An Interactional Perspective of Intimate Partner Violence - Springer Link

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Jan 29, 2008 - Campbell 2004; Dixon and Browne 2003; Frye et al. 2006). ... and Capezza 2005; 2004; Cano and Vivian 2001; Heckert and Gondolf 2004 ...
J Fam Viol (2008) 23:265–279 DOI 10.1007/s10896-007-9150-7

ORIGINAL ARTICLE

An Interactional Perspective of Intimate Partner Violence: An In-depth Semi-structured Interview of a Representative Sample of Help-seeking Women Solveig Karin Bø Vatnar & Stål Bjørkly

Published online: 29 January 2008 # The Author(s) 2007

Abstract This article reports a study of women victimized by intimate partner violence (IPV). We describe three interactional aspects of IPV: (1) responses and conduct before, during, and after IPV episodes, (2) impact of alcohol and drug intoxication, and (3) Predictors of risk for IPV victimization in more than one partnership. A representative sample of 157 help-seeking women, recruited from family counseling offices, the police and shelters, were interviewed about physical, psychological and sexual IPV. The nature and characteristics of the IPV interactions were complex and heterogeneous. There were significant interactional differences between the IPV categories concerning the women_s responses and conduct before, during and after the IPV. The impact of alcohol and drug intoxication was relatively small on the occurrence of IPV. About 75% reported that neither the perpetrator nor the female victim had consumed alcohol or drugs before the index IPV exposure. Only 23% of the women had experienced IPV by previous partners. Women who had been subjected to sexual abuse in their family of origin were at almost 25 times increased risk of IPV victimization in more than one partnership. Childhood exposure to physical IPV between parents increased the risk of IPV victimization in more than one partnership significantly more than if the woman had been subject to childhood physical victimization. S. K. B. Vatnar (*) : S. Bjørkly Centre for Research and Education in Forensic Psychiatry, Ullevål University Hospital, Gaustad, Building 7, 0320 Oslo, Norway e-mail: [email protected] S. Bjørkly Faculty of Health and Social Sciences, Molde University College, Molde, Norway

Keywords Intimate partner violence . Interactional perspective . Women_s prediction and coping . Alcohol and drug use . Revictimization

Introduction Intimate partner violence (IPV) against women is a pressing social issue, and some researchers have even described it as epidemic in our society (Briere and Jordan 2004). A majority of international IPV studies focuses exclusively on violence against female victims. The main argument is that women suffer more severe consequences and seek help more frequently than male IPV victims (Archer 2000; Campbell 2004; Dixon and Browne 2003; Frye et al. 2006). A nationwide survey on domestic violence in Norway found that 10% of the women and 2% of the men had experienced severe IPV (Haaland et al. 2005). Recent reviews of IPV have emphasized that there is a paucity of studies on violence escalation and interaction, dynamics of violence, and prediction and coping of IPV incidents as perceived and experienced by the target of violence (Langhinrichsen-Rohling 2005; Schwartz 2005; Arriaga and Capezza 2005; 2004; Cano and Vivian 2001; Heckert and Gondolf 2004; Mears and Visher 2005; MessmanMoore and Long 2003; Winstok 2007). The research we are reporting here was initiated to address four main researches of the experiences of 157 women: (1) their responses to violence escalation and violence perpetrated by the partner, (2) the effect of pregnancy and motherhood on IPV, (3) the possible influence of immigration and ethnicity, and (4) support and treatment. In this article we only address the first research issue, and we do so by reporting findings from the following areas of research: responses and conduct

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before, during and after the IPV; dynamics of violence; effect of alcohol and drug intoxication; and revictimization. An Interactional Perspective on IPV A major consideration in efforts to assess, predict and change IPV pertains to the manner in which aggression is conceptualized. Theoretical approaches to the analysis of IPV have emphasized variables such as conflict e.g., (Straus 1979), and power and control e.g. (DeKeseredy and MacLeod 1997). There is growing evidence that behaviors and perceptions of behaviors in intimate relationships should be investigated as separate entities, and that it may be important to assess how individuals perceive not only their own communication but also their partners_ communication e.g., (Rhoades and Stocker 2006). In a recent article Winstok (2007) argues for an integration of different approaches in an interactional understanding of IPV. Interactional models emphasize the importance of person– situation interactions in efforts to understand both personality and behaviour. The interactional understanding is also used within other branches of research on violence, such as violence committed by persons with major mental disorder e.g., (Bjørkly 1993; Monahan 1988). The main idea is that aggression involves an influential and continuous interaction between individuals and the various situations they encounter. Situations are defined as the actual episodes are perceived, interpreted, and assigned meaning (Magnusson 1981). Consequently, since we investigate different types of IPV in the present study within an interactional perspective it is acknowledged that a woman who has been subject to for instance psychological and physical IPV on separate occasions probably will have different experiences and perceptions of these interactions. Accordingly, for instance the escalations leading to psychological and physical IPV reported by the same woman will be treated as two separate analytical units because the focus is on person–situation interaction rather than two different IPV situations treated as if they were identical because the same victim and perpetrator were involved. The nature of the IPV that battered women experience is not uniform. Instead, battered women struggle with a variety of combinations of physical violence, psychological violence and sexual violence. The severity of each type of violence or abusive behaviour also varies. It is unclear what causes this variability and how these differences may affect the impact of violence on battered women, and their revictimization (Dutton and Corvo 2006). Although the body of IPV research has focused on patterns, causes and interventions, systematic literature reviews have found that studies on dynamic and interactional aspects are scarce (Bjørkly 2003; Winstok 2007), and that little is known about how women cope in long-term abusive intimate relationships (Lund and

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Greene 2003; Zink et al. 2006). A review of situational determinants in IPV concluded that IPV research rarely examines domestic violence events as interactional and dynamic phenomena (Wilkinson and Hamerschlag 2005). There is a paucity of studies that investigate situational or event factors and their surrounding contexts in a systematic way. In their review, Wilkinson and Hamerschlag (2005) suggested that, by collecting these kinds of data on heterogeneity of IPV, we can bridge huge gaps in our comprehension of this complex and serious problem. In our study, we investigated women_s perceptions of interpersonal factors within an interactional perspective, with an emphasis on interactions in which IPV behaviours emerge. It is claimed that recognition of recurrent warning signs, as specific individual precursors of violence, is of great importance in successful treatment and relapse prevention (Bjørkly 2000; Steadman and Silver 2000). There appears to be a paucity of instruments available for the accurate and clinically useful measurement of warning signs of IPV escalation (Bjørkly 2003). Research findings suggest that many women will underestimate the severity of the early stages of IPV escalations (e.g., Campbell 2004). Accordingly, one aim of our research was to collect information on the responses the women had when they observed their partners_ precursors of violence, another was to find out more about whether such observations helped the women to cope with the escalation in time, or if it only made things worse for them. Impact of Alcohol and Drug Intoxication The impact of alcohol and drug intoxication on IPV is a controversial issue. Research exploring the link between alcohol use and IPV has repeatedly failed to differentiate the nature of men_s violence to women from men_s violence to men (Galvani 2006). Accordingly, the most prevalent conclusion in feminist research on IPV is that the impact of intoxication is not significant in domestic violence (Galvani 2006). Meta-analytic reviews evaluating the evidence on the relationship between drug use and IPV concludes that increases in drug use and drug-related problems are significantly associated with increases in IPV (Moore et al. 2007; Testa 2004). Another review found that about 20% of men and 10% of women were drinking before the most recent and severe act of violence (Klostermann and Fals-Stewart 2006) Some investigators have argued that association between alcohol use and IPV may vary considerably as a function of the characteristics of the person drinking and the circumstances under which intoxication occurs. One conclusion was that women with few social roles and responsibilities have a stronger inclination to report problematic alcohol use (Kerr-Corrêa et al. 2007).

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The most consistent mediator appears to be presence of other factors that are causally implicated in IPV. For example Fals-Stewart_s model of alcohol use, IPV and antisocial personality presumes that men with high levels of antisocial personality characteristics have a tendency to be physically aggressive, even when they are not intoxicated (Klostermann and Fals-Stewart 2006) Still, the study of the link between alcohol and IPV is methodologically complex, and so far, even the relative frequency of physical violence in problem drinking couples, compared with non-problem drinking couples, has not been empirically settled (Kelly and Halford 2006). In line with this, one aim of this study was to investigate the role of alcohol as an interactional predictor of IPV from the perspective of female victims of IPV. Predictors of IPV and IPV Victimization in More Than One Partnership Research indicates that some women return to abusive relationships after having been exposed to IPV (Rhatigan et al. 2005). A review of explanatory models for the termination of violent relationships concluded that general approaches, like reasoned action/planned behaviour and investment models, may be a better way to understand such complex and multifaceted decisions than theories of learned helplessness, traumatic bonding and psychological entrapment e.g., (Rhatigan et al. 2006). It was claimed in the review that the general approaches provided a nonpathological understanding of the women_s decisions to leave an IPV partnership. These models suggest that victimized women take into account the same types of information as non-victimized women do, in deciding whether to terminate their relationships. Preventing reassault/revictimization is especially important to survivors_ recovery from interpersonal violence because exposure to multiple traumatic experiences may negatively affect a person_s capacity to recover from subsequent traumatic events (Dutton et al. 2006). Most of the research on risk factors for IPV focuses on characteristics of the perpetrator, rather than the victim (Norlander and Eckhart 2005; Schumacher, Feldbau-Kohn and Slep 2000a). Information on risk factors pertaining to the victim may contribute to the development of indicated prevention strategies for women. However, if one addresses victim risk factors it is important to acknowledge that risk factors are not necessarily causal variables and do not imply that victims cause the IPV. A review of risk factors for physical IPV concluded that only fewer years of education, unemployment and childhood emotional or verbal victimization are significant mediators of risk (Schumacher et al. 2000a). Yet, even for these associations, only moderate effect sizes were found.

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A review of the literature that addressed the risk and protective factors for psychological IPV concluded that psychological IPV may be more difficult to predict than physical IPV (Schumacher et al. 2000b). In general, no empirical evidence exists concerning socio-economic status discrepancies as predictors of psychological IPV. Schumacher et al. (2000a, b) found that certain relationship variables were significantly associated with psychological IPV with moderate to strong effect sizes. However, this association is difficult to interpret, because these relationship variables exhibit a high degree of conceptual and operational overlap with psychological IPV (Schumacher et al. 2000b). Still, it is interesting that studies of clinical samples with the Psychological Maltreatment of Women Inventory (PMWI) have found control behaviours to be risk factors for psychological IPV of medium to large effect sizes (Schumacher et al. 2000b). A brief review focusing on the risk and protective factors for male-to-female sexual abuse found that several associations were of a moderate effect size, in spite of the fact that partner sexual abuse is a low base rate behaviour (Black et al. 2000). Unemployed women, and women from lowincome households, were more likely to report this type of IPV. Prior unwanted sexual experiences and the severity of physical aggression were also associated with IPV (Black et al. 2000). Other reviews and recent research focusing on child sexual abuse demonstrated that women with a history of childhood sexual abuse or childhood exposure to parents IPV were at increased risk of revictimization (Filipas and Ullman 2006; Kogan 2005; Macy 2007; Messman-Moore and Long 2003; Miller 2006). Within an interactional perspective it is of particularly interest to find out more about the impact of adverse childhood experiences and previous IPV victimization on subsequent IPV experiences. In summary, the scope of this study was to investigate IPV within an interactional perspective. For this purpose, we used a semi-structured interview questionnaire with items that tapped into event and situational factors. We explored women_s responses and conduct before, during, and after the IPV by focusing on (1) the dynamics of violence, (2) the impact of alcohol and drug intoxication, and (3) IPV victimization in more than one partnership. Specific research questions were as follows. &

& & &

Were there significant differences between IPV categories (physical, psychological, and sexual) concerning the women_s responses and conduct before, during and after the IPV? Were the women able to predict the IPV? Did the women have coping strategies, and did they perceive these as self-preserving and effective? Did alcohol and drug intoxication have an impact on the IPV interactions?

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& & &

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Were there significant differences between physical, psychological, and sexual IPV in relation to the impact of alcohol and drug intoxication? Were rates of women who had been IPV victimized in more than one partnership high? Were there significant differences between women who had been IPV victimized in more than one partnership and those who had not been IPV victimized in previous partnerships?

Method The study was approved by the Regional Norwegian Ethics Committee. Written informed consent was obtained from the participants. The interviews were carried out between April 2005 and April 2006 in eight Norwegian counties. Sampling and Recruitment One of the authors (SV) contacted shelters, police, and family counseling offices introduced the study, and made contact with institutions that were willing to participate in the study. These shelters, police, and family counseling offices were selected to secure proportional recruitment from the capital of Norway, small towns and the countryside. The shelters, police and family counseling offices that participated asked every woman who had made contact after exposure to IPV if she would volunteer to participate in the study. Inclusion criteria for the women were. & & &

a minimum age of 18 years; had contacted a shelter, the police or a family counselling office after being subject to IPV (index IPV exposure); and the index IPV exposure had occurred no more than 6 months before the interview. Exclusion criteria were:

& &

refusal to participate; or ethical, psychological or medical reasons for not participating in the research.

Most (92.9%, n=192) of those who were approached to participate in the study volunteered to take part. Of these, 5 (2.6%) were not able to be contacted to make an appointment for the interview, 13 (6.8%) changed their mind before entering the interview, 7 (3.6%) had to cancel because of somatic illness or because they had moved to other parts of the country, and 10 (5.2%) did not show up after the appointment had been made. This resulted in a final sample of 157 participants, corresponding to 73.4% of all the women who were initially approached to participate.

The sample was recruited from 10 shelters (n=73), 5 police districts (n=41) and 6 family counselling offices (n=43). According to official records, shelters, police, and family counseling offices cover about 85% of help-seeking IPV victims in Norway (Norwegian Ministry of Justice 2003, 2005). One hundred and five women were native Caucasian Norwegians and 52 were born in other countries. There was a significant correlation between country of origin in the sample and the distribution of country of origin among immigrant women in Norway in general (Kendall_s taub=0.69, p