RISK FACTORS AND LETHALITY

Categories of Risk Factors for Abusers

The CDC identifies four risk factor categories for abusers: individual, relationship, community, and societal. Not everyone who experiences these risk factors becomes an abuser. Identification and understanding of risk factors can lead to prevention.

INDIVIDUAL RISK FACTORS

• Low self-esteem
• Low income
• Low academic achievement/low verbal communication ability
• Young age
• Aggressive or delinquent behavior as a youth
• Heavy alcohol and drug use
• Depression and suicide attempts
• Anger and hostility
• Lack of nonviolent social problem-solving skills
• Antisocial personality traits and conduct problems
• Poor behavioral control/impulsiveness
• Borderline personality traits
• Prior history of being physically abusive
• Having few friends and being isolated from other people
• Unemployment
• Emotional dependence and insecurity
• Belief in strict gender roles (e.g., male dominance and aggression in relationships)
• Desire for power and control in relationships
• Hostility toward women
• Attitudes accepting or justifying IPV
• Being a victim of physical or psychological abuse (consistently one of the strongest predictors of perpetration)
• Witnessing IPV between parents as a child
• History of experiencing poor parenting as a child
• History of experiencing physical discipline as a child
• Unplanned pregnancy

RELATIONSHIP RISK FACTORS

• Marital conflict/fights, tension, other struggles
• Jealousy, possessiveness, negative emotions within an intimate relationship
• Marital instability, divorces, separations
• Dominance and control of the relationship by one partner over the other
• Economic stress
• Unhealthy family relationships and interactions
• Association with antisocial and aggressive peers
• Parents with less than a high school education
• Social isolation/lack of social support

COMMUNITY RISK FACTORS

• Poverty and associated factors (e.g., overcrowding, high unemployment rates)
• Low social capital; lack of institutions, relationships, and norms that shape a community’s social interactions
• Poor neighborhood support and cohesion
• Weak community sanctions against IPV (e.g., unwillingness of neighbors to intervene in situations where they witness violence)
• High alcohol outlet density

SOCIETAL RISK FACTORS

• Traditional gender norms and gender inequality (e.g., belief that women should stay at home, not enter workforce, and be submissive; belief that men should support the family and make the decisions)
• Cultural norms that support aggression toward others
• Societal income inequality
• Weak health, educational, economic, and social policies/laws
  (CDC, 2019)

Common Risk Factors

POVERTY

Although domestic violence is found in all walks of life, those who live in poverty face additional challenges. The CDC (2019) lists poverty as a risk factor for intimate partner violence. Poverty damages health and well-being in countless ways; exposure to domestic violence is just one. When violence and poverty intersect, they limit coping options. Both poverty and violence lead to stress, feelings of powerlessness, and social isolation, which combine to produce posttraumatic stress disorder, depression, and other emotional difficulties.

Victims who are experiencing poverty face risks that are related to poverty as well as risks from their abuser.

• Risks from the abuser include physical injury; threats and loss of security, housing, and income; and potential loss of their children.
• Risks from poverty include food insecurity, lack of access to health insurance and healthcare, possible racism, unsafe neighborhoods, and poor schools for their children.

The double jeopardy of poverty and violence challenges victims and the healthcare and social service professionals responsible for protecting them. Intervening to stop the violence is only the first step. Issues of income, housing, and healthcare—both mental and physical—must also be addressed. For example, in 2019, approximately 48,000 beds were set aside for survivors of domestic violence in the United States on any single night (National Alliance to End Homelessness, 2020).

FAMILY/CAREGIVER STRESS

Families stressed by illness, unemployment, alcohol, and/or drug use are more likely to experience violence. This is particularly true with elder abuse, especially if the older person is frail or mentally impaired, the caregiver is poorly prepared for the task, or needed resources are unavailable. Adult children who abuse their parents frequently suffer from mental and emotional disorders, alcoholism, drug addiction, and/or financial problems that make them dependent on the parents for support. These families respond to tension or conflict with violence because they have not learned any other way to respond.

DISABILITY/IMPAIRMENT

People with disabilities are more likely to experience abuse than those without disabilities. In one study, intimate partners were determined to have committed 27% of the violent crimes experienced by women with disabilities and 1.1% of men with disabilities. Police response to reports of violence in lower among victims of disabilities (77%) than among people without disabilities (90%). A survey by the Spectrum Institute Disability and Abuse Project reported that 70% of the participants with disabilities experienced abuse and that perpetrators were arrested in only 10% of the cases. Barriers to accessing services further impact people with disabilities who are experiencing IPV (NCADV, 2018).

In addition to physical and psychological abuse, unwanted sexual contact, and intimidation, people with disabilities may also experience the following types of abuse:

• Neglect
• Withholding medications
• Physically harming service animals
• Isolating victims
• Depriving victims of necessary physical accommodations
• Withholding or destroying assistive devices such as wheelchairs
• Financial exploitation
  (NCADV, 2018)

Risk of Lethality

Without any sort of intervention, abuse tends to escalate. While not all abusers kill, and there are no perfect predictors of time and place, research has revealed some patterns of escalation in domestic violence. The time of separation—when an abuse victim leaves the abuser and just afterward—presents the greatest threat to the abuser’s ability to maintain power and control.

Risk factors for domestic violence homicide by a male perpetrator include:

• Access to a firearm (five times higher)
• Previous threats with a weapon
• Previous nonfatal strangulation (seven times higher)
• Previous rape of the victim
• Previous threats to harm the victim
• Previous stalking of the victim
  (Spencer, 2018)

HOMICIDE-SUICIDE

Incidents in which a family member kills a domestic partner or other family members and then dies by suicide are rare and account for 4.8% of suicides, but in the context of intimate partner homicide, they represent 27% to 32% of homicides. Homicide followed by suicide is a common behavior in male perpetrators but not in females (Smucker, 2018).

INTIMATE PARTNER VIOLENCE AND GUNS

Nearly one million women currently living have either been shot or shot at by an intimate partner. A 2018 survey of the National Domestic Violence Hotline found over 33% of calls to involve reports of being threatened with a gun. An analysis of mass shootings indicates that 54% of the shooters shot an intimate partner or family member (Sorenson, 2018; Logan, 2018; Everytown for Gun Safety, 2018).

Florida does not specifically require the surrender of firearms at the scene of a domestic violence incident, per F.S. 790.07 and 790.08, and persons convicted of domestic violence misdemeanors can purchase firearms. However, the law requires that law enforcement officials review available records to determine if the applicant would be prohibited by federal law from purchasing a firearm or ammunition. F.S. 790.233 and 741.31(4)(b)(1) prohibit the purchase or possession of a firearm by any person who has been issued a protective order related to domestic violence, stalking, or cyberstalking. In 2018, domestic violence firearm prohibitions were expanded to include dating partners (Giffords Law Center, 2018).

Understanding Perpetrators and Victims

People outside of abusive relationships often wonder both why a perpetrator abuses and why a victim of abuse remains in such a relationship.

WHY PERPETRATORS ABUSE

Typically, abusers want power and control, and their various behaviors are intended to achieve that end.

Although an abuser’s behavior may also arise from or be exacerbated by a mental illness, that is not usually the case; however, abusive behaviors may be complicated by substance abuse problems. Health professionals should be alert to any signs of these complicating factors when assessing high-risk individuals.

WHY VICTIMS STAY

Victims who stay with an abuser are often judged by others who do not understand the complex problems these victims may face. To better understand these challenges, domestic violence researchers evaluated hundreds of posts from victims on social media and identified eight reasons that victims stay in abusive relationships. The researchers also concluded that victims fear being judged by others and are more likely to respond positively to concern and compassion than to criticism and pressure.

• Distorted thoughts: Victims who are controlled and hurt become traumatized, resulting in confusion and self-blame.
• Damaged self-worth: Victims believe that they are worthless and deserve the abuse as a result of being treated badly.
• Fear: The threat of physical or emotional harm is traumatic and debilitating.
• Wanting to be a “savior”: Some victims want to help their partners, continue to love them, and hope that they will change for the better.
• Children: Some victims sacrifice themselves to keep their children safe or express that they do not want their children to grow up without the other parent.
• Family expectations and experience: Past experiences can distort the victim’s opinion of themselves or healthy relationships. Others feel pressured to remain in the relationship because of family values or religious beliefs.
• Financial constraints: Many victims report an inability to provide for their children alone and that they cannot maintain employment because of abuse. Others suffer from financial abuse.
• Isolation: Abusers can separate victims from family and friends either physically or through emotional abuse.
  (Cravens, 2015)