Domestic violence is
abuse that happens in a personal relationship. It can happen between past or
current partners, spouses, or boyfriends and girlfriends.
violence affects men and women of any ethnic group, race, or religion; gay or
straight; rich or poor; teen, adult, or elderly. But most of its victims are
women. In fact, 1 out of 4 women will be a victim at some point.1
The abuser may use fear, bullying, and threats
to gain power and control over the other person. He or she may act jealous,
controlling, or possessive. These early signs of abuse may happen soon after
the start of the relationship and might be hard to notice at first.
After the relationship becomes more serious, the abuse may get worse.
Money troubles and problems with drugs or alcohol can make it more
likely that abuse will happen.
Abuse is also common in teens who
are dating. It often happens through controlling behaviors and jealousy.
It's important to get help. Talk with someone you trust, such as a friend, a help center, or your doctor. Talking with someone can help you make the changes you need.
Your first step is to contact a local advocacy group for support, information, and advice on how to stay safe. Call the National Domestic Violence Hotline at 1-800-799-SAFE (1-800-799-7233) for the nearest program. The hotline is available 24 hours a day, 365 days a year, in English, Spanish, and other languages.
You can also see the National Coalition Against Domestic Violence website at www.ncadv.org/resources/StateCoalitionList.php to find the program nearest to you that offers shelter and legal support.
Here are some other things you can do:
Here are some things you can do to help:
Keep in mind that the person may not want or be ready to leave. He or
she probably knows the abuser best and knows what options are safest. But it is
important for victims of abuse to know where they can get help.
People who are not abused
might find it hard to understand why anyone would stay in a violent
relationship. Some people think that if a person stays in an abusive
relationship, she or he must be weak or needy. This is not true.
There is more to this issue than simply leaving or staying. A woman may
fear that the abuser will hurt her and her children or take her children away.
She may have limited financial options. She may blame herself. She may stay for
religious reasons or because she does not want to break up the family. Also,
she may still love her abuser and hope that things will get better. Men who are being abused may have similar feelings.
Domestic violence hurts victims as well as their families. Don't ignore
People who suffer from abuse can be badly hurt. They are also
likely to have long-lasting (chronic) health problems, such as
depression, headaches, and
post-traumatic stress disorder. This is because of the
repeated injuries and stress from living with abuse.
happen more often and get worse when women are pregnant. It is dangerous for
both the mother and the baby. It can raise the baby's risk of low birth weight,
premature birth, and death.
The pregnant woman is at higher risk of other problems, such as infections and
And abuse has a big effect on children. Children who live
in a home where abuse happens see violence as a normal way of life. It also
raises their chance of being in a violent relationship as adults, either as
abusers or as victims.3 Teens are at greater risk
for depression, drug and alcohol use, and unsafe behavior.
Learning about domestic violence:
Stopping domestic violence:
Most relationships have
difficult times, and almost every couple argues now and then. But violence is
different from common marital or relationship problems.
Domestic violence is a pattern of abuse that a
partner—former or current partner, spouse, or boyfriend or girlfriend—uses to
control the behavior of another.
Domestic violence often starts
with threats, name-calling, and slamming doors or breaking dishes, and
it can build up to pushing, slapping, and other violent acts. If you are concerned about your relationship, ask yourself the
Does your partner:
If any of these things or other types of abuse are happening, you need to seek
help. It's important to know that you are not alone. The way your partner acts is not your fault. Help is available.
Do you have a friend, coworker, relative, or neighbor who
you think may be in an abusive relationship?
Here are some signs to watch for:
Other warning signs:
Be supportive, and let your friend know that you are there to listen and help. For more information, see How To Help.
Domestic violence affects all types of people,
regardless of gender, ethnicity, race, sexual identity, social status,
Many people have been hurt by domestic violence. About 25% of women (25 out of 100) and 8% of men (8 out of 100) in the United States have been physically
and/or sexually abused by an intimate partner at some point in their adult
lives.1 But just because it happens a lot doesn't make it okay.
Here are some things you should know:
Other things that can put you at risk include having a partner who has lost a job or who has medical or mental health problems.
Domestic abuse is also a
big problem among the elderly. For more information, see
Domestic violence is the most common cause of
injury to women ages 18 to 44 in the United States. After abuse starts, it usually continues. And it's likely to get worse over time. Abuse that starts with a slap
may build up over time to kicking and shoving and finally choking.
The repeated injury and stress of living in a violent
relationship can cause long-lasting health problems, such as:
have a higher risk of major health problems. Women who are abused are also more likely to smoke or abuse
alcohol, which can also lead to health problems.5 Other health problems linked to sexual abuse include sexually transmitted infections (including
HIV/AIDS) and unintended pregnancies.
Pregnancy can be an especially
dangerous time for women who are in abusive relationships. Abuse may get worse or even start during pregnancy. As many as 4% to 8% of all pregnant
women are in abusive relationships.2 Problems during pregnancy, such
as low weight gain,
anemia, infections, and bleeding, are higher for these
Babies who are born to abused women also suffer. Abuse during
pregnancy has been shown to increase the baby's risk of low birth weight,
premature birth, and death.2
There's no excuse for abuse. If you are being abused, it's time to get help. You deserve to be safe. Call the National Domestic Violence Hotline at 1-800-799-7233.
When there's violence in the home, children are always affected, even if they're asleep or not in the room when the abuse happens. The longer you live in a violent situation, the harder it will be for your children.
When abuse happens, your children may feel scared and ashamed, or they may even think that they caused the problem. Worse, they can grow up thinking that it's okay to hurt others or let other people hurt them.
Abuse also affects:
Asking for help is hard. But it's important for you and your children that you get the support you need. You and your children deserve to be safe. When you leave an abusive
relationship, you show by example that violence is wrong and that it's possible to make healthy choices.
People who are not abused might
find it hard to understand why anyone would stay in an abusive relationship. Victims are often blamed. Some
people falsely believe that if a person stays, she
or he must be weak or needy. This is not true.
Changing or ending any relationship is hard. It can be even harder when the relationship is abusive. People stay for many reasons, such as:
Many victims of
domestic violence are willing to talk about their
relationship when they are approached in a kind and understanding manner. But
don't confront a victim if the person is not ready to talk. Let the person know
you are willing to listen whenever he or she wants to talk. Be understanding if
the person is unable to leave. He or she often knows the situation best and
when it is safest to leave.
Reassure the person that the abuse is
not his or her fault and that no one deserves to be abused. If the person has
children, gently point out that you are concerned that the violence is
affecting them. Many victims do not understand that their children are being
harmed until someone else voices the concern.
Remind the victim
that domestic violence is against the law and that help is available. You may
be able to help a victim understand his or her options. Be willing to assist in
any way you can with transportation, money, or child care. Encourage your
friend to talk with a health professional.
The most dangerous
time for a victim of domestic violence can be when the person is leaving an abusive
relationship, so any advice about leaving must be knowledgeable and practical.
Encourage the victim to get advice from an advocacy agency with experience in
the area of domestic violence.
Helping a person contact local
domestic violence groups is an important step. If you know someone who is being
abused, call the National Domestic Violence Hotline at 1-800-799-SAFE
(1-800-799-7233) or see the National Coalition Against Domestic Violence's website at www.ncadv.org/resources/StateCoalitionList.php to find the nearest program offering
shelter and legal support. There are many programs across the country that
provide options for safety, advocacy, support, and needed information and
Here are some other ways to help:
violent relationship puts you and your children at
risk for injury and even death. Developing a plan will help provide for your
safety and the safety of your children.
Your first step is to contact a local advocacy group for support, information, and advice on how to stay safe. Call the National Domestic Violence Hotline at 1-800-799-SAFE (1-800-799-7233) or visit www.thehotline.org for the nearest program. The hotline is available 24 hours a day, 365 days a year, in English, Spanish, and other languages.
After you have left, you may need to take extra measures to stay safe. Your local advocacy group can help you get in touch with legal and social services in your area. This group may also provide information on counseling and support groups that can help you recover emotionally from your abuse.
Many women and men are
reluctant to call police when they have been hurt. Victims fear that their partners
will retaliate or that police officers will be insensitive and embarrass them,
among other concerns. But many communities have made great progress in
educating police officers and other people in the criminal justice system about
Many states require
that police officers automatically arrest the abuser if they believe domestic
violence has occurred. In some communities, assistance from local victim's
advocacy groups and state social services are requested at the same time. Along
with these services, the law can be another tool you can use to increase your
safety and independence.
In many states, police officers can help
you obtain a temporary
protective order (or restraining order) at the scene
of the crime. These orders usually last until a permanent protective order can
In general, protective orders require the abuser to
stay away from you, your home, your workplace, or your school—to stop all
contact, whether by telephone, notes, email, or other means—and to stop
harming or threatening you. You can request a protective order at any time. An
abuser can be arrested for violating a protective order, which is considered
contempt of court and a minor (misdemeanor) criminal offense.
Protective orders are available in all states, but each state has its own laws
governing them. Many states allow you to obtain a protective order
without an attorney. The court can also extend the protective
order to your children and order the abuser to have no contact with them, your
children's doctors, day care, or school.
Keep your protective order with you at all times, and keep
a copy in a safe place. If you travel to another state, check to see if your
protective order is valid in that state. Some states enforce protective orders
from other states, but many do not.
While protective orders do not
automatically prevent you from being abused, they do deter abusers. In one
large study that followed women for 12 months, women who obtained permanent
protective court orders were 80% less likely to be physically or
psychologically abused than those who did not get permanent protective
Contact your local domestic
violence group, legal aid society, or family court for help. See the National
Coalition Against Domestic Violence's website at
www.ncadv.org/resources/StateCoalitionList.php to find the program nearest to you that
offers shelter and legal support. Also, the National Domestic Violence Hotline
1-800-799-SAFE (1-800-799-7233) can provide you with contacts.
The court may also award temporary custody of children to you, along with child
support, spousal support, and use of the home and car along with the protective
order. The court may be able to order the batterer to pay your legal costs and
fees. As a victim of a crime, you may also be eligible for additional financial
support from the court.
Many states require that
abusers attend batterer intervention programs. These programs try to make
abusers accountable for their behavior and educate them about healthy
alternatives to their abuse. Batterer intervention programs report varying
degrees of success, although so far, studies have not verified that success.
Most experts believe that batterer programs are most effective when the abuser
recognizes that his or her behavior is abusive, and wants to change.9
Teens who abuse their girlfriends or boyfriends do the same things as adults who abuse their partners. Teen dating violence is just as serious as adult domestic violence. And it's common. About 2 in 10 teen girls say they have been physically or sexually abused by a dating partner. About 1 in 10 teen boys report abuse in dating relationships.10
In adult domestic violence, women are more often the victim. In teen
relationship abuse, both boys and girls report abuse about equally.11 But boys tend to start the violence more often and use
Abusive relationships have good times and bad times. Part of what makes dating violence so confusing is that there is love mixed with the abuse. This can make it hard to tell if you're really being abused. If you're not sure, see Signs of Domestic Violence.
You deserve to be treated in a loving, respectful way at all times by your boyfriend or girlfriend.
Ask yourself these questions. Does your boyfriend or girlfriend:
If you answered yes to any of these questions, you might be in an abusive relationship. Talk to your parents or another adult
family member, a school counselor, or teacher. Or you can get help from the National Domestic
Violence Hotline at 1-800-799-SAFE (1-800-799-7233) or go to www.thehotline.org or the National Teen Dating Abuse Hotline at 1-866-331-9474 (www.loveisrespect.org).
Remember, you're not alone. Talking really does help. And without help, the violence will only get worse.
This online resource is provided by the American Psychiatric Association for anyone seeking mental health information. It includes information on many common mental health concerns, including warning signs of mental disorders, treatment options, and preventive measures.
This website is sponsored by the Nemours Foundation. It
has a wide range of information about children's health—from allergies and
diseases to normal growth and development (birth to adolescence). This website
offers separate areas for kids, teens, and parents, each providing
age-appropriate information that the child or parent can understand. You can
sign up to get weekly emails about your area of interest.
NCADV's work includes coalition building at the local, state, regional and national levels; support for the provision of community-based, nonviolent alternatives (such as safe home and shelter programs) for battered women and their children; public education and technical assistance; policy development and innovative legislation; focus on the leadership of NCADV's caucuses developed to represent the concerns of organizationally under represented groups; and efforts to eradicate social conditions that contribute to violence against women and children.
The National Domestic Violence Hotline offers crisis
intervention, information about domestic violence, and referrals to local
service providers for victims of domestic violence (men, women, and teens) and those
calling on their behalf. The hotline is available 24 hours a day, 365 days a
year, in English, Spanish, and other languages. The hotline connects callers to
more than 4,000 shelters and service providers in the United States, Puerto
Rico, and the U.S. Virgin Islands.
The Violence Against Women landing page is provided by the U.S. Department of Health and Human Services Office on Women's Health. It provides information on all types of violence against women, including specific resources and information on how to get help.
CitationsFamily Violence Prevention Fund (2004). National Consensus Guidelines on Identifying and Responding to Domestic Violence Victimization in Health Care Settings. Available online: http://endabuse.org/programs/healthcare/files/Consensus.pdf.Sharps PW, et al. (2007). Intimate partner violence and the childbearing year: Maternal and infant health consequences. Trauma, Violence, and Abuse, 8(2): 105–116.Sillman JS (2008). Domestic violence. In EG Nabel, ed., ACP Medicine, section 16, chap. 20. Hamilton, ON: BC Decker.Jewkes R (2002). Intimate partner violence: Causes and prevention. Lancet, 359(9315): 1423–1425.Gerber MR, et al. (2005). Adverse health behaviors and the detection of partner violence by clinicians. Archives of Internal Medicine, 165(9): 1016–1021.Roberts TA, et al. (2003). Longitudinal effect of intimate partner abuse on high-risk behavior among adolescents. Archives of Pediatrics and Adolescent Medicine, 157(9): 875–881.National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (2011). Understanding intimate partner violence: Fact sheet. Available online: http://www.cdc.gov/ViolencePrevention/pdf/IPV_factsheet-a.pdf.Holt VL, et al. (2002). Civil protection orders and risk of subsequent police-reported violence. JAMA, 288(5): 589–594.Jackson S, et al. (2003). Batterer intervention programs: Where do we go from here. National Institute of Justice Special Report, No. 195079. Available online: http://www.ncjrs.org/pdffiles1/nij/195079.pdf.Ackard DM, et al. (2007). Long-term impact of adolescent dating violence on the behavioral and psychological health of male and female youth. Journal of Pediatrics, 151(5): 476–81.Roberts TA, Klein J (2003). Intimate partner abuse and high-risk behavior in adolescents. Archives of Pediatrics and Adolescent Medicine, 157(4): 375–380.Other Works ConsultedBonomi AE, et al. (2006). Intimate partner violence and women's physical, mental, and social functioning. American Journal of Preventative Medicine, 30(6): 458–466.Bonomi AE, et al. (2007). Intimate partner violence in older women. Gerontologist, 47(1): 34–41.Campbell JC (2007). Prediction of homicide of and by battered women. In JC Campbell, ed., Assessing Dangerousness: Violence by Batterers and Child Abusers, pp. 85–104. New York: Springer.Casteel C, Sadowski L (2010). Intimate partner
violence towards women, search date September 2009. Online version of
BMJ Clinical Evidence:
http://www.clinicalevidence.com.Hilton NZ, Harris GT (2007). Assessing risk of intimate partner violence. In JC Campbell, ed., Assessing Dangerousness: Violence by Batterers and Child Abusers, pp. 105–125. New York: Springer.Sheridan DJ, et al. (2007). Prediction of interpersonal violence: An introduction. In JC Campbell, ed., Assessing Dangerousness: Violence by Batterers and Child Abusers, pp. 1–23. New York: Springer.Thompson RS, et al. (2006). Intimate partner violence: Prevalence, types, and chronicity in adult women. American Journal of Preventative Medicine, 30(6): 447–457.Tolan P, et al. (2006). Family violence. Annual Review of Psychology, 57: 557–83.
March 8, 2012
Adam Husney, MD - Family Medicine & Brigid McCaw, MD, MS, MPH, FACP - Family Violence Prevention
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