Intimate partner violence: treating abuser and abused

Abstract

Intimate partner violence is associated with significant psychiatric comorbidity. Treatment has focused on male perpetrators but recent studies indicate that this is of limited success in reducing male violence. This article reviews the current available treatments from three perspectives: that of the victim, the perpetrator, and the couple who wish to remain together. It also provides guidelines to assist the general psychiatrist in determining what treatment to offer patients who present with intimate partner violence. Guidelines emphasise the need for assessment of risk factors that indicate a potentially lethal relationship and the importance of the diagnosis and treatment of comorbidity, especially alcohol misuse and dependence.Alison Heru is Associate Professor of Psychiatry and Human Behavior (Clinical) at Brown Medical School (Butler Hospital, 345 Blackstone Boulevard, Providence, Rhode Island 02906, USA. Email: aheru@butler.org). She received her medical degree from Glasgow University, Scotland, and her psychiatric training in Edinburgh, Kingston Jamaica and at Brown University. Dr Heru and her colleagues have recently completed a study of the prevalence of intimate partner violence in patients hospitalised with suicidal ideation. As a result of this study, she is developing a couples treatment that includes a component for managing intimate partner violence.

Personalidade de mulheres vítimas de violência doméstica: uma revisão sistemática da literatura

“…A violência contra a mulher é um fenômeno de grande magnitude, motivo pelo qual tem sido considerada como um problema de saúde pública e como uma questão de violação dos direitos humanos (Joachim, 2000;Campbell, 2002;Heru, 2007;Schraiber e d'Oliveira, 2008) tanto por sua elevada incidência, como pela gravidade das consequências negativas para as vítimas e para seus familiares. Está presente no mundo todo, não respeita fronteiras de classe social, raça/etnia, religião, idade ou grau de escolaridade.…”

How Have Academic Theories of Domestic Violence Influenced Western Physical Domestic Violence Treatment Programs in Recent Years?

“…and domestic violence has recently received substantial research providing a plethora of studies and findings [51]. While it is crucial to mention that no study has been able to demonstrate a causal link between psychopathology and violence that can be generalized to the public [52], numerous reasons as to why this is the case exist. Firstly, the studies that have found links to psychopathology and violence have used participants that have either been arrested for their offences or attend treatment programs.…”

'He said he loved me. I wanted to be loved': Young women's experiences of coping with violence in intimate relationships.

“…Others made the same conclusion regarding the links between IPV and depression (Arias, Lyons, & Street, 1997;Bonomi, Anderson, Rivara, & Thompson, 2007;Fedovskiy, Higgins, & Paranjape, 2008;Fogarty, Fredman, Heeren, & Liebschutz, 2008;Heru, 2007;Koopman et al, 2007;Leiner, Compton, Houry, & Kaslow, 2008;Sullivan, Meese, Swan, Mazure, & Snow, 2005;Tadegge, 2008;Van Hook, 2000) and between IPV and post-traumatic stress symptoms (DeJonghe, Bogat, Levendosky, & von Eye, 2008;Fedovskiy et al, 2008;Humphreys & Joseph, 2004;Scheffer Lindgren & Renck, 2008;Sullivan et al, 2005). Other effects of IPV on mental health include hypervigilance, flashbacks, nightmares, and loss of personal control (Wittenberg, Joshi, Thomas, & McCloskey, 2007).…”

“…Moreover, anger and aggression are involved with IPV (Cavell & Malcolm, 2007), as are the need for intimacy between the two partners and emotional distance (Doumas, Pearson, Elgin, & McKinley, 2008). Furthermore, Heru (2007) argued the constant threat of violence might strengthen the bond between the two partners because it brings them together against the violence. Wade (1997), in his book regarding the interplay between oppression and resistance, claimed the nature of human resistance and resilience exists in relationships that have violence and control.…”

“…The mental health consequences for the young women in the current study from coping with an IPV relationship parallel and re-enforce previous research in the areas of depressive symptoms, post-traumatic stress characteristics, and loss of self-identity. First, researchers have reported women in IPV relationships commonly experience depressive thoughts and emotions (Arias et al, 1997;Bohn, 2003;Bonomi et al, 2007;Fedovskiy et al, 2008;Fogarty et al, 2008;Hazen et al, 2008;Health Canada, 1999;Heru, 2007;KeenanMiller et al, 2007;Koopman et al, 2007;Leaman & Gee, 2008;Leiner et al, 2008;Sullivan et al, 2005;Sullivan & Holt, 2008;Tadegge, 2008;Van Hook, 2000), which the young women experienced. Second, consistent with prior studies (Cattaneo & Goodman, 2005;Eby, 2004;Filipas & Ullman, 2006;Frasier et al, 2004;Health Canada, 1999;Leiner et al, 2008;Lilly, 2008;Muhajarine & D'Arcy, 1999;Scheffer Lindgren & Renck, 2008;Sullivan & Holt, 2008), the young women noted connections among IPV, chronic stress, and posttraumatic stress characteristics such as hypervigilance, anger, shame, fear, and embarrassment.…”