The "battering syndrome": Prevalence and clinical characteristics of domestic violence in primary care internal medicine practices

Jeanne M. McCauley, David E Kern, Ken Kolodner, Laurie Dill, Arthur F. Schroeder, Hallie K. DeChant, Janice Beth Ryden, Eric B Bass, Leonard Derogatis

Research output: Contribution to journalArticle

Abstract

Objectives: To determine the prevalence of domestic violence among female patients and to identify clinical characteristics that are associated with current domestic violence. Design: Cross-sectional, self-administered, anonymous survey. Setting: 4 community-based, primary care internal medicine practices. Patients: 1952 female patients of varied age and marital, educational, and economic status who were seen from February to July 1993. Measurements: The survey instrument included previously validated questions on physical and sexual abuse, alcohol abuse, and emotional status and questions on demographic characteristics, physical symptoms, use of street drugs and prescribed medications, and medical and psychiatric history. Results: 108 of the 1952 respondents (5.5%) had experienced domestic violence in the year before presentation. Four hundred eighteen (21.4%) had experienced domestic violence sometime in their adult lives, 429 (22.0%) before age 18 years, and 639 (32.7%) as either an adult or child. Compared with women who had not recently experienced domestic violence, currently abused patients were more likely to be younger than 35 years of age (prevalence ratio [PR], 4.1 [95% Cl, 2.8 to 6.0]); were more likely to be single, separated, or divorced (PR, 2.5 [Cl, 1.7 to 3.6]); were more likely to be receiving medical assistance or to have no insurance (PR, 4.3 [Cl, 2.8 to 6.6]); had more physical symptoms (mean, 7.3 ± 0.38 compared with 4.6 ± 0.08; P <0.001); had higher scores on instruments for depression, anxiety, somatization, and interpersonal sensitivity (low self-esteem) (P <0.001); were more likely to have a partner abusing drugs or alcohol (PR, 6.3 [Cl, 4.4 to 9.2]); were more likely to be abusing drugs (PR, 4.4 [Cl, 1.9 to 10.4]) or alcohol (PR, 3.1 [Cl, 1.5 to 6.5]); and were more likely to have attempted suicide (PR, 4.3 [Cl, 2.8 to 6.5]). They visited the emergency department more frequently (PR, 1.7 [Cl, 1.2 to 2.5]) but did not have more hospitalizations for psychiatric disorders. In a logistic regression model into which 9 risk factors were entered, the likelihood of current abuse increased with the number of risk factors, from 1.2% when 0 to 1 risk factors were present to 70.4% when 6 to 7 risk factors were present. Conclusions: In a large, diverse, community-based population of primary care patients, 1 of every 20 women had experienced domestic violence in the previous year; 1 of every 5 had experienced violence in their adult life; and 1 of every 3 had experienced violence as either a child or an adult. Current domestic violence is associated with single or separated status, socioeconomic status, substance abuse, specific psychological symptoms, specific physical symptoms, and the total number of physical symptoms.

Original languageEnglish (US)
Pages (from-to)737-746
Number of pages10
JournalAnnals of Internal Medicine
Volume123
Issue number10
StatePublished - Nov 15 1995

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Domestic Violence
Internal Medicine
Primary Health Care
Violence
Psychiatry
Logistic Models
Alcohols
Medical Assistance
Attempted Suicide
Educational Status
Divorce
Sex Offenses
Street Drugs
Insurance
Self Concept
Social Class
Pharmaceutical Preparations
Alcoholism
Substance-Related Disorders
Hospital Emergency Service

ASJC Scopus subject areas

  • Medicine(all)

Cite this

The "battering syndrome" : Prevalence and clinical characteristics of domestic violence in primary care internal medicine practices. / McCauley, Jeanne M.; Kern, David E; Kolodner, Ken; Dill, Laurie; Schroeder, Arthur F.; DeChant, Hallie K.; Ryden, Janice Beth; Bass, Eric B; Derogatis, Leonard.

In: Annals of Internal Medicine, Vol. 123, No. 10, 15.11.1995, p. 737-746.

Research output: Contribution to journalArticle

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abstract = "Objectives: To determine the prevalence of domestic violence among female patients and to identify clinical characteristics that are associated with current domestic violence. Design: Cross-sectional, self-administered, anonymous survey. Setting: 4 community-based, primary care internal medicine practices. Patients: 1952 female patients of varied age and marital, educational, and economic status who were seen from February to July 1993. Measurements: The survey instrument included previously validated questions on physical and sexual abuse, alcohol abuse, and emotional status and questions on demographic characteristics, physical symptoms, use of street drugs and prescribed medications, and medical and psychiatric history. Results: 108 of the 1952 respondents (5.5{\%}) had experienced domestic violence in the year before presentation. Four hundred eighteen (21.4{\%}) had experienced domestic violence sometime in their adult lives, 429 (22.0{\%}) before age 18 years, and 639 (32.7{\%}) as either an adult or child. Compared with women who had not recently experienced domestic violence, currently abused patients were more likely to be younger than 35 years of age (prevalence ratio [PR], 4.1 [95{\%} Cl, 2.8 to 6.0]); were more likely to be single, separated, or divorced (PR, 2.5 [Cl, 1.7 to 3.6]); were more likely to be receiving medical assistance or to have no insurance (PR, 4.3 [Cl, 2.8 to 6.6]); had more physical symptoms (mean, 7.3 ± 0.38 compared with 4.6 ± 0.08; P <0.001); had higher scores on instruments for depression, anxiety, somatization, and interpersonal sensitivity (low self-esteem) (P <0.001); were more likely to have a partner abusing drugs or alcohol (PR, 6.3 [Cl, 4.4 to 9.2]); were more likely to be abusing drugs (PR, 4.4 [Cl, 1.9 to 10.4]) or alcohol (PR, 3.1 [Cl, 1.5 to 6.5]); and were more likely to have attempted suicide (PR, 4.3 [Cl, 2.8 to 6.5]). They visited the emergency department more frequently (PR, 1.7 [Cl, 1.2 to 2.5]) but did not have more hospitalizations for psychiatric disorders. In a logistic regression model into which 9 risk factors were entered, the likelihood of current abuse increased with the number of risk factors, from 1.2{\%} when 0 to 1 risk factors were present to 70.4{\%} when 6 to 7 risk factors were present. Conclusions: In a large, diverse, community-based population of primary care patients, 1 of every 20 women had experienced domestic violence in the previous year; 1 of every 5 had experienced violence in their adult life; and 1 of every 3 had experienced violence as either a child or an adult. Current domestic violence is associated with single or separated status, socioeconomic status, substance abuse, specific psychological symptoms, specific physical symptoms, and the total number of physical symptoms.",
author = "McCauley, {Jeanne M.} and Kern, {David E} and Ken Kolodner and Laurie Dill and Schroeder, {Arthur F.} and DeChant, {Hallie K.} and Ryden, {Janice Beth} and Bass, {Eric B} and Leonard Derogatis",
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T2 - Prevalence and clinical characteristics of domestic violence in primary care internal medicine practices

AU - McCauley, Jeanne M.

AU - Kern, David E

AU - Kolodner, Ken

AU - Dill, Laurie

AU - Schroeder, Arthur F.

AU - DeChant, Hallie K.

AU - Ryden, Janice Beth

AU - Bass, Eric B

AU - Derogatis, Leonard

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N2 - Objectives: To determine the prevalence of domestic violence among female patients and to identify clinical characteristics that are associated with current domestic violence. Design: Cross-sectional, self-administered, anonymous survey. Setting: 4 community-based, primary care internal medicine practices. Patients: 1952 female patients of varied age and marital, educational, and economic status who were seen from February to July 1993. Measurements: The survey instrument included previously validated questions on physical and sexual abuse, alcohol abuse, and emotional status and questions on demographic characteristics, physical symptoms, use of street drugs and prescribed medications, and medical and psychiatric history. Results: 108 of the 1952 respondents (5.5%) had experienced domestic violence in the year before presentation. Four hundred eighteen (21.4%) had experienced domestic violence sometime in their adult lives, 429 (22.0%) before age 18 years, and 639 (32.7%) as either an adult or child. Compared with women who had not recently experienced domestic violence, currently abused patients were more likely to be younger than 35 years of age (prevalence ratio [PR], 4.1 [95% Cl, 2.8 to 6.0]); were more likely to be single, separated, or divorced (PR, 2.5 [Cl, 1.7 to 3.6]); were more likely to be receiving medical assistance or to have no insurance (PR, 4.3 [Cl, 2.8 to 6.6]); had more physical symptoms (mean, 7.3 ± 0.38 compared with 4.6 ± 0.08; P <0.001); had higher scores on instruments for depression, anxiety, somatization, and interpersonal sensitivity (low self-esteem) (P <0.001); were more likely to have a partner abusing drugs or alcohol (PR, 6.3 [Cl, 4.4 to 9.2]); were more likely to be abusing drugs (PR, 4.4 [Cl, 1.9 to 10.4]) or alcohol (PR, 3.1 [Cl, 1.5 to 6.5]); and were more likely to have attempted suicide (PR, 4.3 [Cl, 2.8 to 6.5]). They visited the emergency department more frequently (PR, 1.7 [Cl, 1.2 to 2.5]) but did not have more hospitalizations for psychiatric disorders. In a logistic regression model into which 9 risk factors were entered, the likelihood of current abuse increased with the number of risk factors, from 1.2% when 0 to 1 risk factors were present to 70.4% when 6 to 7 risk factors were present. Conclusions: In a large, diverse, community-based population of primary care patients, 1 of every 20 women had experienced domestic violence in the previous year; 1 of every 5 had experienced violence in their adult life; and 1 of every 3 had experienced violence as either a child or an adult. Current domestic violence is associated with single or separated status, socioeconomic status, substance abuse, specific psychological symptoms, specific physical symptoms, and the total number of physical symptoms.

AB - Objectives: To determine the prevalence of domestic violence among female patients and to identify clinical characteristics that are associated with current domestic violence. Design: Cross-sectional, self-administered, anonymous survey. Setting: 4 community-based, primary care internal medicine practices. Patients: 1952 female patients of varied age and marital, educational, and economic status who were seen from February to July 1993. Measurements: The survey instrument included previously validated questions on physical and sexual abuse, alcohol abuse, and emotional status and questions on demographic characteristics, physical symptoms, use of street drugs and prescribed medications, and medical and psychiatric history. Results: 108 of the 1952 respondents (5.5%) had experienced domestic violence in the year before presentation. Four hundred eighteen (21.4%) had experienced domestic violence sometime in their adult lives, 429 (22.0%) before age 18 years, and 639 (32.7%) as either an adult or child. Compared with women who had not recently experienced domestic violence, currently abused patients were more likely to be younger than 35 years of age (prevalence ratio [PR], 4.1 [95% Cl, 2.8 to 6.0]); were more likely to be single, separated, or divorced (PR, 2.5 [Cl, 1.7 to 3.6]); were more likely to be receiving medical assistance or to have no insurance (PR, 4.3 [Cl, 2.8 to 6.6]); had more physical symptoms (mean, 7.3 ± 0.38 compared with 4.6 ± 0.08; P <0.001); had higher scores on instruments for depression, anxiety, somatization, and interpersonal sensitivity (low self-esteem) (P <0.001); were more likely to have a partner abusing drugs or alcohol (PR, 6.3 [Cl, 4.4 to 9.2]); were more likely to be abusing drugs (PR, 4.4 [Cl, 1.9 to 10.4]) or alcohol (PR, 3.1 [Cl, 1.5 to 6.5]); and were more likely to have attempted suicide (PR, 4.3 [Cl, 2.8 to 6.5]). They visited the emergency department more frequently (PR, 1.7 [Cl, 1.2 to 2.5]) but did not have more hospitalizations for psychiatric disorders. In a logistic regression model into which 9 risk factors were entered, the likelihood of current abuse increased with the number of risk factors, from 1.2% when 0 to 1 risk factors were present to 70.4% when 6 to 7 risk factors were present. Conclusions: In a large, diverse, community-based population of primary care patients, 1 of every 20 women had experienced domestic violence in the previous year; 1 of every 5 had experienced violence in their adult life; and 1 of every 3 had experienced violence as either a child or an adult. Current domestic violence is associated with single or separated status, socioeconomic status, substance abuse, specific psychological symptoms, specific physical symptoms, and the total number of physical symptoms.

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