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OCR for page 35
2
Nature and Scope of
Violence Against Women
As discussed in Chapter 1, the 1996 NRC report Understanding Vio-
lence Against Women outlines a series of methodological problems
that have impeded the development of knowledge in this area. In
the years since that report was produced, some of these problems have
been addressed (e.g., the inclusion of questions about violence against
women in surveys pertaining to other types of high-risk or violent behav-
ior), yet others remain. This chapter focuses on the need for a coordinated
and integrated research strategy that can build stronger scientific data-
bases to enhance our understanding of violence against women.
Much of what is known about the violent victimization of women has
been derived from methodologically disparate survey data. Certainly,
survey research has been instrumental in setting some parameters for the
scope of two types of violence intimate-partner violence and sexual as-
sault. Data on these problems indicate that the risk of such victimization
varies substantially across racial and ethnic groups (Dugan and Apel,
2002; Rennison and Welchans, 2000; Tjaden and Thoennes, 1998~. Never-
theless, survey research has been less successful in providing reliable esti-
mates of the prevalence and incidence of intimate-partner violence and
sexual assault, about the context of these violent events, about the devel-
opmental patterns of such violence over time, and about the ways in which
women's victimization experiences may be linked to women's offending
behaviors (Campbell et al., 2002a; Richie, 1996~. To advance a more sys-
tematic approach to the study of violence against women, this chapter
considers in turn the strengths and weaknesses of the major national
35
OCR for page 36
36
RESEARCH ON VIOLENCE AGAINST WOMEN
datasets that provide information on violence against women; other
datasets that were not designed to examine violent victimization, but have
included relevant questions pertaining to the violent victimization of
women; information provided by current datasets about the extent and
nature of violence against women; and methodological issues that have
precluded linking extant datasets, improving measurement, and enhanc-
. .
ng ongoing survey researc I.
MANOR DATASETS
A wide array of datasets provides information on violence against
adult and/or adolescent females, although this is not always the primary
focus of the various data collection efforts. Many of these datasets include
information from national samples of women or large groups of U.S.
women that are representative of a particular population. Each has both
strengths and limitations. The most serious limitations of existing datasets
are as follows: (1) most were designed for primary purposes other than
collecting information on violence against women; (2) most are not con-
tinuous and so cannot show changes over time; and (3) although many
collect data on similar issues (e.g., prevalence), definitions of violence
against women, as well as data collection instruments, vary, making it
difficult to compare results. These and other shortcomings, especially
nonresponse and false-response errors, need to be addressed in future
research. At a 1998 conference on research on violence against women,
sponsored by the Centers for Disease Control and Prevention (CDC) and
the National Institute of Justice (NIT), a matrix of datasets that include
some information on violence against women was created with an eye to
determining how to link information from disparate surveys, an issue dis-
cussed further below. The committee has expanded this matrix somewhat
and included it here as Table 2-1. In a paper commissioned for the work-
shop, Campbell et al. (2002a) describe the following major datasets on
which most researchers in the field currently rely:
The National Crime Victimization Survey (NCVS), sponsored by
the Bureau of Justice Statistics (BIS), is the second-largest ongoing gov-
ernment-run U.S. survey (Bachman, 2000~. It is the most extensive victim-
ization data source, documenting characteristics of victims and
nonvictims aged 12 and older living within sampled housing units. In
addition to detailed information on each household and the interviewed
individual within that household, the survey documents respondents' re-
cent experiences as crime victims, including details of each event and its
consequences. From 1972 to the present, data collection, using a rotating
panel design in selected housing units, has been conducted seven times
OCR for page 37
NATURE AND SCOPE OF VIOLENCE AGAINST WOMEN
37
during each 3-year period. In 2000, the response rate was 93.0 percent of
eligible households and 89.3 percent of eligible individuals (Rennison,
2002~. This survey is one of only a handful of continuous datasets that
collects information on violence against women. Each year, BIS uses the
data to publish reports on current crime distributions and to document
patterns and consequences for several types of victims (Bureau of Justice
Statistics, 2000~.
NCVS data do permit an examination of whether and how violent
victimization differs for women and men, but they have several limita-
tions. While the redesign effort in 1992 led to improved estimates of do-
mestic and sexual violence (see Bachman and Taylor, 1994, for a thorough
description of the redesign effort and its improvements), analysis of long-
term trends has been curtailed because the content of assault and sexual
assault items was changed. In addition, no information is collected on
victimization history and the communities and cultures within which the
violence occurs, although NCVS data with census-tract codes attached
are available to researchers with permission from the U.S. Census Bureau.
Data pertaining to the immediate context of violent events (e.g., urban
setting, home ownership, public housing) are also limited.
The National Surveys of Family Violence (NSFV) encompassed two
cross-sectional surveys conducted by the University of New Hampshire
under the auspices of the Family Violence Research Program, sponsored
by the National Institute of Mental Health (Gelles and Straus, 1988; Straus
et al., 1988~: the first was conducted in 1975 and relied on in-person home
interviews; the second was conducted in 1985 and relied on random-digi-
tal-dial telephone interviews. Each was designed to provide a compre-
hensive examination of violence in the family, including spouse abuse,
child abuse (including physical punishment as a form of discipline), sib-
ling-to-sibling abuse, and parent abuse (victimization of a parent or par-
ents by the child/children of the family). The surveys were intended to
provide data on the prevalence of these various types of family violence
and to identify the risk (and protective) factors involved.
Family violence was operationalized with the Conflict Tactics Scales
(CTS) (Straus,1979~. These scales are based on self-reports of 18 behaviors
(grouped into three subscales consisting of rational, verbal, and violent
acts) that may have occurred within the context of a disagreement. Over
the course of the two surveys, the CTS were modified to include an addi-
tional series of questions regarding whether an act of violence produced
an injury that required medical attention (Gelles, 1987~.
These surveys represented the first nationwide examination of vio-
iBJS uses the first interview for bounding purposes only; it is not included in these data.
OCR for page 38
38
RESEARCH ON VIOLENCE AGAINST WOMEN
TABLE 2-1 Characteristics of Major Violence Against Women Datasets
Has a
Direct
Question
on Violence
Against
Women
of Data
Dataset Sample Collection
Frequency Context
of
Survey
Use of
Health or
Social
Services
(by victin
Measuret
Supplementary Homicide
Homicide Reports incidents
(SHR) reported by
police
departments
National Crime
Victimization
Survey (NCVS)
National
sample of
households
National Incident- Criminal
Based Reporting incidents
System (NIBRS) reported by law
enforcement
agencies
National
Longitudinal
Study of
Adolescent
Health ADD
Health (NLSAH)
National
sample of
adolescents,
grades 7-12
Monitoring the National
Future sample of 8th,
10th, and 12th
graders
Pregnancy Risk
Assessment
Monitoring
System
(PRAMS)
National Youth
Survey
Continuous Criminal justice
Yes
Continuous Criminal justice Yes
Continuous Criminal justice Yes
Health No
Continuous Health No
Postpartum Continuous Health Yes
women from
32 states;
oversampling of
various racial/
ethnic groups and
women who
delivered low-
birthweight
children
National sample
of youth
Criminal Justice No
No
Health ar
some soci
No
Some hea
Some hea
and social
No
No
OCR for page 39
NATURE AND SCOPE OF VIOLENCE AGAINST WOMEN
rtasets
39
is a
rect
question
Violence
rainst
amen
Use of
Health or
Social
Services
(by victim)
Measured Etiologya
Comorbid
Factorsb
Can Be Prevalence
Assessed Data
Incidence Chronicity
Data Data
No Yes
No Yes
Yes No
Health and Potentially Potentially Potentially Yes Yes
some social
No No
No No Yes No
Some health Potentially No No Yes No
Some health Potentially Potentially Potentially Potentially Potentially
and social
No No
No Yes
No No Yes No
Yes Yes Yes Yes
Continued
OCR for page 40
40
TABLE 2-1 Continued
RESEARCH ON VIOLENCE AGAINST WOMEN
Has a Use of
Direct Health or
Question Social
Frequency Context on violence Services
of Data of Against (by victin
Dataset Sample Collection Survey Women Measurec
National Health Nationalsample Health No Health
and Social Life of general
Survey (NHSLS) population, aged
18-59
National College Nationalsample Health No No
Health Risk of undergraduate
Behavior Survey students
(NCHRBS)
National Physicians Continuous Health No Health
Ambulatory
Medical Care
Survey (NAMCS)
National Hospital National Continuous Health No Health
Ambulatory sample of
Medical Care patient record
Survey forms
(NHAMCS)
National Hospital National Continuous Health No Health
Discharge Survey sample of
(NHDS) inpatient record
forms for
short-term hospital
stays
National Health Nationalsample Continuous Health No Health ar
Interview Survey of households some soci
(NHIS)
National Survey Nationalsample Continuous Health No Health
of Family Growth of general
(NSFG) population,
aged 15-44
National Vital National sample Continuous Health No No
Statistics System of death
(NVSS) certificates
OCR for page 41
NATURE AND SCOPE OF VIOLENCE AGAINST WOMEN
41
is a Use of
rect Health or
question Social Comorbid
Violence Services Factorsb
,ainst (by victim) Can Be Prevalence Incidence Chronicity
amen Measured Etiologya Assessed Data Data Data
Health Yes Yes Yes Yes No
No No
Health No
Health No
Health No
No No Yes No
Yes No No No
Yes No No No
Yes No No No
Health and Potentially Yes Potentially Potentially Potentially
some social
Health No
No No
No No No No
No No No No
Continued
OCR for page 42
42
TABLE 2-1 Continued
RESEARCH ON VIOLENCE AGAINST WOMEN
Has a Use of
Direct Health or
Question Social
Frequency Context on violence Services
of Data of Against (by victin
Dataset Sample Collection Survey Women Measurec
National
Morbidity
Followback
Survey (NMFS)
National sample
of people who
have died in a
given year, with
oversampling of
African-Americans
Continuous Health
No
No
National Nationalsample Continuous Health No Health
Electronic Injury of emergency
Surveillance room visits
System (NEISS) involving injuries
National Nationalsample Continuous Health No No
Household of general
Survey on Drug population,
Abuse (NHSDA) aged 12 and up
National Violence National sample Criminal justice Yes Health
Against Women of general
Survey (NVAWS) population
New Hampshire Sample of Health Yes No
Youth at Risk New Hampshire
high school
students
National Surveys National Health Yes Social
of Family survey of families
Violence (NSFV)
Youth Risk Nationalsample Continuous Health Yes Health ar
Behavior of youth, social
Surveillance grades 9-12
System (YRBSS)
Behavioral Nationalsample Continuous Health Yes No
Risk Factor of general
Surveillance population
System (BRFSS)C
effects on violence against women.
aRisk factors for intimate-partner violence.
bother conditions that affect the magnitude of violence against women.
OCR for page 43
NATURE AND SCOPE OF VIOLENCE AGAINST WOMEN
43
is a Use of
rect Health or
question Social Comorbid
Violence Services Factorsb
,ainst (by victim) Can Be Prevalence Incidence Chronicity
amen Measured Etiologya Assessed Data Data Data
No Yes
Health No
Yes No No No
No No No No
No Potentially Yes No Yes Yes
Health Yes
No Yes
Social Yes
Health and Yes
social
No Yes
Yes Yes Yes Yes
Yes No No No
Yes Yes
No Yes
No Yes Yes Yes
Yes Potentially Potentially No
CNational data are derived from aggregating state statistics. States differ in their inclusion
of questions on intimate-partner violence and in the types of questions asked.
NOTE: Where geocodes are available, linkages could be used to examine area spatial effects
on violence against women.
OCR for page 44
44
RESEARCH ON VIOLENCE AGAINST WOMEN
fence perpetrated by both male and female members of a couple. Numer-
ous research publications have resulted from the data collected, some es-
timating the prevalence of intimate-partner physical violence, and others
examining associations between violence victimization and other topics
(Gelles and Straus, 1988; Straus et al., 1988; Gelles, 1987; Straus, 1979~. The
completion rate for the first survey was 65 percent of the entire sample; 84
percent of eligible respondents completed the second survey (Straus and
Gelles, 1986~.
Despite the prominent role of the NSFV in research on partner vio-
lence, it has several well-known limitations. The CTS assess violence only
in the context of a disagreement, and their earlier versions do not measure
the severity of behaviors reported. Also, their original format did not as-
sess a wide range of types of violence (including sexual violence). The
new CTS2 includes emotionally abusive and sexually violent tactics and
can be formatted so that the impact of a tactic is also measured. However,
neither form of the CTS gathers information concerning whether the vio-
lence used was defensive in nature a shortcoming of almost all current
instruments employed in measuring intimate-partner violence. Because
partner violence may best be conceptualized as a chronic condition that
encompasses interrelated ongoing events, examining such violent behav-
iors out of context may miss important dimensions of the overall situation
(Smith et al., 1999~.
The National Violence Against Women Survey (NVAWS) was de-
signed by Tjaden and Thoennes (1999) to remedy a limitation of the NCVS:
because the NCVS is a general crime survey aimed at generating annual
estimates of many types of crime, sample size constraints limit its useful-
ness as a source for better understanding historical and recent relational
contexts likely to be associated with violence against women. Using a ran-
dom-digit-dial household telephone survey, 8,000 women and 8,005 men
aged 18 and older were sampled throughout the United States from No-
vember 1995 to May 1996. The interviews were completed by 72 percent
of the women and 69 percent of the men sampled (Tjaden and Thoennes,
2000~. The NVAWS employed a modified version of the CTS to collect
data on physical assaults; data on sexual assaults and stalking, as well as
injuries resulting from these victimization experiences, were also col-
lected. This survey was unique among national surveys in its focus on
respondents' lifetime histories of violence and its attention to gathering
detailed information on perpetrators that could be linked across violent
incidents. Despite these advantages, however, the NVAWS did not pro-
vide estimates of violent victimization that are comparable to those ob-
tained by either the NCVS or the NSFV; the referent populations, some of
the screening questions, and the quantification of series victimizations all
differ. The NCVS focuses on assaults on respondents aged 12 and older,
OCR for page 45
NATURE AND SCOPE OF VIOLENCE AGAINST WOMEN
45
while the NVAWS focused on victimizations of respondents aged 18 and
older. The NCVS also differs from the NVAWS in the approach used to
count series victimizations.
The National Youth Survey is a nationally representative longitudi-
nal survey of 1,725 persons who were aged 11-17 in 1976 when the study
began and are now aged 37~3. The study has collected information on
these individuals over time to assess their changing attitudes, beliefs, and
behaviors with regard to deviance, exposure to delinquent peers, self-re-
ported depression, delinquency, drug and alcohol use, victimization,
pregnancy, abortion, use of mental health and outpatient services, vio-
lence by respondent and acquaintances, use of controlled drugs, and
sexual activity. Data are available on the demographic and socioeconomic
status of respondents, on parents and friends, and on neighborhood prob-
lems. The sample is 53 percent male and 47 percent female. The ethnicity
of participants is comparable to that of the general population of the
United States. The completion rate of eligible youth sampled was 73 per-
cent in the initial wave of the survey; the completion rate of original re-
spondents was 78 percent for the ninth wave in 1992 (Menard, 2002~. This
longitudinal survey reports on intimate-partner violence committed by
both male and female respondents. Its estimates of lifetime prevalence are
considerably higher than those derived from the surveys described above.
OTHER DATASETS
Supplementary Homicide Reports (SHR), part of the Federal Bureau
of Investigation's Uniform Crime Reporting (UCR) program, is a major
source of data on homicides (Bureau of Justice Statistics, 2002~. Supple-
mental reports on homicide incidents have been voluntarily submitted
monthly by local law enforcement agencies since 1976. These reports de-
tail such information as age, race, and sex of victims and offenders,
weapon use, circumstance of the crime, and the residential population
and county and Metropolitan Statistical Area (MSA) codes of the report-
ing agency. SHR is particularly useful for research on intimate-partner
homicide because it also collects data on the victim-offender relationship,
categorized as intimate (spouse, ax-spouse, boyfriend, or girlfriend), other
family, other acquaintance, or stranger. However, some limitations have
been noted. First, supplemental reports are voluntary; about 91 percent of
homicides reported in the UCR are included in SHR (Bureau of Justice
Statistics, 2002~. The actual incidence of homicides is underestimated com-
pared with the National Vital Statistics System of the National Center for
Health Statistics (Annest and Mercy, 1998~. Also, ethnicity is determined
by the observations of the reporting officer.
A number of other ongoing data collection efforts include questions
OCR for page 48
48
RESEARCH ON VIOLENCE AGAINST WOMEN
TABLE 2-2 Prevalence of Nonfatal Intimate-Partner Violence (IPV)
Physical Abuse (Past Year)
% Report
Survey Year Sample Measurement Female
National Prevalence Surveys
National Surveys 1975 Households containing Conflict Tactics 12.1% ova
of Family Violence cohabiting (married or Scale 3.8% sevt
nonmarried) couple
n = 2,143
1985 Households containing Conflict Tactics 11.3% ova
cohabiting (married or Scale, modified 3.0% sevt
nonmarried) couple
n = 3,520
National Alcohol 1992 Married and cohabiting Conflict Tactics 9.1% over
and Family Violence persons aged 18+ Scale, modified 1.9% sevt
Survey n = 1,970
NationalAlcohol 1995 Married and cohabiting couples Conflict Tactics 5.21%a to
Survey n = 1,599 couples Scale, modified
National Violence 1995-1996 Persons aged 18+ Conflict Tactics 1.3%
Against Women n = 8,000 women, 8,000 men Scale, modified
Survey
Married and cohabiting Conflict Tactics 1.1%
persons aged 18+ Scale, modified
n = 5,982 men, 5,655 women
NationalCrime 2001 Persons aged 12+ 0.43%
Victimization n = 79,950
Survey
Longitudinal Studies
Dunedin 1993-1994 Study participants aged 21 Physical abuse 40.9%
Multidisciplinary who were in romantic scale (CTS plus
Health and relationships and their 4 additional items)
Development Study partners n = 360 couples
Study participants aged 21 Conflict Tactics 38.8%
who were married or cohabiting Scale
n = 250
Study participants age 21 who Conflict Tactics 27.1% ova
were married, cohabiting, Scale
or dating n = 861
NationalYouth 1992 Study participants who were Conflict Tactics 20.2% ant
Survey married or cohabiting Scale
n= 1,340
aBoth partners reported the act occurred.
bOnly respondent reported the act occurred.
OCR for page 49
NATURE AND SCOPE OF VIOLENCE AGAINST WOMEN
V)
49
% Reporting IPV Physical Abuse Victimization
ment Female Male Total
Tactics 12.1% overall, 11.6% overall, 16.0% overall
3.8% severe 4.6% severe 6.1% severe
Tactics 11.3% overall, 12.1% overall, 15.8% overall
edified 3.0% severe 4.4% severe 5.8% severe
Tactics 9.1% overall, 9.5% overall,
edified 1.9% severe 4.5% severe
Tactics 5.21%a to 13.61%b 6.22%a to 18.21%b 7.84%a to 21.48%b
edified
Tactics 1.3% 0.9%
edified
Tactics 1.1% 0.6%
edified
0.43% 0.08% 0.26%
abuse 40.9% 47.4%
ES plus
anal items,
Tactics 38.8% 55.8°X
Tactics 27.1% overall, 12.7% severe 34.1% overall, 21.2% severe
Tactics 20.2% any, 5.7% severe 27.9% any, 13.8% severe
OCR for page 50
50
RESEARCH ON VIOLENCE AGAINST WOMEN
or to predict that a particular person will become a victim or an offender.
They can often, however, indicate propensities for and patterns of risk by
gender, race and ethnicity, and circumstances.
Gender
In general, overall victimization rates of women are low (compared
with those of men or juveniles, for example) an important reason for the
almost total absence of research on this problem historically. However,
the NCVS indicates that victimization by intimates accounts for 20 per-
cent of violence experienced by women and 3 percent of that experienced
by men (Rennison, 2003~. Moreover, because women are most often vic-
timized in "safe spaces" where no one witnesses the crime, they are more
vulnerable to repeat attacks and are more likely to be severely injured or
killed by intimate partners than by others. It is for these reasons that most
research on the victimization of women has focused on intimate-partner
violence (Bureau of Justice Statistics, 2000; Tjaden and Thoennes, 2000;
National Research Council, 1996~.
Interestingly, in nationally representative longitudinal studies in the
United States and the above-described 21-year birth cohort study in New
Zealand, women have reported higher levels of perpetration of intimate-
partner violence than men, and men higher levels of victimization than
women (Moffitt and Caspi, 1999~. Some scholars have attributed this dis-
crepancy to methodological problems in the CTS, which were used in
these studies. Moreover, when serious violence (i.e., resulting in severe
injury or death) is the focus, women do not report such higher levels of
perpetration (Kruttschnitt, 2002~. Moffitt and Caspi (1999) also note that
male perpetrators are much more deviant (e.g., more likely to use illegal
drugs or be chronically unemployed) than their female counterparts. Fi-
nally, it is intriguing to note that rates of violent victimization have been
declining overall. However, violence against women for all crime types
has been declining at lower rates than that against men (Bureau of Justice
Statistics, 2000~.
Race and Ethnicity
In a paper prepared for the workshop, Dugan and Apel (2002) use
data from the NCVS over an 8-year period (January 1992 to June 2000) to
model risk factors for all cases of nonlethal violent victimization of
women. They note that until recently, researchers limited investigations
of violence to African-American and white women, lumping groups such
as Asian/Pacific Islanders and Native Americans into a generic "other"
OCR for page 51
NATURE AND SCOPE OF VIOLENCE AGAINST WOMEN
51
category or omitting them entirely (Dugan et al., 2000; Bureau of Justice
Statistics, 2000; Greenfield et al., 1998~.2
The usefulness of disaggregating female victims by race is under-
scored by the analysis of Dugan and Apel, who found that Native Ameri-
can women have considerably higher rates of victimization than other
groups of women, they appear most likely to be victimized by someone
they know, and their assailant is often using drugs or alcohol. Asian
women have the highest proportion of incidents in public places and are
more likely to be victimized by sober strangers or multiple offenders.
White, African-American, and Hispanic teenage girls all have higher odds
of victimization than young adult women, and those aged 60 or older
display a significantly low risk. Having some college, but not 4 years, is
positively related to violence for African-American and Hispanic women.
Residential stability as measured by number of months living at the same
location appears to lessen the risk for white and African-American women
only.
Circumstances
Dugan and Apel (2002) found that the strongest risk factor for violent
victimization of women is living in a household with one adult and chil-
dren. This risk is greatest for Asian/Pacific Islander women. Controlling
for other indicators of poverty, living in public housing is also a risk, es-
pecially for African-American and Hispanic women. Dugan and Apel
(2002) conclude that living in the city, having more or younger children,
or having low income appears to raise the risk of violence for all but His-
panic and Asian women. Moffitt and Caspi (1999) found that risk factors
for female perpetrators of partner violence include disturbed family rela-
tionships, especially weak attachments, harsh discipline, and conflict be-
tween parents.
Although most research in this field reflects the belief that female vic-
timization may be driven by some factors that differ from those affecting
rates of male victimization, existing longitudinal studies point to risk fac-
tors that are similar to those for other kinds of criminal offending and
victimization (Moffitt and Caspi, 1999; Straus and Gelles, 1992; Elliott et
2An important exception is the survey by Tjaden and Thoennes (2000), which describes
differences in lifetime prevalence of violent victimization for Asian/Pacific Islander, Native
American (including Alaskan Native), and mixed-race women (see also Rennison, 2001~.
Such analyses are, however, typically bivariate, leaving unanswered the question of which
risk factors are of greater concern for any one group over the others.
OCR for page 52
52
RESEARCH ON VIOLENCE AGAINST WOMEN
al., 1986~. Thus, an important research question is which risk factors spe-
cific to partner violence or other violence against women do not apply
also to criminal offending or victimization in general. For example, most
studies of homicide against women have been descriptive in nature and
have focused on the murder of women by intimate male partners. More
information about the characteristics of the killing of women in other cir-
cumstances would be helpful in understanding the lethal victimization of
women in the context of homicide studies in general.
Health Consequences of Violence
It is widely recognized that violence against women, including inti-
mate-partner violence, sexual assault, and rape, is associated with nega-
tive physical and mental health outcomes. Many studies have found a
correlation between violence against women and emotional and physical
health problems that go beyond the immediate effects of the abuse. Rela-
tionships have been found between previous physical abuse of women
and stress-related physical health problems (Campbell et al., 2002b;
Sutherland et al., 1998; Koss and Heslet, 1992), gynecological problems
(Campbell et al., 2002b; Coker et al., 2000; Letourneau et al., 1999; Golding,
1996), and neurological injuries (Campbell et al., 2002b; Coker et al., 2000;
Diaz-Olavarrieta et al., l999~. A recent meta-analysis revealed that women
who experience domestic violence have elevated rates of insomnia, de-
pression, post-traumatic stress disorder, panic disorder, and substance
abuse symptoms that can persist for years after the abuse ends (Golding,
1999~.
One concern noted in Understanding Violence Against Women is that
part of what is known about the health of abused women is provided by
studies using samples drawn from women seeking medical care or from
health plan populations. Such samples may not be representative of all
victims: there may be differences in injury types, and uninsured women
may not seek care. Hathaway et al. (2000) found that there was no differ-
ence between abused and nonabused women in rates of routine health
care, although abused women were less likely to have health insurance.
Lemon et al. (2002) report no differences in checkups and clinical breast
examinations, but note that abused women are more likely to undergo
Pap smear screening. However, findings of recent studies using popula-
tion-based samples are largely consistent with findings of studies using
clinic or health plan populations in showing that women who have been
abused are more likely to report physical or emotional disabilities, smok-
ing, unwanted pregnancy (Hathaway et al., 2000), high-risk alcohol use
(Lemon et al., 2002), gynecologic problems (Plichta and Abraham, 1996),
and mental health problems (Hathaway et al., 2000; Danielson et al., 1998~.
OCR for page 53
NATURE AND SCOPE OF VIOLENCE AGAINST WOMEN
53
In the Dunedin sample, 65 percent of women who had experienced
severe abuse met criteria for one or more disorders listed in the Diagnos-
tic and Statistical Manual of the American Psychiatric Association (DSM
III-R). Abused women in this cohort were three times more likely than
nonabused women to suffer a mental illness. Their disorders included
depression, drug dependence, antisocial personality disorder, and schizo-
phrenia (Moffitt and Caspi, 1999~.
An important concern remains with regard to establishing causality.
Most studies focus on correlates of violence, failing to establish the tem-
poral sequence of events and leaving the pathways between abuse and
health outcomes unspecified. Many victims of intimate-partner violence
have reported problems, such as unemployment, lack of transportation,
substandard housing, and financial difficulties, that may predispose
women to poor health outcomes (Browne et al., 1999; Eby, 1996; Sullivan
et al., 1992~. One population-based study, by Sutherland et al. (2001), ad-
dressed this problem by investigating whether intimate-partner violence
has a significant effect on women's health beyond that which can be ex-
plained by poverty. Both income and physical abuse contributed to
women's rates of physical health symptoms, and abuse contributed to the
variance in physical health beyond that predicted by income level alone.
Additional research is needed to further explain the direct and indirect
causes of health problems experienced by victims of abuse.
Risk of Injury and Death
Dugan and Apel (2002) measured the likelihood of injury in all types
of violent crimes against women. They found that crimes involving physi-
cal contact with known persons and the presence of a weapon were pre-
dictors of severe injury. According to the NVAWS, 36 percent of women
who had been raped since age 18 and 42 percent of women who had been
physically assaulted since age 18 reported that they had been injured dur-
ing their most recent victimization. However, most of the injuries were
relatively minor (scratches, bruises, welts), while more serious injuries
(broken bones, dislocated joints, concussions, lacerations, bullet wounds)
were sustained by relatively few of the victims (Tjaden and Thoennes,
2000~. In a study by the RAND Corporation, intimate-partner violence
was found to be one of the most common causes of injury in women
(Rand, 1997~.
When survivors of serious injury are compared with those who
were killed, findings suggest that women who are harmed by their hus-
bands, as opposed to a live-in boyfriend or acquaintance, are overrepre-
sented as victims of homicide (Dugan and Apel,2002~. The Dunedin study
found that men who severely injured their partners demonstrated extreme
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RESEARCH ON VIOLENCE AGAINST WOMEN
levels of deviance as characterized by polydrug use, antisocial personal-
ity disorder, chronic unemployment, and violent acts against persons out-
side the family (Moffitt and Caspi, 1999~. In preliminary findings from her
study of women killed by their intimate partners, Campbell (2002) found
the most important pre-incident demographic risk factor in predicting le-
thality in abusive relationships to be perpetrator unemployment.
Dawson (2002) describes a recent framework that has been applied
to understanding declines in intimate-partner homicide (see also Dugan
et al., 1999, 2000~. The "exposure reduction" framework highlights key
social changes that may have contributed to the decline in intimate-part-
ner homicide in recent decades. These include changes in the nature of
intimate relationships fewer and/or delayed marriages and more di-
vorce; improved socioeconomic status of women, including increasing
gender equality; and the increased availability of domestic violence re-
sources, including legal and social services (e.g., domestic violence courts,
shelters). Considering that intimate-partner homicide is often preceded
by a history of intimate-partner violence, the exposure reduction frame-
work holds that the impact of social changes that help abused women
exit violent relationships or prevent women from entering such relation-
ships may also reduce the rate of intimate lethal victimization. Further
research is needed on the potential of this framework for increasing un-
derstanding of murders and assaults of women. If we are to be able to
prevent such crimes, moreover, longitudinal research in the United States
is needed to determine which risk factors (if any), for which groups of
women, are truly unique to lethal events or outcomes involving severe
injury. The committee recommends that work be initiated to examine the
feasibility and cost-effectiveness of successfully conducting such longi-
tudinal studies.
METHODOLOGICAL ISSUES
Improving Measurement
As noted above, many federally and some privately sponsored data
collections include information on violence against women. As noted ear-
lier, in 1998, NIT and CDC sponsored a conference on improving research
on violence against women. The matrix produced at that conference (the
basis for Table 2-1) categorizes the existing datasets relevant to this re-
search according to the following characteristics:
· Whether the survey was a one-time only study or continuous. Con-
tinuous was defined as conducted at regular intervals (e.g., every 6
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NATURE AND SCOPE OF VIOLENCE AGAINST WOMEN
55
months in the case of the NCVS, annually in the case of the Youth Risk
Behavior Survey) and expected to be conducted (repeated) in the future.
· Whether the survey was precise (generally defined as designed to
minimize standard measurement errors).
· Whether a supplement or follow-back could be undertaken to bet-
ter estimate violence against women.
· Whether the survey was a health or criminal justice survey.
· Whether there was a social service utilization measure for violence
against women.
· Whether risk factors for violence against women could be esti-
mated from the survey.
Despite the variations in the quality of the various surveys listed in
Table 2-1, creating linkages among existing survey data would provide
important additional resources for scholars interested in the contexts and
outcomes of violent victimization. Generally, such linkages will not be
possible across individuals in the different datasets but may be possible
across common geographic areas, for example, states or cities. In addi-
tion, linkages between national-level surveys can be developed that relate
differing characteristics of events to one another. A good example is the
research on the outcomes of violent victimization based on the merging of
data from the SHR with NCVS data (see Felson and Messner, 1996; Kleck
and McElrath, 1991~. If the NCVS could be linked to data from the Na-
tional Health Interview Survey, information could be obtained on health-
related outcomes of violent injuries. Research is needed on the feasibility
of linking different datasets and on how to validate survey data with data
on clinical, legal, and social outcomes. An important aspect of this linking
process will be developing a framework for standard definitions.
To advance understanding of violence against women, the constructs
researchers use must be valid and reliable across different social settings,
samples, and measurement conditions. Currently, the behaviors used to
measure or operationalize "violence" or abuse are wide-ranging, and this
seriously compromises our understanding of the prevalence and distribu-
tion of violence against women. For example, even where the same mea-
sures and comparable samples are used, prevalence estimates differ by a
factor of 2 (see Moffitt and Caspi, 1999~. Part of the problem is a lack of
information on the amount of harm or the nature of an injury resulting
from a violent act. As Johnson (1995) demonstrates, research that uses the
CTS and does not tap the consequences of various violent tactics comes to
a very different conclusion about the prevalence of violent victimization
among men and women than would be derived from agency or official
data. Although much of Johnson's argument revolves around sampling
issues rather than measurement issues, there is no question that differ-
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RESEARCH ON VIOLENCE AGAINST WOMEN
ences in what is counted as a violent act (e.g., pushed or shoved versus
broken bones) affect how many women and men are classified as victims
of intimate-partner violence. These discrepancies in findings raise a cen-
tral question: What elements should be included in the definition of vio-
lence, or what kinds of behaviors should be considered violent? Cook
(2000) documents at least 29 different measurement instruments used in
research on violence against women. These measures vary not only in the
types, levels, and degrees of coercion they measure, but also in the sever-
ity of the acts they include. Rigorous inquiry into violence against women
is precluded when scholars fail to distinguish among what constitutes an
act of violence, abuse, or battering.
The NSFV suggests that abuse has a normative criterion but uses the
terms "abuse," "assault," and "violence" relatively interchangeably, dif-
ferentiating only between what are termed "minor" and "severe" violent
acts based on the potential risk of injury (Straus and Gelles, 1992:75-85~.
These terms fail to distinguish among physical violence, physical aggres-
sion, and psychological abuse. This lack of conceptual and operational
clarity is particularly problematic when attempts are made to compare
survey findings with data on clinical populations, among whom abuse
may be determined by specific medical criteria. It is also problematic con-
sidering that what constitutes being victimized and what constitutes of-
fending may be culturally determined. If we want to be able to determine
whether critical aspects of abusive and violent behaviors against women
(e.g., their prevalence, incidence, and distribution) differ from those of
other kinds of violent behavior, we need to employ consistent definitions
and measures.
This distinction between nominal and operational definitions applies
not just to questions of how violence or abuse is measured, but also to
questions of how different research settings introduce measurement prob-
lems. Violence may be operationalized differently in clinical, legal, and
research settings or, as occurred in the redesign of the NCVS in 1992, even
within the same setting over different periods of time.
Causes, correlates, and epidemiological and survey estimates of vio-
lence may all be sensitive to the conceptual and operational clarity
of definitions. Far more than half of violent crimes against women re-
main unredressed, in large part because they are unknown to criminal
justice authorities. Scholars have developed some important methods for
assessing this so-called "dark figure of crime," but a large proportion of
violent crimes perpetrated between intimates and family members are
still unreported.
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NATURE AND SCOPE OF VIOLENCE AGAINST WOMEN
Improving Research
57
The committee recommends more research to examine the situational
contexts and dynamic interactions that lead to violence against women.
Research on violent events complements studies of the individual pro-
pensities of victims or offenders, and focuses instead on the occurrence of
violence, identifying the specific conditions that channel individual moti-
vation and predispositions into violent actions. This approach addresses
the social or psychological pathways that bring individuals to specific vio-
lent events and the transactions or decisions that comprise the onset,
course, conclusion, and aftermath of the event.
Recent studies on interpersonal violence among strangers illustrate
the confluence of motivation, perceptions of risk and opportunity, and
the social control attributes of the setting that shapes the decision to par-
ticipate in a violent event, as well as its outcome (Wilkinson and Pagan,
2001~. Other research shows that violence against women serves specific
functions for assailants, and that those functions may covary with the type
of assault. Tedeschi and Felson (1994) hypothesize that all violence is re-
lated to one or more of the following three goals: compliance, identity,
and justice. To understand the catalyst for a violent event among inti-
mates, researchers must examine the social construction and discourse on
male-female relationships, perceived imbalances in power, control dy-
namics, identity threats, relationship problems, and communication pat-
terns . It is important to recognize that "when violence occurs it is not an
isolated event in peoples' lives, but is embedded firmly in the process of
interpersonal communication which people use to regulate their lives" .
Research on the "sparks," motivations, interaction patterns, and decision
making associated with violent events can identify leverage points for
reducing the threat of violence or averting it entirely.
Some violent events against female victims are stranger assaults, and
understanding the situational and structural contexts of those events pro-
vides another window on social factors that elevate risks beyond those
attributable to individual offenders or victims. While women's victimiza-
tion results from various forms of violence, there are commonalities across
those events that can be examined to provide a differentiated understand-
ing of the unique and shared risks involved. The following are some ex-
amples of research on situational contexts and violent interactions:
· Research on the processes of victim selection Stranger assaults
may appear at first glance to be random occurrences, but there are processes
of victim selection that can be studied to identify attributes of individuals,
settings, and social interactions that may motivate victim selection.
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RESEARCH ON VIOLENCE AGAINST WOMEN
· Research on location selection The selection of locations for as-
saults against women may reflect a rational decision-making process that
can be modified to reduce risk and prevent physical or sexual assault.
· Research on victim-offenderinteraction patterns Studies of the
patterns of social interaction in stranger violence have generated robust
theories of violent interaction that can be extended to the unique circum-
stances of gender-related assaults. Studies of these interaction patterns in
domestic violence show how personality factors interact with situational
contexts to launch interaction dynamics that end in assaults by male inti-
mate partners against women (see Jacobson and Gottman, 1998; Wilkinson
and Hamerschlag, 2002; Wilkinson and Pagan, 2001~. Replications and
extensions of this research should encompass a more diverse set of rela-
tionships and different types of assault. These studies should examine
and decompose the stages of violent events from arousal to aggression-
to identify behavioral scripts or cognitive frames that are amenable to in-
tervention or prevention efforts.
Several datasets currently available can be examined to begin the pro-
cess of theory construction. Research designs using survey methods, event
history research with samples of individuals, and laboratory experiments
can begin to generate the empirical data that will produce a more refined
and productive knowledge base from which prevention efforts can be
launched.
CONCLUSION
Although progress has been made in the effort to measure and under-
stand the nature of violence against women, a more coordinated research
strategy would help remedy the measurement problems that remain. The
committee recommends that an effort be made to investigate how to link
different datasets and how to link information from these datasets with
findings from clinical research to provide more information on the risks
of, responses to, and consequences of violence against women and the
impact of interventions. Such an effort should include the formulation of
a framework for developing standard definitions to overcome the lack of
conceptual and operational clarity, as well as other problems involved in
measuring violence against women, especially differences in sample se-
lection among studies. In addition, more attention should be devoted to
developing event-based measures of violence against women.
Representative terms from entire chapter:
potentially potentially potentially
