Intimate partner violence and U.S. military populations

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Intimate partner violence (IPV) is defined as physical and sexual violence or threat of violence, intimidation, or coercion that occurs between past or current intimate partners. [1] Perpetrators of violence may use coercion tactics to keep the partner in the home. These tactics could include threatening harm to a family pet or threatening to take custody of children if the partner attempts to leave. IPV is a serious public health concern in the United States and one that has the potential to affect an individual’s medical readiness. [2] Within the military community, intimate relationships may be particularly vulnerable to occupation-stress that is specific to military operations. These demands might include frequent moves to undesirable locations or overseas, separation from extended family for unknown lengths of time, frequent variability in work schedule, long hours, career uncertainty, mission ambiguity, training environments meant to simulate varying operational environments, and risk that is inherent to the field. [2] Although there are programs in place designed to support the family unit (i.e., Family Readiness Group (FRG), Family Advocacy Program (FAP)), the stress of multiple deployments, combat exposure, and exposure to traumatic events (i.e., combat, IED, mortar rounds, witnessing death or atrocities) cause additional strain on the family unit as service members reintegrate into the home environment following the return home from a deployment. [3] Deployments bring additional stress on the family unit as two-parent homes transition to one-parent homes while attempting to maintain their semi-regular schedules. [3]

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2018 discrimination case

In 2018, a discrimination scandal involving employees at the Family Advocacy Program in Pearl Harbor, Hawaii led military officials to re-evaluate how caseworkers treated male victims. An investigation found that FAP caseworkers did not follow DoD policies, refused to provide services for male victims, purposefully withheld evidence of a woman committing child abuse and domestic violence, and did not record when male victims requested help.

The case was written about in the Honolulu Civil Beat: https://www.civilbeat.org/2021/01/a-bitter-domestic-dispute-could-shake-up-how-the-navy-handles-abuse-cases-in-hawaii/

As of February 2021, the case has yet to be finalized and is pending further review. This has prompted the writing of the “Military Anti-Discrimination Act.” The bill is meant to allow service members to file claims against the military for cases of discrimination. It is currently being considered by lawmakers and does not have a sponsor.

Theories of IPV

There are several theories that attempt to explain the use of force within an intimate relationship. Cultural spill-over effect [4] posits that the more a culture supports the use of violence to achieve their objectives, the more likely individuals in that culture will legitimize violence and generalize those beliefs across multiple domains, which include those where the use of violence or aggression is not socially appropriate. [5] Occupational stress spill-over theory posits that male-dominated, hypermasculine occupations may inadvertently emphasize control though the use of physical force, [2] [6] which generalizes across domains where the use of force is socially unacceptable.

Types and severity

The Department of Defense (DoD) Defense Task Force on Domestic Violence categorizes violence severity into three categories: severe, moderate, and mild. [7] The behaviors categorized under each level of severity are relatively similar between branches of service. Severe physical abuse is defined as choking or strangulation, any injury during sustained while pregnant, threat of harm with a knife or firearm, emotional abuse and intimidation (i.e., “battered spouse syndrome” [7] ), sexual abuse, and major physical injuries that require long-term medical treatment such as inpatient care. Moderate abuse includes objects thrown at spouse, physical abuse (i.e., pushing, biting, kicking, hitting shoving, or punching) and injuries that require short-term medical treatment (i.e., one visit to the hospital). Mild abuse involves verbal threats and physical injuries that don’t require medical treatment. [7]

Prevalence

The prevalence rates of IPV across military populations ranges from 13.5–58% with lower rates observed in military samples not selected based on psychopathology. [6] In 2001, over 18,000 incidents of abuse were reported to the DoD Family Advocacy Programs. [2] Of those incidents reported, 84% involved physical abuse, 66% of victims were spouses of military community and less than 25-years-old. From 1995–2001, there were 217 domestic homicides in military communities. [2] Physical abuse is more likely to be reported than psychological abuse (i.e., emotional and verbal abuse.) [1] Children exposed to IPV may exhibit more behavioral problems, lower performance in school, and aggressive behavior across multiple settings than those not exposed to violence in the home. [6] IPV perpetration among veteran populations with posttraumatic stress disorder (PTSD) is up to three times higher than those without PTSD. [1]

Analysis of violence

Violence can be further characterized by directionality. Bi-directional violence is defined as violence that is committed by both individuals in the relationship, which include violence committed in anger or retaliation. [3] [8] [9] Unilateral violence is defined as violence perpetrated by one individual in the relationship and has been connected to dissociative violence, parasomnia, and hypnopompic violence (i.e., violence due to hyperarousal during sleep) in the literature. [8] [1]

Risk factors

Research suggests that individuals experiencing psychopathology are at a greater risk of perpetration or victimization of IPV compared to veterans without a formal clinical diagnosis. [5] [2] Individuals who experience symptoms associated with PTSD are at a greater risk of perpetrating IPV and being victimized than civilians and veterans without PTSD symptoms. [1] Intrusive negative thoughts, flashbacks, feelings of generalized distress, lack of connection with family or community, and hyperarousal are symptoms that have been shown to influence the relationship between combat exposure and IPV perpetration. [10] This relationship varies with type and level of combat exposure (i.e., witnessing atrocities). [1] [3] History of traumatic brain injury (TBI) has been associated with higher rates of IPV perpetration. [1] [10] Additional risk factors include heavy alcohol and drug use, which has been shown to increase the risk of violence among couples who score high in verbal aggressive conflict communication style. [2] Childhood trauma was found to be correlated with increased risk of violence with Air Force and Navy FAPs reporting 11–25% of service members experiencing physical or emotional abuse by a parent and 49% of treatment-mandated active duty service member samples reporting childhood abuse. [2] Research suggests a positive correlation between length of deployment and severity of self-reported IPV following a deployment. [2] Being junior in rank and marrying at a young age (i.e., below 25-years of age) were also identified. [3]

IPV protocol and programs

DoD Directive 6400.1, which required each branch of service to establish FAP, also required each military installation to have at least one victim advocate. The role of the victim advocate is to help individuals obtain a military protective order, collaborate with unit commanders, help prepare safety plans, connect victims to civilian resources, and provide 24-hour service availability to victims. [7] FAP advocates, chaplains, and medical professionals must maintain the victims’ confidentiality when cases of IPV are reported by the victim, except in specific cases when confidentiality must be broken to ensure the safety of children, older adults, and vulnerable adults. Reports made to other staff (i.e., direct leadership or FRG members) are not confidential and may be reported to military law enforcement or commanders. [11]

Available programs

There are multiple programs designed to support military families. FAP was developed to support the specific needs of military families and currently provides several programs designed to reduce IPV. These programs include new parent support, individual counseling, couples counseling, workshops, and seminars. [11] Strength at Home-Men’s Program (SAH-M), a 12-week cognitive-behavioral and trauma-informed group intervention designed to reduce IPV, has been shown to help individuals limit psychical and psychological IPV, and improve emotional processing, which has been associated with violence. [12] [13]

Related Research Articles

Violence is the use of physical force to cause harm to people, animals, or property, such as pain, injury, death, damage, or destruction. Some definitions are somewhat broader, such as the World Health Organization's definition of violence as "the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, which either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation."

Psychological abuse, often called emotional abuse, is a form of abuse characterized by a person subjecting or exposing another person to a behavior that may result in psychological trauma, including anxiety, chronic depression, or post-traumatic stress disorder.

<span class="mw-page-title-main">Complex post-traumatic stress disorder</span> Psychological disorder

Complex post-traumatic stress disorder (CPTSD) is a stress-related mental disorder generally occurring in response to complex traumas, i.e. commonly prolonged or repetitive exposures to a series of traumatic events, within which individuals perceive little or no chance to escape.

Gender is correlated with the prevalence of certain mental disorders, including depression, anxiety and somatic complaints. For example, women are more likely to be diagnosed with major depression, while men are more likely to be diagnosed with substance abuse and antisocial personality disorder. There are no marked gender differences in the diagnosis rates of disorders like schizophrenia and bipolar disorder. Men are at risk to suffer from post-traumatic stress disorder (PTSD) due to past violent experiences such as accidents, wars and witnessing death, and women are diagnosed with PTSD at higher rates due to experiences with sexual assault, rape and child sexual abuse. Nonbinary or genderqueer identification describes people who do not identify as either male or female. People who identify as nonbinary or gender queer show increased risk for depression, anxiety and post-traumatic stress disorder. People who identify as transgender demonstrate increased risk for depression, anxiety, and post-traumatic stress disorder.

Intimate partner violence (IPV) is domestic violence by a current or former spouse or partner in an intimate relationship against the other spouse or partner. IPV can take a number of forms, including physical, verbal, emotional, economic and sexual abuse. The World Health Organization (WHO) defines IPV as "any behavior within an intimate relationship that causes physical, psychological or sexual harm to those in the relationship, including acts of physical aggression, sexual coercion, psychological abuse and controlling behaviors." IPV is sometimes referred to simply as battery, or as spouse or partner abuse.

Domestic violence occurs across the world, in various cultures, and affects people across society, at all levels of economic status; however, indicators of lower socioeconomic status have been shown to be risk factors for higher levels of domestic violence in several studies. In the United States, according to the Bureau of Justice Statistics in 1995, women reported a six times greater rate of intimate partner violence than men. However, studies have found that men are much less likely to report victimization in these situations.

Teen dating violence is the physical, sexual, or psychological / emotional abuse within a dating relationship among adolescents. Intimate partner violence (IPV) has been a well examined and documented phenomenon in adults; however, there has not been nearly as much study on violence in adolescent dating relationships, and it is therefore not as well understood. The research has mainly focused on Caucasian youth, and, as of 2013, there are no studies which focus specifically on IPV in adolescent same-sex relationships.

<span class="mw-page-title-main">Military sexual trauma</span> U.S. legal term for sexual assault or harassment during military service

As defined by the United States Department of Veterans Affairs, military sexual trauma (MST) are experiences of sexual assault, or repeated threatening sexual harassment that occurred while a person was in the United States Armed Forces.

<span class="mw-page-title-main">Domestic violence</span> Abuse of members of the same household

Domestic violence is violence or other abuse that occurs in a domestic setting, such as in a marriage or cohabitation. Domestic violence is often used as a synonym for intimate partner violence, which is committed by one of the people in an intimate relationship against the other person, and can take place in relationships or between former spouses or partners. In its broadest sense, domestic violence also involves violence against children, parents, or the elderly. It can assume multiple forms, including physical, verbal, emotional, economic, religious, reproductive, or sexual abuse. It can range from subtle, coercive forms to marital rape and other violent physical abuse, such as choking, beating, female genital mutilation, and acid throwing that may result in disfigurement or death, and includes the use of technology to harass, control, monitor, stalk or hack. Domestic murder includes stoning, bride burning, honor killing, and dowry death, which sometimes involves non-cohabitating family members. In 2015, the United Kingdom's Home Office widened the definition of domestic violence to include coercive control.

Research published from 2000 to 2020 illustrates increased prevalence rates of sexual violence against people with intellectual disabilities, compared to the general population.:61 The World Health Organization (WHO) funded a study which concluded that 15% of the adult population worldwide in 2012 had a disability, putting them at increased risk of physical, sexual, and intimate partner violence. Of that 15%, 6.1% or an estimated 7,008,716,704 adults worldwide had intellectual disability with 5.5% experiencing sexual violence. In another 2012 report, the WHO found that worldwide, children with intellectual disabilities experienced a 4.6 times greater risk of sexual violence than those without disability.

Domestic violence against men is violence or other physical abuse towards men in a domestic setting, such as in marriage or cohabitation. As with domestic violence against women, violence against men may constitute a crime, but laws vary between jurisdictions. Men who report domestic violence can face social stigma regarding their perceived lack of machismo or other denigrations of their masculinity, the fear of not being believed by authorities and being falsely accused of being the perpetrator. Additionally, intimate partner violence (IPV) against men is generally less recognized by society than intimate partner violence against women, which can act as a further block to men reporting their situation.

<span class="mw-page-title-main">Management of domestic violence</span>

The management of domestic violence deals with the treatment of victims of domestic violence and preventing repetitions of such violence. The response to domestic violence in Western countries is typically a combined effort between law enforcement, social services, and health care. The role of each has evolved as domestic violence has been brought more into public view.

Domestic violence in Kenya constitutes any harmful behavior against a family member or partner, including rape, assault, physical abuse, and forced prostitution. Domestic violence in Kenya reflects worldwide statistics in that women are the overwhelming majority of victims. Over 40% of married women in Kenya have reported being victims of either domestic violence or sexual abuse. Worldwide, over 30% of "ever-partnered women" aged 15 and older have experienced physical or sexual partner violence. The distinct factors and causes of this high percentage have often not been studied due to lack of data.

Domestic violence within lesbian relationships is the pattern of violent and coercive behavior in a female same-sex relationship wherein a lesbian or other non-heterosexual woman seeks to control the thoughts, beliefs, or conduct of her female intimate partner. In the case of multiple forms of domestic partner abuse, it is also referred to as lesbian battering.

<span class="mw-page-title-main">Domestic violence in same-sex relationships</span>

Domestic violence in same-sex relationships is a pattern of violence or abuse that occurs within same-sex relationships. Domestic violence is an issue that affects people of any sexuality, but there are issues that affect victims of same-sex domestic violence specifically. These issues include homophobia, internalized homophobia, HIV and AIDS stigma, STD risk and other health issues, lack of legal support, and the violence they face being considered less serious than heterosexual domestic violence. Moreover, the issue of domestic violence in same-sex relationships has not been studied as comprehensively as domestic violence in heterosexual relationships. However, there are legal changes being made to help victims of domestic violence in same-sex relationships, as well as organizations that cater specifically to victims of domestic violence in same-sex relationships.

Betrayal trauma is defined as a trauma perpetrated by someone with whom the victim is close to and reliant upon for support and survival. The concept originally introduced by Jennifer Freyd in 1994, betrayal trauma theory (BTT), addresses situations when people or institutions on which a person relies for protection, resources, and survival violate the trust or well-being of that person. BTT emphasizes the importance of betrayal as a core antecedent of dissociation implicitly aimed at preserving the relationship with the caregiver. BTT suggests that an individual, being dependent on another for support, will have a higher need to dissociate traumatic experiences from conscious awareness in order to preserve the relationship.

The culture of violence theory addresses the pervasiveness of specific violent patterns within a societal dimension. The concept of violence being ingrained in Western society and culture has been around for at least the 20th century. Developed from structural violence, as research progressed the notion that a culture can sanction violent acts developed into what we know as culture of violence theory today. Two prominent examples of culture legitimizing violence can be seen in rape myths and victim blaming. Rape myths lead to misconstrued notions of blame; it is common for the responsibility associated with the rape to be placed on the victim rather than the offender.

<span class="mw-page-title-main">Sexual assault of LGBT persons</span>

Sexual assault of LGBT people, also known as sexual and gender minorities (SGM), is a form of violence that occurs within the LGBT community. While sexual assault and other forms of interpersonal violence can occur in all forms of relationships, it is found that sexual minorities experience it at rates that are equal to or higher than their heterosexual counterparts. There is a lack of research on this specific problem for the LGBT population as a whole, but there does exist a substantial amount of research on college LGBT students who have experienced sexual assault and sexual harassment.

Violence against women in the United States is the use of domestic abuse, murder, sex-trafficking, rape and assault against women in the United States. It has been recognized as a public health concern. Culture in the United States has led towards the trivialization of violence towards women, with media in the United States possibly contributing to making women-directed violence appear unimportant to the public.

Trauma- and violence-informed care (TVIC) describes a framework for working with and relating to people who have experienced negative consequences after exposure to dangerous experiences. There is no one single TVIC framework, or model, and some go by slightly different names, including Trauma Informed Care (TIC). They incorporate a number of perspectives, principles and skills. TVIC frameworks can be applied in many contexts including medicine, mental health, law, education, architecture, addiction, gender, culture, and interpersonal relationships. They can be applied by individuals and organizations.

References

  1. 1 2 3 4 5 6 7 Rodrigues, Amy E.; Funderburk, Jennifer S.; Keating, Niki L.; Maisto, Stephen A. (2014-03-18). "A Methodological Review of Intimate Partner Violence in the Military". Trauma, Violence, & Abuse. 16 (3): 231–240. doi:10.1177/1524838014526066. ISSN   1524-8380. PMID   24648490. S2CID   30110266.
  2. 1 2 3 4 5 6 7 8 9 Klostermann, Keith; Mignone, Theresa; Kelley, Michelle L.; Musson, Sabrina; Bohall, Gregory (2012). "Intimate partner violence in the military: Treatment considerations". Aggression and Violent Behavior. 17 (1): 53–58. doi:10.1016/j.avb.2011.09.004. ISSN   1359-1789.
  3. 1 2 3 4 5 Jones, Alysha (2012). "Intimate Partner Violence in Military Couples: A Review of the Literature". doi:10.1037/e621642012-032.{{cite journal}}: Cite journal requires |journal= (help)
  4. ↑ BARON, LARRY; STRAUS, MURRAY A.; JAFFEE, DAVID (1988). "Legitimate Violence, Violent Attitudes, and Rape: A Test of the Cultural Spillover Theory". Annals of the New York Academy of Sciences. 528 (1 Human Sexual): 79–110. Bibcode:1988NYASA.528...79B. doi:10.1111/j.1749-6632.1988.tb50853.x. ISSN   0077-8923. PMID   3421615. S2CID   8847764.
  5. 1 2 Bradley, Christopher (2007-04-18). "Veteran Status and Marital Aggression: Does Military Service Make a Difference?". Journal of Family Violence. 22 (4): 197–209. doi:10.1007/s10896-007-9072-4. ISSN   0885-7482. S2CID   13214683.
  6. 1 2 3 MARSHALL, A; PANUZIO, J; TAFT, C (2005). "Intimate partner violence among military veterans and active duty servicemen". Clinical Psychology Review. 25 (7): 862–876. doi:10.1016/j.cpr.2005.05.009. ISSN   0272-7358. PMID   16006025.
  7. 1 2 3 4 Department of Defense, DoD (2003). "Defense Task Force on Domestic Violence: Third year report" (PDF). PsycEXTRA Dataset. Retrieved 2019-01-20.
  8. 1 2 LaMotte, Adam D.; Taft, Casey T.; Weatherill, Robin P.; Scott, Jillian Panuzio; Eckhardt, Christopher I. (2014). "Examining intimate partner aggression assessment among returning veterans and their partners". Psychological Assessment. 26 (1): 8–15. doi:10.1037/a0034579. ISSN   1939-134X. PMID   24079959.
  9. ↑ Misca, Gabriela; Forgey, Mary Ann (2017-08-15). "The Role of PTSD in Bi-directional Intimate Partner Violence in Military and Veteran Populations: A Research Review". Frontiers in Psychology. 8: 1394. doi: 10.3389/fpsyg.2017.01394 . ISSN   1664-1078. PMC   5559770 . PMID   28861023.
  10. 1 2 Farrer, Thomas J.; Frost, R. Brock; Hedges, Dawson W. (2012-03-30). "Prevalence of Traumatic Brain Injury in Intimate Partner Violence Offenders Compared to the General Population". Trauma, Violence, & Abuse. 13 (2): 77–82. doi:10.1177/1524838012440338. ISSN   1524-8380. PMID   22467643. S2CID   5491444.
  11. 1 2 "The Family Advocacy Program". Military One Source. 26 August 2022.
  12. ↑ Creech, Suzannah K.; Benzer, Justin K.; Ebalu, Tracie; Murphy, Christopher M.; Taft, Casey T. (2018-07-24). "National implementation of a trauma-informed intervention for intimate partner violence in the Department of Veterans Affairs: first year outcomes". BMC Health Services Research. 18 (1): 582. doi: 10.1186/s12913-018-3401-6 . ISSN   1472-6963. PMC   6056924 . PMID   30041642.
  13. ↑ Berke, Danielle S.; Macdonald, Alexandra; Poole, Gina M.; Portnoy, Galina A.; McSheffrey, Savannah; Creech, Suzannah K.; Taft, Casey T. (2017). "Optimizing trauma-informed intervention for intimate partner violence in veterans: The role of alexithymia". Behaviour Research and Therapy. 97: 222–229. doi: 10.1016/j.brat.2017.08.007 . ISSN   0005-7967. PMID   28826068.
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