Intimate Partner Violence

A Guide for Psychiatrists Treating IPV Survivors

The term "Intimate Partner Violence" describes physical, sexual or psychological harm done to an individual by a current or former partner or spouse.

Despite adverse mental health consequences associated with Intimate Partner Violence (IPV), the mental health needs of IPV survivors often goes unmet. Lack of universal screening, stigma, and fear of retaliation by intimate partners may prevent survivors of IPV from disclosing their situations to mental health providers. IPV survivors often have immediate needs for safety and resources to improve their ability to cope, establish independence from their abusive partners, and engage in treatment.

This toolkit intends to help mental health providers in treating IPV survivors. It includes definitions associated with IPV, data on the prevalence of IPV, and the impact of IPV on survivors and their families. The toolkit also includes information on IPV among:

  • Women
  • Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) Community
  • Immigrants and Refugees

Definition, Epidemiology and Risk Factors of IPV

"Intimate Partner Violence" describes physical, sexual or psychological harm by a current or former partner or spouse. Approximately 1 in 4 women and 1 in 9 men in the United States have experienced rape, physical violence and/or stalking by an intimate partner in their lifetime.

Although IPV affects individuals across race/ethnicity, gender, and socioeconomic background, minority women experience IPV at disproportionately high rates (see table below).

Other risk factors for IPV include socioeconomic deprivation (low income and lower educational status), exposure to adverse childhood experiences (ACEs), young age, unemployment, and being a member of a sexual minority.

National Lifetime Prevalence Rates of Violence by Race/Ethnicity
  White Black Asian/ Pacific Islander Hispanic American Indian
Women N=645 N=780 N=133 N=628 N=88
Rape 7.7% 7.4% 3.8% 7.9% 15.9%
Physical 21.3% 26.3% 12.8% 21.2% 30.7%
Stalking 4.7% 4.2% -- 4.8% 10.2%
Overall 24.8% 29.1% 15.0% 23.4% 37.5%

Impact of IPV on Mental Health

The impact of IPV affects survivors differently. Some may exhibit adaptive and resilient responses to abuse, while others may develop psychiatric symptoms.

Approximately 20% of IPV survivors reported experiencing a new onset of psychiatric disorders such as major depressive disorder (MDD), generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD) and a wide range of substance use disorders.

Survivors often internalize the verbal abuse from their partner. They may blame themselves for their situation, experience fear, as well as anger and resentment towards themselves. Chronic abuse may result in compulsive and obsessive behaviors and lead to self-destruction or suicide.

After enduring abuse, trauma reactions may lead survivors to experience difficulties in new relationships. IPV-associated abuse may affect emotional regulation, facial interpretation, and reading of social cues.

Physical Health Effects of IPV

IPV survivors are more likely to experience higher rates of health problems and perceive their overall health as poor.

The most common physical symptoms include injuries, headaches, insomnia, chronic pain, choking sensations, hyperventilation, and gastrointestinal symptoms, chest, back, and pelvic pain.

Traumatic brain injury (TBI) and nonfatal strangulation (choking) are often unrecognized forms of IPV and can lead to significant short and long-term neurologic sequelae. (See references and appendix in the Women's section for more information)

IPV can also result in unplanned pregnancies and pregnancy complications for the mother and child. IPV survivors are disproportionately affected by comorbid HIV/AIDS with substance use disorders.

 

Intimate Partner Violence
Population Specific Information

Learn more about treating patients who have experienced IPV:

Intimate Partner Violence Home

Authors
  • Mayumi Okuda Benavides, M.D., Assistant Professor, Columbia University, Department of Psychiatry
  • Obianuju O. Berry, M.D., M.P.H., Postdoctoral Clinical/Research Fellow, Columbia University
  • Molly Mangus, Former Policy Advisor, NYC Mayor's Office to Combat Domestic Violence
Physician Reviewed

Carole Warshaw, M.D.

  • Director, National Center on Domestic Violence, Trauma & Mental Health
  • Executive Director, Domestic Violence & Mental Health Policy Initiative
About the Toolkit

This introductory guide offers an array of topics that will be essential in understanding how to work with patients who have experienced intimate partner violence. It provides basic information to raise awareness of the needs of these patients. This toolkit does not represent official APA policy, but offers a perspective from physicians that work with this community on a regular basis. The objective of this toolkit is to help a broader range of psychiatrists become familiar with best practices for treating IPV patients. Please consult the references included in each section for further reading.