228 - Intimate Partner Violence

Abstract

Intimate partner violence—a violation of human rights—is defined as any behavior within an intimate relationship or ex-relationship that causes physical, psychological, or sexual harm, including physical aggression, psychological violence (such as intimidation, constant humiliation), controlling behaviors, restricting access to services, and sexual violence. Intimate partner violence is present in all societies, with a 1/3 global lifetime prevalence in women. An explanatory framework that can guide etiological and intervention research on intimate partner violence is the ecological model, integrating evidence on individual, family, community and socio-economic structural factors. Most research reporting clinical manifestations associated with exposure to intimate partner violence has focused on women. However, although usually less severe than in women, intimate partner violence experienced by men also increases risk of chronic physical and emotional health problems and injuries. Although injury is the most obvious clinical manifestation of intimate partner violence, most people who experience intimate partner violence do not present to health care providers with signs of obvious trauma, but rather with a constellation of overlapping physical and mental health problems. These conditions may persist even when the abuse ends—particularly chronic pain, gynecological problems, anxiety, depression and post-traumatic stress disorder. Although there is no evidence to justify universal screening for intimate partner violence in health care settings, clinicians should have a low threshold for asking about abuse and should know how to respond appropriately and safely, including facilitating referral to a specialist resource that can offer advocacy and further support. There is evidence that women survivors of intimate partner violence benefit from advocacy and some evidence they benefit from trauma-informed psychological treatment.