Non-fatal Strangulation is an Important Risk Factor for Homicide of Women

Abstract

The purpose of this study was to examine non-fatal strangulation by an intimate partner as a risk factor for major assault, or attempted or completed homicide of women. A case control design was used to describe non-fatal strangulation among complete homicides and attempted homicides (n = 506) and abused controls (n = 427). Interviews of proxy respondents and survivors of attempted homicides were compared with data from abused controls. Data were derived using the Danger Assessment. Non-fatal strangulation was reported in 10% of abused controls, 45% of attempted homicides, and 43% of homicides. Prior non-fatal strangulation was associated with greater than six-fold odds (odds ratio [OR] 6.70, 95% confidence interval [CI] 3.91-11.49) of becoming an attempted homicide, and over seven-fold odds (OR 7.48, 95% CI 4.53-12.35) of becoming a completed homicide. These results show non-fatal strangulation as an important risk factor for homicide of women, underscoring the need to screen for non-fatal strangulation when assessing abused women in emergency department settings.

Intimate Partner Violence at the Scene: Incident Characteristics and Implications for Public Health Surveillance

“…Consistent with previous research, women were more likely than men to be strangled (Melton and Belknap 2003), and threatened to be killed (Melton and Belknap 2003;Tjaden and Thoennes 2000), both of which are risk markers for lethality that have been shown to increase the odds of homicide five times or more over non-fatal IPV (Campbell et al 2003;Glass et al 2008). Strangulation, in particular, is pernicious because, although potentially lethal, it typically leaves no immediate injuries or marks (Strack, McClane, and Hawley 2001).…”

A Systematic Review of the Epidemiology of Nonfatal Strangulation, a Human Rights and Health Concern

“…A large case---control study in the United States found previous strangulation to be a substantial and unique predictor of attempted and completed homicide of women by a male intimate partner, 52 the most common assailant in the homicide of women in South Africa, the United States, selected European countries, and elsewhere. 53---55 However, when the perpetrator's access to a gun and other firearm-related variables were taken into consideration, strangulation was no longer related to the risk of intimate partner homicide.…”

An Investigation into Potentially Lethal Acts of Male-Perpetrated Intimate Partner Violence

“…In an article outlining the disproportionate experience of victimisation of Aboriginal and Torres Strait Islander (ATSI) women in Australia, Stubbs and Tolmie noted that "data consistently demonstrate extreme levels of family violence experienced by Indigenous women and children [19]". These women are up to 35 times more likely than non-ATSI women to sustain injuries requiring hospitalisation from IPV victimisation [20].…”

“…These women are up to 35 times more likely than non-ATSI women to sustain injuries requiring hospitalisation from IPV victimisation [20]. Furthermore, intimate partner homicide rates of ATSI Australians are nearly double the proportion of non-ATSI homicides despite them making up less than three percent of the Australian population [19]. It is not surprising then, that Campbell and associates' metaanalysis on intimate partner homicide found that minority status was a statistically significant risk factor [8].…”