Battered+Women+Syndrome+and+Intimate+Partner+Violence

=**Introduction **= toc

Battered woman syndrome (BWS) is the culmination of symptoms caused by exposure to the traumatic events of intimate partner violence (Walker 2009). Although women do commit intimate partner violence, which can have a lasting impact on their partners, the number of women who are abused is significantly higher than the amount of men. Research in the Netherlands concluded that 83% of IPV suspects are male (Webber, Bouman 2017). Therefore, battered woman syndrome has not adopted a gender-neutral title such as battered person syndrome (Webber, Bouman 2017). Battered woman syndrome is closely related to post-traumatic stress disorder (Paradis 2017). Due to the significant amount of violence perpetrated against women, this issue is of significant importance. The US Department of Justice established that “Of the estimated 4.8 million intimate partner rapes and physical assaults perpetrated against women annually, approximately 2 million will result in an injury to the victim, and 552,192 will result in some type of medical treatment to the victim” (Tjaden, Thoennes 2000). These findings suggest that this is a public health concern and necessitates further study. This page will overview BWS by touching on the topics of intimate partner violence, BWS’ use in court, related disorders, screening for IPV, and treatments utilized today.

=**Intimate Partner Violence **=

 Intimate partner violence, or IPV, is when one partner abuses another verbally, emotionally, physically, and/or sexually ( Craparo et al. 2014). There is vehement controversy about whether the definition should be further specified by malicious intention and if it should pertain to partners not living together (Tjaden, Thoennes 2000). IPV is regularly coupled with intimidation tactics, stalking, financial hostility, and isolation strategies so that the perpetrator may gain or maintain control over the victim and their life (Tjaden, Thoennes 2000; Walker 2009; Craparo et al. 2014).

Research has attempted to distinguish the personality profile of batterers and abusers. Of notable importance is personality disorder (PD) (Craparo et al. 2014; Weber, Bouman 2017) as a defining characteristic. These disorders are categorized into eccentric disorders, dramatic or erratic disorders, and anxious or fearful disorders. They are marked by unstable relationships and self-image as well as significant impulsivity (Leichsenring et al. 2011).

There is no consensus on what the [|typical battered woman presents as]. Some research says that there is a higher likelihood of being battered if you are a certain race, such as African American, Latino, Native American, or Alaskan Native (AWHONN 2001; Craparo et al. 2014). Additionally, research adds that things like alcohol use, earlier experience with abuse, socioeconomic status, growing up with IPV, and societal treatment of women are all risk factors for being more likely to experience IPV (Craparo et al. 2014; Dicola 2016). IPV presents in heterosexual relationships, homosexual relationships, and with prevalence among trafficked women and transgender women (Dicola 2016).



=**Use in Court **=

Awareness of abused women became public and relevant to the courts in the 1960s. BWS is best known by the courts in cases where battered women feel so threatened for their own safety or for that of their children’s that they kill their abusers (Russell, Melillo 2006). In court, the term syndrome is believed to proffer the image of a mentally unstable woman rather than one who responded reasonably due to her abusive situation (Russell, Melillo 2006). In these instances, due to the many misconceptions about BWS held by the public, forensic experts are often called in to testify on the battered woman’s behalf about her mental well-being and the long-term negative effects that abuse and IPV have had on her life (Paradis 2017; Terrance 2014; Russell, Melillo 2006). Research found that expert testimony was inadequate in helping to persuade mock juries to acquit battered defendants pleading self-defense. However, it did find that the testimony did influence individual juror’s perceptions toward the defendant (Terrance 2014). Research has also determined that for women who claim a BWS defense, presenting evidence of an active history of fighting back is actually detrimental to their claim (Russell, Melillo 2006).

The feminist movement is tasked with developing “…[|legal theory and practice] that are accurate to the realities of women’s diverse experiences but that also take account …the complexity and allow for change” (Schneider 2000).


 * Connected Disorders **



[|PTSD], is a disorder that is most often experienced by people who have undergone or witnessed a traumatic event. PTSD is usually characterized by recurrent thoughts of the incident or intense flashbacks to the event. These symptoms are paralleled in the experiences of battered women by the constant replaying of the abuse and the routine introspection about what could have been done differently to mitigate the occurrence. People with PTSD also often have hyperarousal (hypersensitivity) to surrounding stimuli. Oftentimes, victims of IPV are “on edge” or misinterpret normal social interaction as incoming abuse. Also, victims may have anxiety. Finally, PTSD is characterized by avoidance or numbing behaviors, such as disassociation, minimization, repression, and denial (Walker 2009). Many women also use these types of behaviors as coping strategies to survive what is happening to them when they experience violence in their relationships. By minimizing or denying the reality of an abusive situation, survivors of abuse can sometimes compartmentalize their trauma and, thus, continue to function in social and professional situations. Research shows the significant positive correlation between the severity of violence experienced and PTSD (Hegarty 2004; Baragi 2007).

Another key symptom exhibited by abused women is known as learned helplessness. Learned helplessness (LH) is the inability of the victim to predict the actions that her abuser will take in response to her behavior. Because of LH, the victim loses the motivation required in order to attempt to mitigate abuse. Studies comparing battered women with and without PTSD found that abuse victims with PTSD scored significantly higher, by 19.2%, on LH (Bargai 2007) than their counterparts without PTSD. LH is believed to be the link between exposure to violence and mental disorder in battered women (Bargai 2007). LH is also thought to lead to submissiveness and passivity (Russell, Melillo 2006). Studies have been able to provide numerical data relating domestic violence and depression; they found that in women with depression, 61.0% had a lifetime prevalence of domestic violence (Dieneman 2010). Other studies then expound that sexual abuse/violence was the strongest predictor of depression (Bargai 2007). Depressed women are notably more likely to experience severe abuse in the future as well.

=**Screening **=

Screening for IPV is recommended in private and safe settings by medical professionals such as [|nurses and doctors]. Recommendations of frequency vary based on age and health status. However, in 2013, the U.S. Preventative Services Task Force (USPSTF) recommended routine screening for IPV in all female patients of childbearing age. Some states require mandatory reporting of abuse to law enforcement based on child abuse laws. Lack of time and training are reasons which women may not be screened for abuse (AWHONN 2001).

Battered women tend to have difficulty in disclosing their abuse (Rhodes et al. 2007; Walker 2009). Research indicates that physicians must demonstrate compassion and avoid judgmental behavior in order to facilitate open discussion. They should ask direct open-ended questions and then ask follow up questions. Additionally, using empathy and creating “windows of opportunity” for sharing difficult information allows the victim to feel known and understood (Rhodes et al. 2007). It is strongly recommended that the patient be without their partner screening by medical professionals (Dicola, Spaar 2016). <span style="font-family: Arial,sans-serif; font-size: 10pt;">Physicians may use tools such as HITS (Hurt, Insult, Threaten, Scream), self-reporting, STAT (Slapped, Threatened, and Throw), physician administered tests, or WAST (Woman Abuse Screening Tool) (AWHONN 2001).

=**<span style="font-family: Arial,sans-serif; font-size: 10pt;">Treatment **=

<span style="font-family: Arial,sans-serif; font-size: 10pt;">The primary treatment available to survivors of abuse is called [|STEP (Survivor Therapy Empowerment Program) therapy]. It has been found to lower anxiety and PTSD symptoms. STEP is a three-part program: psychoeducation, discussion, and skill-building. By learning new coping and life skills, women are able to feel empowered and more in control of their life once more. In conjunction with STEP, women may also utilize trauma therapy or feminist therapy. Feminist therapy recognizes the split power dynamic of psychotherapy between the therapist and the client. It also recognizes situational factors beyond control which helps the victim see that there are factors which she can control (Walker 2009).

=**<span style="font-family: Arial,sans-serif; font-size: 10pt;">Conclusion **=

<span style="font-family: Arial,sans-serif; font-size: 10pt;">Despite all of the information available, there is still a lot of uncertainty in the topic of BWS. The DSM-IV does not recognize BWS as an official disorder, instead it is subsumed under PTSD due to its similar effects. There is much more research possible which could provide insight or clarification on many subtopics of BWS as well as differentiate it from PTSD. Some of these research avenues include personality profiles on abuser and victim, how reactions to abuse change by category of person, finding out what healthier coping methods exist for battered women, and many more. The link between BWS and the common symptoms of PTSD, depression, and LH are relatively well known and well-studied. By increasing public knowledge of the topic through extended research, there is a possibility that more women could be impacted in the case of court battles. Additionally, common knowledge on the subject can aid in the prevention and treatment of IPV generally.

=<span style="font-family: Arial,sans-serif; font-size: 13.3333px;">Bibliography =

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=**Hyperlinks**=

http://www.aaets.org/article138.htm

https://www.nlm.nih.gov/exhibition/confrontingviolence/materials/OB10955.pdf

https://pro.psychcentral.com/battered-woman-syndrome-key-elements-of-a-diagnosis-and-treatment-plan/

https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd

http://www.domesticviolenceinfo.ca/article/court-process-185.asp