Citation

Taft CT, Campbell JC. Am. J. Prev. Med. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, Elsevier Publishing)

DOI

10.1016/j.amepre.2023.08.017

PMID

37633427

Abstract

Intimate partner violence (IPV), typically defined as physical, sexual, or psychological aggression towards a relationship partner, including coercive, controlling behaviors, is a significant public health problem.1 Approximately one in four women and one in five men report experiencing IPV in their lifetime,2,3 with consequences ranging from extensive negative mental and physical health outcomes to death, including both homicide and suicide.4-6 People of color are disproportionately impacted by IPV in the U.S., with rates up to 2.7 times higher than their White counterparts.7 The annual population economic costs of IPV including healthcare, lost worker productivity, criminal justice, lost earnings, and other costs exceed $3.6 trillion over the course of victims' lifetimes (2014 US dollars).8 Given its scope and consequences, one might think that research focused on addressing IPV at the source, meaning programs working with the individuals engaging in these behaviors, sometimes referred to as "batterer intervention programs" and labeled here as "IPV intervention programs," would be a top funding priority. In fact, federal agencies rarely direct funds for research focused on discovering and disseminating the most effective behavior-change interventions for those who use IPV. Examining effective ways to prevent IPV escalation is such a neglected area of study that the field has almost ceased to exist. This kind of "secondary prevention" - to stop IPV - is what many if not most of those who are experiencing IPV desire rather than dissolution of the relationship or criminal justice actions against their partners.9 Federal funding is necessary because the kind of studies that are needed are expensive; complex clinical trials that attend to partner safety and community contexts.

It may be illustrative to compare research conducted on IPV interventions with another field that began at roughly the same time, interventions for posttraumatic stress disorder (PTSD). PTSD was first classified as a diagnosis by the American Psychiatric Association in 1980 in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III).10 At about the same time, IPV interventions began to proliferate stemming from the battered women's shelter movement and domestic violence laws in the late 1970's.11 Comparing the development of interventions for these two problems, a review of published meta analyses and other relevant literature reviews reveals that there have been more than 300 randomized controlled trials examining the effectiveness of PTSD interventions12 and only eight randomized controlled trials examining the effectiveness of IPV intervention programs, which have also often been described as lacking methodological rigor.13 The substantial difference between these two fields demonstrates a lack of focus on preventing trauma, with almost all funding focused on working with those who experience trauma rather those who may be inflicting such trauma. It is unclear whether this lack of funding is due to the need to devote resources primarily to survivors, because IPV is not a diagnosable disorder that falls within the scope of large national funders, or because the usual funding levels of some federal agencies is insufficient to support the complex RCTs needed to adequately research this area...

Language: en

Keywords

domestic violence; Intimate Partner Violence; abuser intervention