Assessing Physical, Sexual, and Psychological Violence Perpetrated by Intimate Male Partners toward Women: A Spanish Cross-Sectional Study

Article excerpt

There have been many studies on the impact of intimate partner violence (IPV) on women's health, there being agreement on its detrimental effect. Research has focused mainly on the impact of physical violence on health, with few studies assessing the effect of sexual and psychological violence. Furthermore, there are many differences in the way violence experienced by women is assessed. While some researchers use available instruments, others develop their own questionnaires. This article gives detailed information about physical, sexual, and psychological violence, lifetime history of women's victimization, and aspects of women's behavior and feelings obtained with the questionnaire used in a Spanish cross-sectional study. Our results corroborate that IPV is not homogeneous, it being necessary to ask women about each type of violence they have experienced. Furthermore, to accurately assess the impact of IPV on women's health, it is necessary to control for other variables that also have detrimental effects on health.

Keywords: intimate partner violence; women; physical violence; sexual violence; psychological violence; lifetime history of intimidation

During the last two decades, there have been many studies on the impact of intimate partner violence (IPV) on women's health (Campbell, 2002; Golding, 1999; Martinez, Garcia-Linares, & Pico-Alfonso, 2004), there being agreement on its detrimental effect. However, the current instruments to measure the phenomena of battered women's experience are very different and do not capture a complete understanding of it (Dutton, 1999; Smith, Smith, & Earp, 1999). Thus, it is necessary to obtain a clear picture of this experience of violence in order to accurately assess its impact on their health and long-term recovery.

Research has mainly focused on the impact of physical violence on health. However, although it has been estimated that sexual violence is concomitant with physical violence in approximately 40% of all cases (Campbell & Alford, 1989), its impact has been assessed in few studies (e.g., Bennice, Resick, Mechanic, & Astin, 2003; Eby, Campbell, Sullivan, & Davidson, 1995). Furthermore, although women may also be physically and sexually attacked during pregnancy, very few studies ask women about this (Murphy, Schei, Myhr, & Du Mont, 2001; Saltzman, Johnson, Gilbert, & Goodwin, 2003).

Most women who are physically abused by their intimate male partner are also psychologically abused by him (Coker, Smith, McKeown, & King, 2000; Follingstad, Rutledge, Berg, Hause, & Polek, 1990; Ratner, 1993), but few studies have been carried out to determine the impact of this concomitance on health (e.g., Arias & Pape, 1999; Coker, Smith, Bethea, King, & McKeown, 2000; Dutton, Goodman, & Bennett, 1999; Sackett & Saunders, 1999). Difficulties in operationalizing and measuring psychological violence may have impeded progress. Studies indicate that the existence of psychological violence is reported by women as having a worse effect than physical violence, and is strong enough to predict posttraumatic stress disorder, depression, and low self-esteem (Aguilar & Nightingale, 1994; Sackett & Saunders, 1999; Street & Arias, 2001; Vitanza, Vogel, & Marshall, 1995). The impact of psychological violence alone has been relatively understudied. In general, it has been found that it can be as devastating on health, if not more so, than physical violence (Aguilar & Nightingale, 1994; Coker, Smith, Bethea, et al., 2000; Follingstad et al, 1990; O'Leary, 1999).

Thus, there is little systematic, empirical documentation on the concurrency of the three types of violence (physical, sexual, and psychological) and their separate occurrence (Aguilar & Nightingale, 1994; Coker, Smith, McKeown, et al., 2000). It is important to keep in mind that women are not homogeneous in their experience of battering; and, therefore, it is necessary to explore more accurately the impact that the different types of violence have on women's health. …