Male Perpetrators of Intimate Partner Violence: Support for Health Care Interventions Targeted at Level of Risk

Brief Intimate Partner Violence Perpetration Screening Tools: A Scoping Review

Recent research findings indicate that patients are willing to disclose their use of violence to health-care providers if asked. Health-care providers have a unique opportunity to screen their patients for intimate partner violence (IPV) perpetration; however, given the time constraints and limited personnel within medical offices and emergency-care facilities, instrument brevity is critically important. The development and evaluation of tools to screen for IPV perpetration in health-care settings, particularly brief instruments, is limited by the lack of adequate guidelines, clear institutional policies for screening, and reviews of the available literature. Given the need for validated measurement tools, we assessed the psychometric properties of measurement tools designed to quickly detect IPV perpetration by conducting a scoping review. Our search identified five measures meeting eligibility requirements. Inclusion criteria required that study information be published in a peer-reviewed journal, be published in English or Spanish languages, contain 10 or less items, report psychometric testing results, require no additional information, and be designed to detect IPV perpetration. We searched subject-specific databases and the bibliographies of relevant publications to identify studies. As part of appraising and synthesizing the evidence, we found most measures to have good reliability and validity. Most measures contained 2-5 items. Most studies were conducted in the United States and utilized an adequate sample size. There were considerable differences in how each of the measures determined a positive or negative screening. Gaps in the literature and areas for future research pertained to sample diversity, invariance testing, and practice guidelines for implementation.

Family-Only Perpetrators of Intimate Partner Violence: A Systematic Review

This article presents the first systematic review of family-only intimate partner violence (IPV) perpetrators (as originally proposed by Holtzworth-Munroe & Stuart). The aims of the present review were to summarize and describe the prevalence of the family-only perpetrator subtype, as well as to investigate what characteristics were associated with perpetrators within this subtype. Electronic literature searches in several databases (e.g., PsychINFO, Web of Science, and PubMed) were carried out. Of the 3,434 studies identified, 30 studies met the inclusion criteria as well as the methodological quality criteria. Thematic analyses were conducted, where several themes and subthemes were identified. The proportion of family-only perpetrators, averaged across sample types, was 47.5%. Drawing on the thematic analyses of the reviewed studies, family-only perpetrators presented as a less violent subtype, displaying several pro-social personality traits, as well as a lower degree of psychopathology. The findings were in line with Holtzworth-Munroe and Stuart's predictions. The findings also demonstrated the utility of a 2-fold typology, consisting of a family-only and a generally violent (GV) subtype, as well as the need to reconsider the one-size-fits-all approach to IPV treatment. We also included a discussion of the terminology of the subtypes and propose an adoption of the terms "partner only violent" and "generally violent" subtypes.

Emergency Department Visits and Injury Hospitalizations for Female and Male Victims and Perpetrators of Intimate Partner Violence

Introduction. The potential for hospital-based interventions for male victims of intimate partner violence (IPV) as well as adult perpetrators of both genders has been largely unexplored despite early evidence of acute-care utilization that may be as high as female victims. The current investigation compared the emergency department (ED) and injury-related-hospitalization rates of IPV-involved individuals against standardized national norms, assessing differences by gender and victim/perpetrator-status. Methods. This cross-sectional study collected one-year ED and in-patient visit data from hospital records for individuals listed as victim or perpetrator in an IPV criminal charging request in a Midwestern county (N=2,937). Expected rates were calculated based upon age-adjusted national norms. Results. The IPV-involved population generated ED rates 4.1 times higher than expected and injury-related-hospitalization rates that were 4.0 times higher than expected. Bi-directionally-violent individuals (both victim and perpetrator in IPV charges) consistently had the highest utilization rates (ED 8.4 RR, injury-hospitalization 22.5 RR). Victims, primarily female, had higher ED-visits than perpetrators, primarily male (victims = 4.6 RR, perpetrator = 3.1 RR). Perpetrators, though, had higher injury hospitalizations (victims = 0.8RR, perpetrators = 5.5 RR). Conclusions. Substantial opportunities exist within acute-care medical settings to intervene with IPV-involved women, men, victims, and perpetrators, although the magnitude of the opportunity varied by setting, gender and victim/perpetrator-status.

Inpatient hospitalization and intimate partner violence: who are we treating?

BACKGROUND

The majority of research into health care use of intimate partner violence (IPV) has focused on female victims and primarily their emergency department use. There are limited data on injury-related hospitalization rates for female victims and even less for male victims and perpetrators. The goal of this study was to determine the annualized rates of inpatient injury-related hospitalization among individuals involved as either victims or defendants in IPV.

METHODS

This was an observational retrospective study linking data from two Level 1 trauma centers and the county prosecutor's office from 2000 to 2010 in Kalamazoo County, Michigan. (1) Hospital data included injury-related admissions (DRG International Classification of Diseases-9th Rev. codes 800-959.9 excluding 905-909.9). (2) Prosecutor data contained all charging requests for crimes between intimate partners. Annualized rates were calculated for the year before the IPV crime and for the year after, using the following algorithm: (number of hospitalizations) / (total population) × (per 10,000). Confidence intervals and two-sided statistical significance were calculated at the 95% confidence level.

RESULTS

During the study period, 21,179 IPV crimes were committed, involving 12,913 individual defendants and 14,797 victims. There were 30,301 injury-related hospitalizations by this group during this period. Compared with national hospitalization rates of 3.2 per 10,000 people for injury/poisoning (DRG International Classification of Diseases-9th Rev. 800-959.9 and 990-995), IPV victim annual admission rates were 31.9, defendants at 90.4, and bidirectional individuals at 339.1 per 10,000 people, in the 2 years surrounding the crime. Males, regardless of crime role, have higher injury-related hospitalization rates in this period compared with females (male, 115.6; female, 41.8). Males (victims or defendants) and bidirectional participants of either sex had rates that were significantly higher the year after than the year before the crime.

CONCLUSION

Individuals involved in IPV have a 10-fold higher injury-related hospitalization rate as compared with age-matched national rates. Admission rates vary by sex, crime role, and time frame, with males and bidirectional participants having the highest rates.

LEVEL OF EVIDENCE

Epidemiological study, level III.