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Journal Article

Citation

Rudolph MN, Hughes DH. Psychiatr. Serv. 2001; 52(3): 281-306.

Copyright

(Copyright © 2001, American Psychiatric Association)

DOI

10.1176/appi.ps.52.3.281

PMID

unavailable

Abstract

Nearly 2 million women per year are reported to be physically assaulted by their male partners, and one in four women in the United States will be physically abused during her lifetime (R5231051). The demographic risk factors for domestic violence include age between 12 and 30; unmarried status, especially if cohabiting; presence of children in the home; previous disability; pregnancy; and homelessness (R5231052). In addition, substance abuse increases risk substantially; up to 45 percent of female alcoholics and 50 percent of female drug abusers have been battered (R5231052). However, women are not the only victims of domestic violence. Although men are less likely to have a history of abuse than women, they are more likely to be attacked by their partners with knives, guns, or thrown objects and to suffer serious injury or death as a result (R5231052).

The victim can also be a perpetrator. In a committed relationship, when a woman assaults a man, the man has nearly always abused the woman (R5231052). Other risk factors for domestic aggression include attitudes of patriarchy, which is defined as males having power over females in the home with respect to money, social interactions, and sex; exposure as a victim or witness to abuse in the family during childhood; unemployment; and current substance abuse (R5231052). The strongest single predictor of injury to a victim of domestic assault is a history of alcohol abuse by the perpetrator (R5231051).

Although many standardized measures of partner violence exist, including the Index of Spouse Abuse (R5231053) and the Conflict Tactics Scale (R5231054), they tend to be impractical for use in the emergency setting. However, newer measures such as the Spousal Assault Risk Assessment Guide (R5231055) are quite promising in identifying domestic abusers. For victims, most clinicians find that the use of open-ended questions that are specific about typical behaviors yet nonjudgmental is effective in eliciting a history of domestic abuse (R5231052). Others prefer to use the question, "Have you been hit, kicked, punched, or otherwise hurt by someone within the past year? If so, by whom?" (R5231051). Whatever screening method is used, it is important to keep in mind that the greatest impediment to effectively identifying victims of violence is not that they conceal their status but that clinicians do not ask them to reveal it (R5231052).

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