By Mahoney, Diana
Clinical Psychiatry News , Vol. 33, No. 12
Most interventions for domestic violence are, by design, crisis oriented. They seek to curtail the cycle of violence by identifying, protecting, and perhaps strengthening people who have already been injured, by attempting to rehabilitate perpetrators, or by promoting community awareness of the problem.
Such interventions are effective--to a degree. According to national statistics, domestic violence-related homicides have decreased significantly over the last 20 years, presumably in part because of increased public awareness and the growing number of resources available to help victims. But these interventions do not prevent the damage from occurring in the first place, because they often fail to go deep enough into the gnarled root system to address the core causes.
According to the CDC's National Center for Injury Prevention and Control, domestic violence incidents cause nearly 2 million injuries and 1,300 deaths each year. "Across the country, more than three women are murdered by their husbands or boyfriends every day. One in every three women will be physically assaulted by a partner, and every year, 10 million children experience domestic violence in their homes," said Judith Kahan, chief executive officer of the Center Against Domestic Violence in Brooklyn, N.Y. "In New York City, if you added up all the reported robberies, burglaries, and murders in 2003 and multiplied that number by 2, it still would not equal the number of calls received by the city's domestic violence hot line."
In addition to the physical, emotional, and social costs of such abuse, the financial costs are estimated to exceed $8 billion, including the direct costs of medical and mental health care and the indirect costs of lost productivity (Violence Vict. 2004;19:259-72).
Preventing domestic violence deserves top priority on the nation's public health agenda. Yet trying to stop domestic violence without getting to its root can be compared to pulling a dandelion out of the ground from its head: The grass looks better for a while, but the weed continues to thrive.
The challenge of addressing the issues that live below the surface is exacerbated by the numerous theories on the underlying causes of domestic violence. For example, the biological theory suggests that violent behavior can be explained by genetics, biochemistry, and changes in brain development related to early trauma.
Some researchers believe domestic violence is rooted in individual psychopathology or dysfunctional personalities, likely shaped by early childhood experiences that lead to an inability to regulate emotions, develop trust in others, and have healthy relationships.
Another theory suggests that domestic violence is rooted in dysfunctional family interactions. Related to this is the social learning and development theory, which suggests that domestic violence is learned through exposure to behavior that is modeled, rewarded, and supported by families and cultures. In other words, if children grow up in families for whom aggression is the main type of conflict resolution, they will model that in their own relationships.
Finally, the societal structure theory holds that domestic violence reflects women's historical cultural inequality, and the reinforcement of this in political and economic arenas.
Significant overlap exists among the theoretical models, and experts in all camps would likely agree that domestic violence is a complex problem affected by multiple variables, the seeds of which are often sewn in childhood. For this reason, prevention efforts that seek to intervene before the seeds have an opportunity to take root--especially in higher risk populations, including females, racial minorities, and children from families living in poverty--hold the most promise.
For example, a longitudinal evaluation of a CDC-supported domestic violence prevention program called Southside Teens About Respect (STAR) in Chicago showed that awareness workshops conducted in various community locations and a school-based curriculum led to substantial improvements in participants' conflict behavior, self-ratings of relationship skills, help-seeking attitudes, and beliefs about violence in relationships. …