Domestic violence

• What is Domestic Violence
• Statistics on Domestic Violence
• Risk Factors for Domestic Violence
• Progression of Domestic Violence
• Symptoms of Domestic Violence
• Clinical Examination of Domestic Violence
• How is Domestic Violence Diagnosed?
• Prognosis of Domestic Violence
• How is Domestic Violence Treated?
• Domestic Violence References

What is Domestic Violence

Domestic violence is when an individual is in some way hurt by a person that he or she knows. Domestic violence is not limited to physical harm: a person also can be sexually abused or psychologically abused. Often a victim is hurt in more than one of these ways. Domestic violence usually continues over a long period of time and gets more frequent and more severe over time.

Statistics on Domestic Violence

In 2000, the National Violence Against Women Survey (US) reported, in a study of 8000 women and 8000 men, that nearly 25% of women and 7.9% of men indicated that a current or former spouse, cohabitating partner, or date victimized them at some time in their life. Rape was reported by 7.7% of women and 0.3% of men. Physical assault affected 22.1% of women and 7.4% of men. Within the previous 12 months, 0.2% of women reported having been raped, which would equate nationally to 201,394 women. Physical assault was reported by 1.3% of women and 0.9% of men, resulting in national estimates of 1,309,061 women and 834,732 men so victimized. Victimization often occurs repeatedly.
Data from the survey revealed that women averaged 6.9 physical assaults by the same partner, with men averaging 4.4 assaults. Given the data on multiple attacks per victim, it is estimated that every year approximately 4.8 million intimate partner rapes and physical assaults are perpetrated against women, and approximately 2.9 million are committed against men. Almost 5% of women and 0.6% of men in the survey indicated that an intimate had stalked them, with an annual rate of 0.5% of surveyed women and 0.2% of surveyed men. Extrapolation from these data indicates that 503,485 women and 185,496 men were stalked by an intimate partner within the previous 12 months. High-profile news may affect willingness to report domestic violence. Following the Simpson and Goldman murders, the Los Angeles County Sheriff’s Department noted a significant increase in domestic violence dispatches. Estimates indicate that at least 2 million women are assaulted by their partners each year. The true incidence may be twice that. Exact figures for males are hard to come by.

Risk Factors for Domestic Violence

Certain groups of women may be at higher risk for abuse. These include women who:

• Are single, separated or divorced (or planning separation or divorce).
• Are between the ages of 17 and 28.
• Abuse alcohol or other drugs or whose partners do.
• Are pregnant.
• Have partners who are excessively jealous or possessive.

How is Domestic Violence Diagnosed?

Characteristic injuries:

• Bilateral injuries, especially to the extremities.
• Injuries at multiple sites.
• Fingernail scratches, cigarette burns, rope burns.
• Abrasions, minor lacerations, welts.
• Subconjunctival hemorrhage suggests a vigorous struggle between victim and assailant.
• Fingernail markings

Three types of fingernail markings may occur, either singly or in combination as follows:

• Impression marks: These result from fingernails cutting into the skin. They may be shaped like commas or semicircles.
• Scratch marks: These are superficial and long and may be narrow or as wide as the fingernail. Scratches caused by the longer fingernails of women are frequently more severe than those from a male assailant.
• Claw marks: These occur when the skin is undermined, thus they appear to be more dramatic and vicious. While claw marks may be grouped parallel markings down the front of the neck, they often are randomly scattered.

Prognosis of Domestic Violence

Domestic violence typically recurs and progressively escalates both in frequency and severity.

• Of persons first injured by domestic violence, 75% continue to experience abuse.
• Half of battered women who attempt suicide try again.
• Brookoff reported a study of 62 episodes of domestic assault, in which 68% involved the use or display of weapons (5 handguns, 1 shotgun, 17 knives, and 19 blunt instruments such as hammers or baseball bats), and 15% resulted in serious injury.
• Eighty-nine percent of victims reported previous assaults by their current assailants, with 35% experiencing violence on a daily basis.
• The ultimate result of domestic violence may be death from suicide or homicide.

How is Domestic Violence Treated?

It may seem obvious that a victim of domestic violence should leave the abuser, but it’s not always that simple. Some victims of abuse were raised in violent households as children and are caught in a cycle of abuse. Sometimes years of psychological abuse cause victims to believe they deserve to be treated this way. They may feel defeated from repeated abuse and unable to see a way out, or they may desperately hope that the situation will change. They may fear what the abuser will do if they try to leave. Other reasons women do not leave their abusers include having no place to go, no money or no place that will accept her children; fear of losing custody of children; concerns about immigration status (being reported); and religious or cultural beliefs that make abuse seem acceptable.

Domestic Violence References

1. Abbott J: Injuries and illnesses of domestic violence. Ann Emerg Med 1997; 29: 781-785.
2. Bachman R, Saltzman LE: Violence against women: Estimates from the redesigned survey August 1995. NCJ-154348 Special Report. US Department of Justice.
3. Heilig S, Rodriguez M, Martin S, Louie D, eds: Domestic violence: A practical approach for clinicians. San Francisco Medical Society: 1995.