Intimate Partner Violence

Intimate partner violence (IPV) describes patterns of behavior that involve harm by a current or former partner or spouse.  IPV can involve physical and sexual assault, emotional or psychological mistreatment, threats and intimidation, economic abuse, and violation of individual rights. IPV occurs among heterosexual and same-sex couples and does not require sexual intimacy.  All patients are at risk for IPV.1 However, family physicians should be aware of individual, relationship, community, and societal factors that increase the risk for experiencing IPV2. Family physicians who provide ongoing care for patients and communities have a unique opportunity to help break the cycle of abuse by working with families and within their communities to prevent abuse. Family physicians should routinely screen female patients of childbearing age for IPV.3,4 Brief, validated IPV screening instruments exist to support identifying patients experiencing IPV in primary care settings.3 Systemic reviews of the literature suggest most patients welcome IPV screening, and no harm to patients has been demonstrated from randomized controlled trials of IPV screening.3 Primary care-based interventions, including referral to community resources, brief office-based counseling, and home visitation, have been shown to reduce future episodes of IPV and improve outcomes for patients screened for IPV.3 Family physicians should recognize that IPV does not exist in isolation, and be aware that trauma across the lifespan impacts the health of our patients and perpetuate cycles of abuse. Family physicians can teach or help to establish education in their communities on parenting and conflict resolution skills that promote respectful and peaceful personal relationships.

REFERENCES:

  1. Centers for Disease Control and Prevention. Intimate Partner Violence: Definitions. http://www.cdc.gov/violenceprevention/intimatepartnerviolence/definitions.html(www.cdc.gov), July 9. 2013.
  2. Centers for Disease Control and Prevention. Intimate Partner Violence: Risk and Protective Factors. http://www.cdc.gov/violenceprevention/intimatepartnerviolence/riskprotectivefactors.html(www.cdc.gov), July 11, 2013.
  3. American Academy of Family Physicians.  Intimate Partner Violence and Abuse of Elderly and Vulnerable Adults policy, 2013. http://www.aafp.org/patient-care/clinical-recommendations/all/domestic-violence.html. Accessed January 2014.
  4. IOM (Institute of Medicine). Clinical Preventive Services for Women: Closing the Gaps. Washington, DC: The National Academies Press. 2011.

(2002) (April 2014 BOD)