miss the larger context: In our estimation, these interactions are the predictable result of service providers and survivors trying to function within an unworkable system in a context that has very little housing support available to the community.

The need at housing programs in our area dramatically outstrips capacity. This drives survivors who lack resources into an unaffordable rental market, setting off a series of cascading problems. There is a disproportionate impact on communities already subject to structural and interpersonal discrimination, such as the Black women in our study.

Our study shows that this translates into a system that is more focused on determining eligibility than determining needs and restricting spending rather than increasing survivors’ safety, because staff are in the unenviable position of meting out insufficient assistance to many desperate people.

These interactions leave many without good options. One of the participants we interviewed summed up her experience this way: “I was upset. I was discouraged. And it just left me with the thought, well, maybe I’m not in so much danger. Maybe I can just stick it out a little bit longer, just try not to make him upset or anything. I was just trying to make it the best that I could.”

• Domestic violence
• Social services
• Homelessness
• Unaffordable housing
• Housing shortage
• Domestic violence shelter
• domestic violence survivors

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Domestic violence against women in India: A systematic review of a decade of quantitative studies

Ameeta kalokhe.

a Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA

b Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA

Carlos del Rio

Kristin dunkle.

c Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, GA, USA

Rob Stephenson

d Center for Sexuality and Health Disparities, University of Michigan School of Public Health and School of Nursing, Ann Arbor, MI, USA

Nicholas Metheny

Anuradha paranjape.

e General Internal Medicine, Temple University School of Medicine, Philadelphia, PA, USA

Seema Sahay

f Department of Social and Behavioral Sciences, National AIDS Research Institute, Pune, India

Associated Data

Domestic violence (DV) is prevalent among women in India and has been associated with poor mental and physical health. We performed a systematic review of 137 quantitative studies published in the prior decade that directly evaluated the DV experiences of Indian women to summarise the breadth of recent work and identify gaps in the literature. Among studies surveying at least two forms of abuse, a median 41% of women reported experiencing DV during their lifetime and 30% in the past year. We noted substantial inter-study variance in DV prevalence estimates, attributable in part to different study populations and settings, but also to a lack of standardisation, validation, and cultural adaptation of DV survey instruments. There was paucity of studies evaluating the DV experiences of women over age 50, residing in live-in relationships, same-sex relationships, tribal villages, and of women from the northern regions of India. Additionally, our review highlighted a gap in research evaluating the impact of DV on physical health. We conclude with a research agenda calling for additional qualitative and longitudinal quantitative studies to explore the DV correlates proposed by this quantitative literature to inform the development of a culturally tailored DV scale and prevention strategies.

Introduction

Domestic violence (DV), defined by the Protection of Women from Domestic Violence Act 2005 as physical, sexual, verbal, emotional, and economic abuse against women by a partner or family member residing in a joint family, plagues the lives of many women in India. National statistics that utilise a modified version of the Conflict Tactics Scale (CTS) to measure the prevalence of lifetime physical, sexual, and/or emotional DV estimate that 40% of women experience abuse at the hands of a partner ( Yoshikawa, Agrawal, Poudel, & Jimba, 2012 ). Data from a recent systematic review by the World Health Organization (WHO) provides similar regional estimates and suggests that women in South-East Asia (defined as India, Maldives, Sri Lanka, Thailand, Bangladesh, and Timor-Leste) are at a higher likelihood for experiencing partner abuse during their lifetime than women from Europe, the Western Pacific, and potentially the Americas ( WHO, 2013 ).

Among the different proposed causes for the high DV frequency in India are deep-rooted male patriarchal roles ( Visaria, 2000 ) and long-standing cultural norms that propagate the view of women as subordinates throughout their lifespan ( Fernandez, 1997 ; Gundappa & Rathod, 2012 ). Even before a child is born, many families have a clear preference for male children, which may result in their preferential care, and worse, sex-selective abortions, female infanticide and abandonment of the girl-child ( Gundappa & Rathod, 2012 ). During childhood, less importance is given to the education of female children; further, early marriage as occurs in 45% of young, married women, according to 2005–2006 National Family Health Survey (NFHS-3) data ( Raj, Saggurti, Balaiah, & Silverman, 2009 ), may also heighten susceptibility to DV ( Ackerson, Kawachi, Barbeau, & Subramanian, 2008 ; Raj, Saggurti, Lawrence, Balaiah, & Silverman, 2010 ; Santhya et al., 2010 ; Speizer & Pearson, 2011 ). In reproductive years, mothers pregnant with and/or those who give birth to only female children may be more susceptible to abuse ( Mahapatro, Gupta, Gupta, & Kundu, 2011 ) and financial, medical, and nutritional neglect. Later in life, culturally bred views of dishonour associated with widowhood may also influence susceptibility to DV by other family members ( Saravanan, 2000 ).

In addition to being prevalent in India, DV has also been linked to numerous deleterious health behaviours and poor mental and physical health. These includes tobacco use ( Ackerson, Kawachi, Barbeau, & Subramanian, 2007 ), lack of contraceptive and condom use ( Stephenson, Koenig, Acharya, & Roy, 2008 ), diminished utilisation of health care ( Sudha & Morrison, 2011 ; Sudha, Morrison, & Zhu, 2007 ), higher frequencies of depression, post-traumatic stress disorder (PTSD), and attempted suicide ( Chandra, Satyanarayana, & Carey, 2009 ; Chowdhury, Brahma, Banerjee, & Biswas, 2009 ; Maselko & Patel, 2008 ; Shahmanesh, Wayal, Cowan, et al., 2009 ; Shidhaye & Patel, 2010 ; Verma et al., 2006 ), sexually transmitted infections (STI) ( Chowdhary & Patel, 2008 ; Sudha & Morrison, 2011 ; Weiss et al., 2008 ), HIV( Gupta et al., 2008 ; Silverman, Decker, Saggurti, Balaiah, & Raj, 2008 ), asthma ( Subramanian, Ackerson, Subramanyam, & Wright, 2007 ), anaemia ( Ackerson & Subramanian, 2008 ), and chronic fatigue ( Patel et al., 2005 ). Furthermore, maternal intimate partner violence (IPV) experiences have been associated with more terminated, unintended pregnancies ( Begum, Dwivedi, Pandey, & Mittal, 2010 ; Yoshikawa et al., 2012 ), less breastfeeding ( Shroff et al., 2011 ), perinatal care ( Koski, Stephenson, & Koenig, 2011 ), and poor child outcomes ( Ackerson & Subramanian, 2009 ). These negative health repercussions and high DV frequency speak to the need for the development of effective DV prevention and management strategies. And, the development of effective DV interventions first requires valid measures of occurrence and an in-depth understanding of its epidemiology.

While many aspects of DV are similar across cultures, recent qualitative studies describe how some aspects of the DV experienced by women in India may be unique. These studies highlight the role of non-partner DV perpetrators for those living in both nuclear and joint-families ( Fernandez, 1997 ; Kaur & Garg, 2010 ; Raj et al., 2011 ). (These families are patrilineal where male descendants live with their wives, offspring, parents, and unmarried sisters.) They discuss the high frequency and near normalisation of control, psychological abuse, neglect, and isolation, the occurrence of DV to women at both extremes of age (young and old), dowry harassments, control over reproductive choices and family planning, and demonstrate the use of different tools to inflict abuse (i.e. kerosene burning, stones, and broomsticks as opposed to gun and knife violence more commonly seen in industrialised nations) ( Bunting, 2005 ; Go et al., 2003 ; Hampton, 2010 ; Jutla & Heimbach, 2004 ; Kaur & Garg, 2010 ; Kermode et al., 2007 ; Kumar & Kanth, 2004 ; Peck, 2012 ; Rastogi & Therly, 2006 ; Sharma, Harish, Gupta, & Singh, 2005 ; Stephenson et al., 2008 ; Wilson-Williams, Stephenson, Juvekar, & Andes, 2008 ).

This paper presents a systematic review of the quantitative studies conducted over the past decade that estimate and assess DV experienced by women in India, and evaluates their scope and capacity to measure the DV themes highlighted by recent qualitative studies. It aims to examine the distribution of the prevalence estimates provided by the recent literature of DV occurrence in India, improve understanding of the factors that may affect these prevalence estimates, and identify gaps in current studies. This enhanced knowledge will help inform future research including new interventions for the prevention and management of DV in India.

We utilised PubMed, OVID, Cochrane Reviews, PsycINFO, and CINAHL as search engines to identify articles published between 1 April 2004 and 1 January 2015 that focused on the DV experiences of women in India ( Figure 1 ). Our specific search terms included ‘domestic violence’, ‘intimate partner violence’, ‘spouse abuse’, ‘partner violence’, ‘gender-based violence’, ‘sexual violence’, ‘physical violence’, ‘wife battering’, ‘wife beating’, ‘domestic abuse’, ‘violence’, and ‘India’. We first removed duplicate articles and then filtered the articles based on our inclusion criteria: quantitative studies evaluating original data that had been published in English and directly surveyed the DV experiences of women. While we recognise that in cultures where DV is commonplace the reporting of DV perpetration by men may be as high as the frequency of experiencing DV reported by women ( Koenig, Stephenson, Ahmed, Jejeebhoy, & Campbell, 2006 ), we restricted our eligibility criteria to studies directly surveying women about their DV experiences to reduce further inter-study variation and allow for more accurate cross-study comparisons. We excluded reviews, case reports, meta-analyses, and qualitative studies. A single author (ASK or NM) reviewed each individual article to determine whether it met inclusion criteria. If questions arose regarding its inclusion into the review, they were discussed with a second author (SS) until concordance was reached regarding whether or not the paper was to be included.

Adapted PRISMA Flow Diagram demonstrating study selection methodologies and filter results.

Note: An initial PubMed search of articles published between 1 April 2004 and 1 January 2015 focusing on the DV experiences of women in India is depicted. This figure illustrates the search terms, search engines, applied inclusion and exclusion filters, the process by which articles were chosen to be included in the study, and the results of the selection process.

We collected data from each study regarding study population; study setting; use of a validated scale; forms of, perpetrators of, and time frame during which DV was measured; whether an attempt was made to measure severity of DV; whether potential DV correlates were evaluated; and whether DV prevalence was estimated. We subcategorised the forms of violence into physical, sexual, psychological, control, and neglect based on descriptions of questions provided in the studies. Emotional and verbal forms of abuse were classified as psychological abuse and deprivation was classified as neglect. If the study asked participants about agency or autonomy, this was noted in the summary tables. In publications where information about the DV assessment tool and its validation was not provided, we contacted the authors for more information. If authors reported having conducted formative fieldwork to generate questions, pre-tested the items, and/or conducted some assessment of the measurement tool’s expert or face validity, we reported the validation as ‘limited’. If we did not hear back from the authors, we stated the data were ‘not reported’.

Article yield of systematic search

Our initial search of DV articles published in PubMed, OVID, Cochrane Reviews, PsycINFO, and CINAHL between 1 April 2004 and 1 January 2015 yielded 3843 articles ( Figure 1 ). We identified 628 articles using search terms ‘domestic violence’ and ‘India’, 283 articles using ‘intimate partner violence’ and ‘India’, 98 articles using ‘spouse abuse’ and ‘India’, 221 articles using ‘partner violence and India’, 54 articles using ‘gender-based violence’ and ‘India’, 199 articles using ‘sexual violence’ and ‘India’, 120 articles using ‘physical violence’ and ‘India’, 1 article using ‘wife battering’ and ‘India’, 51 articles using ‘wife beating’ and ‘India’, 10 articles using ‘domestic abuse’ and ‘India’, and 2022 articles using ‘violence’ and ‘India’. Of the 3843 articles, 3705 articles were removed because they (1) were duplicated in the search, (2) focused on extraneous topics, (3) lacked Indian context, (4) were not based on original quantitative data, or (5) were based on study data that were not directly obtained through surveying women about their personal DV experiences. Thus, the selection criteria yielded a total of 137 studies examining the DV experiences of women in India: 14 international studies (see Table 1 in supplementary material ), 50 multi-state India studies (see Table 2 in supplementary material ), and 73 single-state India studies (see Table 3 in supplementary material ).

The scope and breadth of recent studies: study populations

Collectively, the reviewed studies provide information on the DV experienced by young and middle-aged women in traditional heterosexual marriages from both urban and rural environments, joint and nuclear families, across Indian states ( Figure 2 ). Among the studies specifying age limits, the vast majority (88% or 92/104) evaluated DV experienced by women age 15–50, with only 11% (11/104) of studies surveying DV suffered by women above age 50 and 1% (1/104) evaluating DV experienced by young adolescents (wed before age 15). Only one study assessed DV experienced by women in HIV discordant. No studies surveyed DV in non-traditional relationships, such as same-sex relationships or live-in relationships. Less than one-third (29% or 40/137) collected data differentiating DV experienced by women in joint versus nuclear families. Thirty-seven per cent (51/137) evaluated domestic abuse suffered by women living in urban settings, 18% (24/137) in rural, and the remainder (44% or 60/137) in both rural and urban environments. Only one examined DV experienced by women residing in tribes. Twenty-three per cent (32/137) and 3% (4/137) utilised a nationally representative and sub-nationally representative study population, respectively. Southern Indian states were by far the most surveyed in the literature (Maharashtra 66 studies, Tamil Nadu 59 studies, and Karnataka 51 studies) and Northern Indian states the least (Uttaranchal, Sikkim, Punjab, Haryana, Chhattisgarh, and Assam each with 33 studies).

A summary of the distribution of recent Indian DV literature by region, state, surveyed perpetrator, and family type.

Note: (a) demonstrates the distribution of studies by rural versus urban region, (b) by state, (c) by the perpetrator surveyed, and (d) whether the survey collected data differentiating DV in joint versus nuclear family households.

Prevalence of DV in India

Collectively, the reviewed studies demonstrate that DV occurs among Indian women with high frequency but there is substantial variation in the reported prevalence estimates across all forms of DV ( Figure 3 ). For example, the median and range of lifetime estimates of psychological abuse was 22% (range 2–99%), physical abuse was 29% (2–99%), sexual abuse was 12% (0–75%), and multiple forms of DV was 41% (18–75%). The outliers at the upper extremes were contributed by a study of in low-income slum communities with high prevalence of substance abuse( Solomon et al., 2009 ) and a second study conducted in a tertiary care centre where surveys were self-administered and thus participants may have felt increased comfort in reporting DV( Sharma & Vatsa, 2011 ). The median and range of past-year estimates of psychological abuse was 22% (11–48%), physical abuse was 22% (9–90%), sexual abuse was 7% (0–50%), and multiple forms of DV was 30% (4–56%). The outlier of 90% for physical abuse was contributed by a study of women whose husbands were alcoholics in treatment ( Stanley, 2012 ). As expected, higher DV prevalence was noted when multiple forms of DV were assessed. Of all forms of DV, physical abuse was measured most frequently, with psychological abuse, sexual abuse, and control or neglect receiving substantially less attention. Further statistical analysis beyond these descriptive statistics was not conducted due to the large inter-study heterogeneity of designs and populations limiting comparability across studies.

A summary of the lifetime and past 12-month prevalence estimates of the various forms of DV as documented by each individual study.

Note: Circles, squares, upright triangles, and inverted triangles represent prevalence estimates of psychological, physical, sexual, and multiple forms of DV, respectively, as provided by each individual study. While medians and ranges are provided, further analysis was not carried out due to the limited homogeneity between studies impeding accurate comparison.

The scope and breadth of recent studies: study design

The past decade of quantitative India DV research has included a breadth of large regional and international studies as well as smaller scale, single-state studies. However, the capacity to draw causal inferences from this literature has been limited by the nearly exclusive use of cross-sectional design. The country and regional-level studies utilised larger, often nationally or sub-nationally representative samples (average sample size: 25,857 women, range: 111–124,385), to provide inter-country or regional epidemiologic comparisons. The single-state studies tended to use smaller sample sizes (average: 1109 women, range: 30–9639) to provide a more in-depth evaluation of DV experienced in a particular population of women.

The vast majority of all reviewed studies utilised cross-sectional design, with only 12% (17/137) using a prospective design to draw causal inferences. Six of these 13 utilised the NFHS-2 and four-year follow-up data from the rural regions of four states to evaluate the effect of DV on mental health disorders ( Shidhaye & Patel, 2010 ), a woman’s adoption of contraception, occurrence of unwanted pregnancy ( Stephenson et al., 2008 ), uptake of prenatal care ( Koski et al., 2011 ), early childhood mortality ( Koenig et al., 2010 ), functional autonomy and reproduction ( Bourey, Stephenson, & Hindin, 2013 ), and contraceptive adoption ( Stephenson, Jadhav, & Hindin, 2013 ), while one used the data to evaluate the effect of autonomy on experience of physical violence ( Nongrum, Thomas, Lionel, & Jacob, 2014 ; Sabarwal, Santhya, & Jejeebhoy, 2014 ). Only one study employed a case-control study to evaluate the link between DV and child mortality ( Varghese, Prasad, & Jacob, 2013 ) and another utilised a randomised control design to evaluate the effect of a mixed individual and group women’s behavioural intervention in reducing DV and marital conflict over time ( Saggurti et al., 2014 ). The remainder of prospective studies evaluated the causal association between DV and incident STIs and/or attempted suicide ( Chowdhary & Patel, 2008 ; Maselko & Patel, 2008 ; Weiss et al., 2008 ), DV and maternal and neonatal health outcomes ( Nongrum et al., 2014 ), the effect of the type of interviewing (face-to-face versus audio computer-assisted self-interviews) on DV reporting ( Rathod, Minnis, Subbiah, & Krishnan, 2011 ), trends in DV occurrence over time ( Simister & Mehta, 2010 ), and the effect of change in a woman or her spouse’s employment status on her experience of DV ( Krishnan et al., 2010 ).

The scope and breadth of recent studies: DV measures

Only 61% (84/137) of studies reported use of a validated scale or made attempts to validate the instrument they ultimately used. When use of a validated instrument was reported, most (82% or 69/84) had been developed for the cultural context of North America and Europe (i.e. modified CTS, Abuse Assessment Screen, Index of Spouse Abuse, Woman Abuse Screening Tool, Partner Violence Screen, Composite Abuse Scale, and Sexual Experience Scale). In fact, only 15 of the studies reporting use of a validated questionnaire adapted or developed their instrument to the Indian context by surveying themes raised by the prior qualitative literature (i.e. use of belts, sticks, and burning to inflict physical abuse, restricting return to natal family home, not allowing natal family to visit marital home). As expected, these studies reported higher frequencies of DV. In personal communication, some authors who chose not to use validated, widely used DV scales (i.e. CTS) stated they did so because of space limitations and inadequacy of existing tools for measuring DV in the Indian cultural context.

Two-thirds of studies (64% or 87/137) assessed two or fewer forms of DV. Of all forms of DV, physical abuse was evaluated most frequently (96% or 131/137), followed by sexual abuse (58% or 79/137), psychological abuse (44% or 60/137), neglect and control (4% or 7/137). Only 11% (15/137) of studies evaluated DV perpetrated by non-partner family members. For these studies evaluating DV perpetrated by partners and non-partner family members, available estimates of lifetime sexual and psychological abuse were always higher than the median prevalence estimates of reviewed studies; available estimates of lifetime physical abuse were often, but not universally, higher. Only 20% (109/137) attempted to evaluate different levels of DV severity. While many (43% or 59/137) studies evaluated lifetime violence, a considerable number assessed recent DV (42% or 58/137 past-12 month DV, 5% or 7/137 past-6 month DV, 4% or 5/137 past-3 month DV, and 4% or 6/137 the time period of current or research partnerships). Additionally, 10% (14/137) evaluated DV occurrence during pregnancy or the peri-partum period.

The scope and breadth of recent studies: measured outcomes

Figure 4 provides a framework for synthesising the potential DV correlates measured to date. It demonstrates that the focus of the quantitative literature has largely been on the mental health and gynecologic consequences of DV but has only begun to evaluate repercussions on physical health and health behaviour. Twelve per cent (16/137) of the studies evaluated one or multiple mental health disorder as outcomes of DV, including PTSD, depression, and suicide, but not anxiety. The literature provided a comprehensive evaluation of the association between DV and gynaecologic health including sexual (15% or 21/137) and maternal health (8% or 11/137). However, only six studies were dedicated to evaluating physical health outcomes (oral health, nutrition, chronic fatigue, asthma, direct injury, and blindness during pregnancy). And while 17 studies were dedicated to evaluating the association between DV and uptake of health behaviours, 11 of the 15 were focused on behaviours related to sexual and maternal health. Thus, the association between health behaviours like the woman’s substance abuse and adherence to medical and clinical care remains largely understudied, as does the link between DV and physical health outcomes such as cardiovascular and gastrointestinal disease, chronic pain syndromes (including migraines), and urinary tract infections.

A framework for conceptualising the reviewed studies.

Note: The proposed framework provides structure for interpreting and synthesising the prior decade’s quantitative research evaluating the domestic violence experienced by women in India.

The past 10 years have been an incredible period of growth in DV research in India and South Asia. Our systematic review contributes to the growing body of evidence by providing an important summary of the epidemiologic studies during this critical period and draws attention to the magnitude and severity of the ongoing epidemic in India. Comprehensively, the reviewed literature estimates that 4 in 10 Indian women (when surveyed about multiple forms of abuse) report experiencing DV in their lifetime and 3 in 10 report experiencing DV in the past year. This is concordant with the WHO lifetime estimate of 37.7% (95% CI: 30.9%43.1%) in South-East Asia (defined as India, Maldives, Sri Lanka, Thailand, Bangladesh, and Timor-Leste) and is higher than the regional estimates provided by the WHO for the Europe, the Western Pacific, and potentially the Americas. In addition to highlighting the high frequency of occurrence, the studies in this review emphasise the toll DV takes on the lives of many Indian women through its impact on mental, physical, sexual, and reproductive health.

Perhaps the most striking finding of our review was the large inter-study variance in DV prevalence estimates ( Figure 3 ). While this variability speaks to the capacity of the India literature to capture the breadth of DV experiences in different populations and settings, it also underscores the need for standardising aspects of study design in the investigator’s control to make effective inter-study and cross-population comparisons. Standardisation of the instruments used to measure DV should be a priority. To optimise the yield of such an instrument in capturing the DV experiences of Indian women, it should build upon currently available, well-validated instruments, but also be culturally tailored. Thus, it should account for the culturally prominent forms of DV identified by the Indian qualitative literature and social media, survey abuse inflicted by non-partner perpetrators, survey multiple forms abuse (i.e. physical, sexual, psychological, and control), and ideally, include a measure of DV severity (i.e. based on frequency of affirmative responses, frequency of abuse, or resultant injury). Our review demonstrates that current studies fall short, with only 61% reporting use of validated questions (rarely developed or adapted to Indian culture), 11% surveying DV perpetrated by non-partner family members, 64% assessing more than two different forms of abuse, and 20% evaluating level of DV severity. Our review also suggests that when questions assessing DV are culturally adapted and validated, evaluate multiple forms of abuse, and survey abusive behaviours by non-partner family members in addition to partners, reporting of DV increases.

While our search yielded many well-designed cross-sectional studies providing insight into the epidemiology of DV in India (i.e. patterns of occurrence, socio-demographic, and health correlates), it also revealed many gaps and thus, a potential research agenda. Future qualitative studies are needed to examine the link between DV and correlates identified by the cross-sectional literature, to inform the development of future prevention strategies, and to enhance delivery of DV supportive services by examining survivor preferences and needs. Additional longitudinal quantitative studies are also needed to better understand predictors of DV and to explore the direction of causality between DV and the physical health associations identified in the reviewed studies. They are also needed to assess the link between DV and other physical health outcomes like injury, cardiovascular disease, irritable bowel syndrome, immune effects, and psychosomatic syndromes as well as non-sexual health behaviours such as substance abuse and medication adherence. This is particularly paramount in India, where physical injury and cardiovascular disease together account for over a quarter of disability-adjusted life years lost ( National Commission on Macroeconomics and Health, 2005 ).

Additionally, our review also exposed gaps in the current understanding of DV in some populations and regions of India. For example, most studies focused on women of age 15–50. Only 11 reported on the DV experiences of women over 50, a stage where frailty, financial and physical dependence, and culturally engendered shame and disgrace associated with widowhood may heighten their risk of experiencing DV, neglect, and control by various family members ( Solotaroff & Pande, 2014 ). And, while 43% of Indian women aged 20–24 marry before the age of 18, we encountered few studies evaluating DV experienced by pre-adolescents or young adolescents married as children ( UNICEF, 2014 ). An additional gap is in evaluating the DV experiences of women engaging in live-in relationships as opposed to marital relationships, divorced or widowed women, women involved in same-sex relationships, and in HIV serodiscordant and concordant relationships, settings in which social and family support systems are already weakened ( Kohli et al., 2012 ). Next, beyond the national and multi-state data sets, there is little representation of the northern states of India (i.e. Uttaranchal, Sikkim, Punjab, Haryana, Chhattisgarh, and Assam) and of women residing in tribal villages ( Sethuraman, Lansdown, & Sullivan, 2006 ). The vast cultural, religious, and socio-economic inter-regional differences in India highlight the need for more in-depth study of the DV experiences of women in these areas.

The high prevalence of DV and its association with deleterious behaviours and poor health outcomes further speak to the need for multi-faceted, culturally tailored preventive strategies that target potential victims and perpetrators of violence. The recent Five Year Strategic Plan (2011–2016) released by the Ministry of Women and Child Development discusses a plan to pilot ‘one-stop crisis centres for women’ survivors of violence, which would include medical, legal, law enforcement, counselling, and shelter support for themselves and their children. The significant differences in women’s empowerment and DV experience by region and population within India ( Kishor & Gupta, 2004 ) underscore the need to culturally- and regionally tailor the screening and support services provided at such centres. For example, in resource-limited states where sexual forms of DV predominate, priority should be given to the allocation of health-care providers to evaluate, document, and treat associated injuries and/or transmitted diseases. In settings where financial control and neglect are common, legal, financial, and educational empowerment may need to be given precedence.

Our review is not without limitations. First, our analysis relied solely on data directly provided in the publications. We did not further contact the authors if information was not provided. Second, a single author (ASK or NM) reviewed the individual papers for inclusion into the review, which may have introduced a selection bias. We tried to limit this bias through discussion of the papers in which eligibility was not clear-cut with a second author (SS) until agreement about the inclusion status was reached. Next, we included studies whose main intent was to evaluate the DV experiences of Indian women as well as studies whose main aim may not have been related to DV at all, but included DV as a covariate in the analysis. Thus, many of the studies that solely included DV as a covariate may not have had the intent or resources to fully examine the DV experience. While this may be viewed as a limitation, our goal was not to critically evaluate each individual study, but to comprehensively review the information currently provided in the Indian DV literature. Lastly, inclusion of multiple studies that utilise the same data set (e.g. NFHS) may have skewed the overall median estimate of DV prevalence and the remainder of our analysis. We felt, however, that the substantial differences in DV assessment (e.g. measurement time frames, forms of DV assessed, whether DV severity was assessed, and measured health correlates) between these studies legitimised their need to be included as separate entities in the review.

In conclusion, our literature review underscores the need for further studies within India evaluating the DV experiences of older women, women in same-sex relationships, and live-in relationships, extending the assessment of DV perpetrated by individuals besides intimate partners and spouses, and assessing the multiple forms and levels of abuse. It further stresses the necessity for the development and validation (in multiple regions and study populations within India) of a culturally tailored DV scale and interventions geared towards the prevention and management of DV.

Supplementary Material

Tables and table references, acknowledgments.

This work was supported by the US Department of Health and Human Services, National Institutes of Health, Fogarty International Center [grant number 1 R25 TW009337-01 K01 TW009664].

Supplemental data for this article can be accessed at http://dx.doi.org/10.1080/17441692.2015.1119293

Disclosure statement

No potential conflict of interest was reported by the authors.

Ameeta Kalokhe , http://orcid.org/0000-0002-3556-1786

Seema Sahay , http://orcid.org/0000-0001-6064-827X

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