Thesis Nurs. 1995 N972i c.2 Nunn, Barbara. Identification of abused women in health 1995. IDENTIFICATION OF ABUSED WOMEN in HEALTH SETTINGS by Barbara Nunn, RN, BSN Submitted in Partial Fulfillment of the Requirements for the Master of Science in Nursing Degree Approved By: b IHoa/ IS G&t J&J'S___________ Date Chairperson, Thesis Committee Edinboro University of Pennsylvania / /Committee Member Date £Commi/^^e £££££?‘Member Date Acknowledgements The author wishes to express sincere appreciation and gratitude to her advisor Dr. Charlotte Paul for her continued guidance and support and to her committee members, Ms. Beverly Danielka and Dr. Dean Stoffer for their assistance. In addition, the writer wishes to express special thanks to her daughter Melissa Nunn for willingness to help. i TABLE OF CONTENTS PAGE ABSTRACT iv LIST OF TABLES vi CHAPTER 1 2 3 1 INTRODUCTION Background of the Problem 1 Purpose of the Study 3 Statement of the Problem 3 Assumptions 4 Definition of Terms 4 Limitations 5 REVIEW OF LITERATURE 6 Battering Syndrome 6 Dimensions of Abuse and Battering 7 Demographics and Vulnerability 11 Stress/Pathology Theory 13 Imbalance of Power Theory 15 Conceptual Framework 17 Conclusion 19 METHODOLOGY 23 Sample 23 Instrumentation 25 Collection of Data 26 ii CHAPTER 5 3 cont.' Data Analysis 27 4 28 DATA ANALYSIS Characteristics of the Sample 28 Family History of Abuse 34 Family of Origin 36 Comparison of Groups 38 Summary 38 CONCLUSIONS AND SUMMARY Recommendations 40 45 APPENDICES A I.M. KING'S THEORY OF NURSING 49 B ABUSE RISK INVENTORY (ARI) 50 C CONSENT FORM 51 D RESEARCH QUESTIONNAIRE 52 E RESEARCH SURVEY CODED AS P QUESTIONS 53 F ARI SCORES FOR RESPONDENTS 56 G CHARACTERISTICS OF THE SAMPLE 57 H ARI MEANS FOR SELECTED VARIABLES 60 REFERENCES 63 iii ABSTRACT The purpose of this study was to identify battered women in a health setting. The sample studied were 100 women in a local family planning clinic. 50 who reported themselves as having been battered within the last year and 50 who did not. Data was obtained by using a copywritten tool, the Abuse Risk Inventory (ARI). The tool included two parts: demographic data in which the client identified herself as having been battered and a survey entitled Interpersonal Relationships. The questionnaire was distributed to the sample population at a family planning clinic. The researcher compared the means of the ARI of the two groups. The difference between the means was analyzed using a t TEST. Findings were signif- leant at the p<.01 level. Several demographics were observed; among them Length of Relationship, Annual Income, and Physical Abuse for both the Respondent and Partner. Observa­ tions of the ARI means were made in each category. Of note was the number of women who had been either physically and emotionally abused either in their current relationship or at a previous time when the batterer could have been a family member. Results from this study supported the premise iv that there is a difference between battered and non-battered women in their interpersonal relation­ ships . This information contributes to the body of knowledge of health promotion for women who are involved in domestic violence. v LIST OF TABLES CHARACTERISTICS OF THE SAMPLE 29 1 AGE 2 MARITAL STATUS/LENGTH OF RELATIONSHIP... 30 3 RACE 31 4 LIVING ARRANGEMENTS 32 5 ANNUAL INCOME 33 6 EDUCATION 34 7 CHILD ABUSE 35 8 OTHER ABUSE 37 9 STATISTICAL ANALYSIS OF GROUPS 38 vi Chapter 1 Introduction Background oX the Problem According to a recent study by the US Department of Justice nearly 33 percent of female homicide victims are murdered by their husbands or male intimate partners. In addition, of all spousal- violence reported, 81 percent constitutes victimizaticn of women by husbands or ex-husbands (1988). Nationally representative surveys conducted on the incidence cf wife abuse showed that in 1975 the rate of husband-to-wife violence was 38 per 1,000 but in 1985 it was 30 per 1000 couples (Straus & Gelles,19860. Lewis (1985) acknowledges that the statistics on the incidence of domestic violence directed toward women by husbands or male partners fail to reflect a true estimation of the incidence of the crime. Problems in definitions, reporting, and recording make much of the relevant data unavail­ able for study (Flitcraft & Stark, 1985). Gayford (1975) establishes that women who are abused by their partners frequently do not report the incident to appropriate authorities or to DOMESTIC VIOLENCE/ASSESSMENT 2 helping professionals. Many are likely to feel shame and embarrassment and are unwilling to discuss the facts with others. They may fear retaliation by their partner if the partner learns the incident has been reported (Martin, 1976). These and other issues prevent abused women from disclosing the true source of injuries to helping professionals. However, abused women do present themselves at physicians offices, hospital emergency departments, clinics, and mental health agencies for treatment of such symptoms as depression, apathy, anxiety, and sleep disorders, rather than for the abuse per se (Greany, 1984). Direct questioning of the woman is often ineffective because of the reluctance of some women to respond truthfully or because of the misinterpretation of the questions or of the concept of what constitutes abuse (Gayford, 1975). Physicians, nurses, social workers and other helping professionals must know that physical abuse is present if they are to be effective in their treatment of these women. Once identified, appropriate treatment and services can be mobilized to help them. Presently, intervention is initiated after a crisis situation and a woman is identified as being DOMESTIC VIOLENCE/ASSESSMENT 3 a "battered woman." However, this researcher's focus was specifically concerned with intervention before a crisis state occurs. Given the serious effects of violence for women, it is desirable to have a method for identifying the women so that appropriate measures can be taken to protect them (Yegidis, 1988). Purpose of this Study The purpose of this study was to identify women who were current victims of abuse or were at risk of abuse by theii' male intimate partners. Nurses are present in all areas of health care and come into contact with abused women before many other types of service providers. At present there has not been a way to identify women who are current victims of abuse or are at risk of abuse by their male partner or ex-partners. The results of this study will contribute to the increased know­ ledge base of intervention strategies in identify­ ing abused women in health settings. Problem Statement: There is a significant differ- ence in intimate relationships between women who are abused and those who are not. DOMESTIC VIOLENCE/ASSESSMENT 4 Assumpt ions This study is based on the following assumptions: 1. Assessment is the first step in a successful treatment plan. 2. Women in abusive relationships may respond differently to certain questions than nonabused women. 3. Battered women seek services for treatment of health problems resulting from abuse, rather than for problems with abuse. 4. Women answer personal questions honestly when anonymity is guaranteed. Definitions nf Terms 1. Battered woman (interchangeable with abused woman): a female who has sustained physical injury, including rape, as the result of assault from a male significant other at least one time. 2. Battering: use of physical force by a man' against a woman. 3. Battering syndrome: a history of abuse and/or injury, often including sexual assault, unsuccessful help-seeking behaviors, medical complaints, and serious psychosocial problems (Flitcraft & Stark, 1985). DOMESTIC VIOLENCE/ASSESSMENT 5 4. Domestic violence: physical abuse between couples, not to include children. Limitations 1. The sample was limited to one geographic 2. There was a limited time frame for the area. study since all measurements were taken during only one association with the subjects. 3. The definition of battering was only inclusive of physical abuse and rape. 4. Those participating in the study were a convenient Sample. 5. Time allocation was limited to two months. DOMESTIC VIOLENCE/ASSESSMENT 6 Chapter 2 Review of the Literature The purpose of this study was to identify women who were current victims of abuse or were at risk of abuse by their male intimate partners. Review of the literature provided an overview of the problem of domestic violence when viewed from the personal, interpersonal and societal perspectives. The Battering Syndrome Battering refers to and includes a range of health problems which follow an initial episode abusive injury. of As defined by Stark (1981) and Stark & Flitcraft (1981) a syndrome among abused women includes: a history of abuse and/or injury, often including sexual assault, unsuccessful help­ seeking, general medical complaints and serious psychosocial problems. Straus, (1980) states that although survey data suggests that a proportion of . males are hit repeatedly by their wives that there is no similar pattern of psychosocial, physical, and social service problems that have been identi­ fied as there have been with women. This suggests that woman battering is different from husband abuse. DOMESTIC VIOLENCE/ASSESSMENT 7 Once a woman is assaulted by a social partner, there is a probability that the "battering syn­ drome" will develop, particularly given the limitations of present interventions (Anwar, 1986). Hilberman (1987) and Dobash (1985) found that as the adult trauma history and unsuccessful help­ seeking continue, battering may present as com­ plaints of pain, injury during pregnancy,- fear or anxiety associated with family conflict, and many psychosocial disorders, including alcoholism, drug abuse, rape, child abuse, attempted suicide and mental illness. Studies by Russell (1980) identify a much higher rate of such problems among battered women as compared with women who are not battered. He concluded that since these problems occurred only after the onset of violence, abuse is a major factor in the etiology of these problems. Dimensions abuse and battering Survey data shows that 12-20% of all couples experience intracouple violence (Kirchner, 1982). Approximately 20% of the adult women in the United States are at risk of being abused by a male intimate (Appleton, 1980). There have been studies (Dobash, 1985, Haber 1985 and Flitcraft, 1985) which conflict with each other on the frequency or DOMESTIC VIOLENCE/ASSESSMENT 8 severity of intraspousal violence even though spouse abuse is characterized by frequent beatings often requiring medical attention. Fried, (1990) found that patterns of violence and injury among non-married couples are comparable to patterns among married couples. Forty-seven percent of the husbands who beat their wives do so three or more times a year (Straus, 1980) and between 25%-30% of all abused women suffer serial beatings, many beaten as frequently as once a week. Furthermore, battering injuries are distinguished by their sexual nature, not their severity (Flaherty, 1986). His findings include the fact that battered women are thirteen times more likely than non-battered women to be injured in the breast, chest and abdomen and three times as likely to be injured while pregnant, an injury pattern suggesting the sexual nature of domestic violence. The greatest proportion of medical visits by battered women do not involve trauma. Rather, they visit general medical, behavioral and psychiatric settings. Battered women are more likely to report depression, anxiety, and vague medical complaints (Stark, 1983). It follows then that battered women are seen by those health care providers that are DOMESTIC VIOLENCE/ASSESSMENT 9 nontraumatic. Stark,(1986) found that 25% of all obstetrical patients are abused women, an even higher percentage than for all women seen in the emergency department. Clearly, identification of the abused woman is not limited to just emergency or trauma services. As a result of abuse, battered women experi- ence a rate of alcoholism and drug abuse that is significantly greater than non-battered women (Eisikovits & Edelson, 1989). Abuse has been reported as the single most important factor in alcohol problems among women, accounting for as much as 50% of female alcoholism (Gondolf & Rus- sell, 1985), Eisikovits & Edelson, (1989) found that alcohol has been consistently associated with violence in men, but it has not been found to cause abusive episodes. Flitcraft (1985) identified attempted suicide as a significant consequence of abuse among women, affecting 1 abused woman in 10. Moreover, she reports of the 10% of the abused woman who attempt suicide, fully 50% do so more than once. The impact of abuse is further demonstrated by the fact that 26% of female suicide attempts presented to the hospital are preceded by abuse. Fifty percent DOMESTIC VIOLENCE/ASSESSMENT 10 of African/Amerlean women who attempt suicide are abused (Hilberman, 1987). Battered women who attempt suicide are significantly more likely to use traumatic means, to attempt suicide repeatedly and to mention marital conflict as the precipi­ tating factor (Greany,1984). Descriptive studies by Finley (1981) frequent- include sexual assault as a factor in abusive relationships. Although rape is a relatively rare event in medical settings, almost one-third of the rape victims seen in the hospital have a history of abuse and among rape victims over the age of thirty, 58% are battered women (Stark, 1984). In addition, woman battering may be the single most important context for child abuse. Douglas (1991) identifies fathers or father substitutes as the typical assailants of both women and children. Furthermore, the finding identified that 45% of the mothers of abused or neglected children are them­ selves abused in the home. Severe mental health problems are considered in the case of abused women. Battered women have a significantly higher rate of psychiatric problems than do non-battered women (Favazza & Centerio, 1988) . Studies by Flitcraft & Stark (1987) indicate that only 37% of battered women use DOMESTIC VIOLENCE/ASSESSMENT 11 psychiatric services; furthermore 78% turned to such services only after the onset of violent injuries. The most common diagnosis carried by abused women is depression, but 1 abused woman in 10 suffers a psychotic break (Stark, 1984). Stark found that battered women are also far more likely than others to be given labels such as hypochondriac . Noting the severity of the consequences of abuse it would seem that there would be some commonalities among the women. Demographic and vulnerability factors Research on domestic violence has focused far more closely on the acts and their consequences than on the background of victims. Efforts to test major causal theories suffer from a lack of consistency in how the problem is defined (Yegidis, 1988). For these reasons the researchei' considered certain personality, demographic and social fac- tors. While such factors do not cause domestic violence, the literature review supported the theory that these factors do increase the like­ lihood that violence will result and that women will be abused. Attempts to create at risk profiles lack the DOMESTIC VIOLENCE/ASSESSMENT 12 sensitivity to identify battered women according to Yegedis (1989). Dobash (1985) and Hilberman (1987) have identified race as an indicator. Their studies have shown that African/American women are 2-3 times more likely than White women to present to hospitals as abuse victims. Quann & Petro (1978) found that there was a slight inverse relation between income and domestic violence. Further, among the adult population, age is inversely related to acts of domestic violence, but does not differentiate abused women from nonabused women. Women who are married, separated, divorced, or single are equally at risk for battering once they have sustained injury. The risk of domestic violence falls only among widowed women (Hilberman, 1987). Straus & Gels (1986) site pregnancy as being associated with more frequent assaults. Kirchner (1982) Dobash (1985) and Flitcraft & Stark (1987) all report that the risk of battering is greatest where a woman has a higher occupational and educational status than her partner. Haber (1985) has found that there were few significant differences in the personality traits of battered and non-battered women. An apparent lack of a DOMESTIC VIOLENCE/ASSESSMENT 13 clear picture of the dynamics of abuse have led social scientists to categorize the problem of domestic violence into two competing paradigms Stress/Pathology and the Imbalance of Power Flitcraft & Stark, 1987). Further research is presented to support these models. Stress/Pathology According to the Stress/Pathology framework violence is a family affair. It is learned and transmitted in childhood and culturally supported and provoked by certain stressors such as poverty and unemployment. Violence in a woman's family of origin appears to be an indicator of a woman's vulnerability to abuse as an adult (Weitzman & Dreen, 1982). They continue that the violence circulates from family member to family member until all of domestic life becomes enmeshed. Carmen, Rieker & Mills (1984) distinguish abused women by a common profile: they are dependent, hostile, unable to communicate or empathize, and have low self-esteem. They also found that the abused women in particular suffer from self-blame and helplessness, often delay reporting their problem, and may refuse help when it is offered. Because of its emphasis on family dynamics, DOMESTIC VIOLENCE/ASSESSMENT 14 the Stress/Pathology model equates violence with acts of force used among cohabitants. (Flitcraft & Stark, 1987). Survey data from Check (1985) report an incidence of such acts as ranging from 4% for abuse of the elderly to 80% for sibling fights. With respect to women, fear and helplessness result from the battering- syndrome. Men respond to abuse with embarrassment which leads to concealment of the fact and as such, do not seek help (Lurie & Quinkin, 1980). Mental health treatment sought by women is emphasized to resolve primary psychiatric and behavioral problems and to provide counseling designed to overcome personal and/or interpersonal deficits (Favazza & Conterio, 1988). Survey data implicate women as well as men in homicides and assaults. However, these homocides and assaults are most frequently the result of domestic violence (Andrews, 1988). It should be noted that reports of these incidents become part of the legal system and as such separated from social services and the health care delivery system. As a result there is not a uniform way to identify abused women. Schulman (1986) indicates that abused women seek medical help for as few as 1 in 5 assaults. Moreover, the self-blame and impaired self-esteem DOMESTIC VIOLENCE/ASSESSMENT 15 that are hallmarks of other post-traumatic stress disorders appear to characterize those abused women who use mental health services (Carmen et. al, 1983). There is growing evidence that a significant proportion of battered women are abused as children (Star, 1978). The intergenerational theme of domestic violence continued to surface throughout the literature review. In summary, the Stress/Pathology theory sees environmental factors of unemployment, low income, minority status, alcohol and abuse in childhood as vulnerability factors in developing abusive relationships as adult women. Imbalance of Power An alternative paradigm focuses on male vio­ lence as a cause of female abuse and views male abuse as a desperate defense against male domin- ation (Flitcraft & Stark, 1987). They continue to elaborate that in this theory, the abuse of women is traced to gender politics. Not only do they feel that men dominate women in the domestic setting but see an extension of this power to other women and children in virtually every institution. Eisikovits DOMESTIC VIOLENCE/ASSESSMENT 16 & Edleson (1989) identify that violence is one option employed by men when they feel their access to money or sex is threatened by female independence or when women fail to fulfill perceived domestic responsibilities. Certain ethnic groups including Hispanic, African/American and Japanese have been identified as having rigid role defini­ tions that support this theory (Gondolf & Russell, 1989) . According to Adams (1988) the need to control is socialized early in a young boy' s childhood and is maintained into adulthood through continued societal messages that allow for male violence against women. This way of thinking is further supported by systems theory investigators Weitzman & Dreen (1982) and Weidman (1982). They believe that battering is learned in the home and is culturally supported through the media. Weitzman and Dreen (1989) see violence as a pattern exhib- ited by a couple. In studies done by Neidig, Friedman, and Collins (1990) it was found that both parties participate in abusive behavior, although not equally. They also put quotes around the terms abuser and victim and imply that these labels are not accurate. Other researchers use terminology such as conjugal violence instead of battering. (Coleman, 1990). All of this research, however, DOMESTIC VIOLENCE/ASSESSMENT 17 focuses on an unequal balance of power between the man and the woman and contributes to the secretive— ness of the relationnship. According to Star (1978), battering is not increasing; rather it suggests that society's attention to battering is due to the visibility of the Women's Movement and a growing disparity between traditional roles and the increasingly complex economic and social responsibilities of women. The assumption of imbalance of power bases its assessment for intervention with the abused women on the increased service needs in health settings. Makepeace, (1984) has identified that battering has extended to dating violence which approximates domestic violence in frequency and severity. According .to Makepeace, male violence against women has extended from the family boundaries. However, this cannot be explained by the legal operational definition of domestic violence since there is no legal commitment in this setting. Conceptual fnamewfiiik The theoretical framework identified as a DOMESTIC VIOLENCE/ASSESSMENT 18 basis for intervention is the Nursing Conceptual Framework proposed by Imogene King. This model contains multidimensional systems as criteria for assessment and intervention (King, 1981). The King Model is broad enough to accommodate domestic violence because of the interaction of the three variables: personal, interpersonal, and social systems (Appendix A). Domestic violence can be conceptualized in all three areas. Domestic violence can be experienced on a personal level. Results from abuse that set up the Battering Syndrome result in serious physical and emotional consequences. Interacting with the next level, the interpersonal level, the abuse within the dyad of that relationship closes the normally functioning open system to the Self and to Society and isolates the individual with only the abusive partner. When viewed from this perspective it may become apparent how child neglect could occur since no input or output would occur in the interpersonal system. Intervention for domestic violence occurs in the social system usually through legal channels. Nursing theories had not been widely used in the literature to identify complex social situations. The investigator hoped to increase the body of data of abused women by conceptualizing the DOMESTIC VIOLENCE/ASSESSMENT 19 problem of domestic violence from this systems approach. The battering syndrome is presented to health care providers with a covert set of problems. The King Model recognizes that the intensity of a relationship existing between members of a dyad changes as multiple societal and individual factors impact the couple. When given the information of the epidemic proportions of the problem of domestic violence and the significant consequences to the individual, the identification of the battered woman is imperative to all three systems. For successful intervention to occur, identification would be made in the personal system. Women seek health services in a multitude of settings such as family planning clinics, medical offices and through mental health professionals. This investigator would hope to utilize King's Nursing Theory as she researches the question of identification of women for abuse. Conclusion Female abuse seems to be the product of many forces operating and interacting at different levels between the individual and the environment. Research has included individuals, couples, and DOMESTIC VIOLENCE/ASSESSMENT 20 social institutions with regard to the problem of domestic violence. Several points have evolved that lend them­ selves to further exploration. Identification procedures established which estimate the incidence of domestic violence are rare. If a consolidated medical record system were available that lists all patient visits, including those to the emergency department, the potential population for primary prevention could be identified by a retrospective review of the full health records of a sample of adult women. In such a review, all women could be identified as at risk for abuse if their history contains at least one injury attributed to assault by a male intimate or a family member or if there was an assaultive episode not attributed to street crime or where the etiology of the injury was inconsistent with the injury sustained. Studies related to health promotion recognize that health, while it is a personal experience, does not exist without direction (Woods, Laffrey, Duffy, Lentz, Mitchell, Taylor and Cowan, 1988). If identification of a woman as abused does not occur at a beginning level of the battering cycle the violence will continue to escalate and the DOMESTIC VIOLENCE/ASSESSMENT 21 consequences to the women become devastating. The direction for health then, will regress or remain static before it ultimately declines. Nurses are confused as to their role in the mire of domestic violence perhaps since the problem has been defined in legal and sociological terms and via the clinical model of health care delivery. Identification of the abusive relationship is necessary in the health setting. Currently intervention strategies for domestic violence are focusing on the legal system for assistance after the abuse occurs. However, the damage is done. There were no studies found that address the identification of the battered woman unless this information comes from the woman herself. In situations where women may be at risk for battering or the woman doesn't realize that her help-seeking behaviors are the result of one or more battering episodes, the nurse has no tools to assist in that assessment. To ask directly if a woman is battered may result in a furtive attempt by the woman to hide the problem of battering. Until the abuse situation is identified there can be no further action. The researcher hoped to add to the base of knowledge of domestic violence with the current DOMESTIC VIOLENCE/ASSESSMENT 22 study. Use of the "Abuse Risk Inventory for Women" (Yegidis, 1989) hopefully provided the researcher with a tool that can identify women in abusive relationships or those who are at risk for abuse (Appendix B). With the expansion of the role of the professional nurse and the increasing emphasis on the provision of holistic health care, research in this area may indicate the need for the nursing to include assessment of each woman as they present in a multiple of health settings. The health care provider has a responsibility to become aware of which women are abused, since the consequences are so devastating. DOMESTIC VIOLENCE/ASSESSMENT 23 Chapter 3 Methodology The purpose of this study was to identify women who were current victims of abuse or were at risk of abuse by their male intimate partners. battered women in a health setting. Women who exhibit the battering syndrome present frequently at a multiple of health settings, rather than only in the emergency department after overt abuse has occurred. The Abuse Risk Inventory (Yegidis, 1989) (Appendix B) was identified in the literature and the materials were obtained by purchasing them through Consulting Psychologists Press, Inc., located in Palo Alto, California. Sample The subjects in this study were drawn from the family planning clinic at a local county health department. There are three sites and approx- imately 20 clients per day were seen at each site. Permission to distribute the questionnaires was granted by the head of the family planning department under the condition of anonymity and without coercion to the clients. A consent form was signed before the survey was distributed (Appendix. C). The data was col- DOMESTIC VIOLENCE/ASSESSMENT 24 lected by means of a sample of convenience, using every client as they arrived until a total of 50 women identified themselves as never having been abused (N) and 50 identified themselves as having been either physically abused or raped (A). This information was gathered from the Research Survey (Appendix D), a demographic questionnaire that was on the reverse side of the ARI form. Membership in either Group A or Group N resulted from selecting either question 13 (Have you been physically abused within the last year) or question 15 ( Have you been raped within the year). This section of the questionnaire consisted of demographic information including age, occupational level, marital status and a history of abuse for both partner and self. participated. A total of 147 clients Forty-seven questionnaires were discarded: sixteen clients didn't finish the survey and 31 clients didn't meet the necessary criteria for the survey (answering yss to 13 or 15 on the research questionnaire). Only one family planning client refused to pax'ticipate in the study after reading the questionnaire. total of 100 surveys remained which met the sample requirements of 50 women who had been abused and 50 who had not. DOMESTIC VIOLENCE/ASSESSMENT 25 Instrumentation The ARI was designed to serve as a screening instrument for potentially abused women receiving medical care from health care providers or social service agencies. The scale provides an alternative to direct questions, based on the assumption that some women may not respond truthfully or may misinterpret what the researcher meant by abuse. A number was assigned to each answer so that this data could be analyzed (Appendix E). The one-page ARI is entitled Interpersonal Relationship Survey. The first 15 items focus on the husband/partner and the remaining 10 items are questions about the couple. The scale was self-administered. It was written at a sixth grade level (Rohrbeck, 1989). Each item was answered on a 4 point scale (Rarely or Never, Sometimes, Often, and Always). Total scores range from 25 to 100. A score above 50 suggests that the respondent may be in an abusive situation or be at risk for abuse. Reliability information is available only for internal consistency; test-retest reliability was still needed to establish stability of the inventory over time.. The ARI has shown an alpha reliability of .80 for a combined sample of abused DOMESTIC VIOLENCE/ASSESSMENT 26 women (in spouse abuse shelters) and a comparison group (King & Cervera, 1987). An earlier version of the ARI showed concurrent validity when it successfully discriminated a group of abused women from a comparison group, classifying approximately 90% of the cases correctly. In the current study the question about physical abuse or rape on the questionnaire was the criteria for determining whether or not the client had been abused. There has not been evidence in the literature of predictive validity; therefore, the ARI scores would not be used to predict future abuse. Co1lection of Dofa Data was collected through the local health department during Family Planning sessions. As each subject arrived the researcher introduced herself and continued to explain the purpose of the research without identifying abuse as the overt topic of the study. The questionnaire form was distributed, accompanied by a consent form that included an explanation that the researcher was collecting data studying interpersonal relationships. A guarantee of confidentiality of the replies was also included on the consent form at the time of the ARI DOMESTIC VIOLENCE/ASSESSMENT 27 distribution. There was no identification of the participant on the ARI questionnaire itself. As each consent form was filled out, the respondents were asked to place it in an envelope with others SO that anonymity could be maintained. Consent forms were left with the nursing supervisor of the family planning clinic. Procedures for Analysis of Data Each survey was scored using the scoring key that was provided by the ARI. Those who had indi­ cated that they had been abused by checking yes for question 13 or 15 were coded into Group A. The remaining 50 were assigned to Group N. Scores are listed in Appendix F. A t TEST was performed using the means of the ARI scores for groups A and N. Significance was accepted at the .01 level. Mean ARI scores were located in Tables 3, 5, and 6 were also obtained for the demographics of Length of Relationship, Income, and Physical Abuse for Self and Partner. No statistical inferences were made with this information. Patterns of distribution were shown that indicated areas for further research. The data was also helpful for validating the use of the ARI in further studies. DOMESTIC VIOLENCE/ASSESSMENT 28 Chapter 4 Analysis of Data The primary purpose of this study was to identify women who were current victims of abuse by their male intimate partners. In order to accom- lish this, an Interpersonal Relationship Survey was administered at a family planning clinic in Southern Chautauqua County. A research question­ naire was also included. Characteristics of the Sample The demographic characteristics of the participants were taken from the Interpersonal Survey Research Questionnaire (Appendix D) that was handed out as part of the Abuse Risk Inventory (Appendix B). Since there are equal numbers in each group, the demographics were presented here as the mean scores of the Abuse Risk Inventory (ARI) and/or the percentages of those in each category. Age The subjects ages ranged from 15-46 years. The ages were coded into one of five ranges, from below eighteen years to over 30. The mean age for those women identified as abused ' (Group A) was 21.40 and DOMESTIC VIOLENCE/ASSESSMENT 29 23.18 for those not abused (Group N). The partners' ages ranged from 18-49 years. Ages of men in Group A averaged 23.68 years old; those in Group B, 25.72 years. See Table 1. TABLE 1 Characteristics of the Sample n=50 n=50 Characteristics Group A Group N Age <18 18-21 22-25 26-30 >30 Mean years Partners" Age <18 18-21 22-25 26-30 >30 Mean years 11 22 7 13 7 6 13 18 8 5 21.40 23.18 n=50 Group A 6 21 6 10 7 n=50 Group N 3 14 10 10 13 23.68 25.72 The average length of the relationships for Groups A and N was 3.50 and 4.10 years, respec- tively. However, ARI scores were the highest for those in relationships at ten (72.00) and thirteen years (72.00) (Appendix F). Almost three-fourths (A39%)(N35%) were single. Married couples comprised nineteen percent DOMESTIC VIOLENCE/ASSESSMENT 30 (A7%)(N12%) of the Participants. Six percent (A3%) (N3%) were separated or divorced and only one respondent was widowed (Al%). See Table 2. TABLE 2 Characteristics of the Sample n=50 n=50 Characteristics Group A Group N Marital Status Single Married Sep./Divorced Widowed 39 7 3 1 35 12 3 0 Longevity of Relationship 1-3 years 4-6 years >6 years 33 11 6 34 8 8 3.50 4.10 Mean years Race The population served through the family planning clinic was almost exclusively Caucasian. African/American respondents numbered two (A2%); Hispanic women numbered two also (A2%). There were no respondents in Group N for either African/ American or Hispanic categories. The White population dominated the sample with Group A comprising 48% and Group N 50% exclusively. The partners' racial patterns were similar: African/American (A4%)(N2%); Hispanic (Al%). Again in this category. The Group N had no respondents DOMESTIC VIOLENCE/ASSESSMENT 31 White population was the majority in the research project with Group A45% and Group N 48%. This information is presented in Table 3. TABLE 3 Characteristics of the Sample n=50 Characteristics Group A Race African/American Hispanic Caucasian 2 2 48 Partners" Race African/American Hispanic Caucasian 4 1 45 n=50 Group N 0 0 50 2 0 48 The findings to the questions on living arrangements were coded into seven categories as identified by the Interpersonal Relationship Research Questionnaire (Appendix D). One percent of Group A lived with a spouse while (N)9% were married. Living with a male partner was about equal fro both groups (A8%)(N9%). The smallest group comprised those who lived alone (A3%)(N4%). Six percent of the Group A lived with their husbands while only 2% of Group N did so. Living with a male partner with children had equal scores with percentages of 6% for both groups. The largest who lived with their parents group was the women DOMESTIC VIOLENCE/ASSESSMENT 32 (A20%)(N16%). This would be logical since the mean age of the women was 22.29 years. The remaining women lived with friends and relatives not named in the previous categories (A7%)(N4%). See Table 4. TABLE 4 Characteristics of the Sample n=50 Characteristics Group A Li vi ng Arrangemen t Husband Male Partner Alone Husband/Ch iId. Male Part./ChiId. Parents Other n=50 Group N 1 6 3 5 10 20 5 10 9 7 2 6 15 1 Annual Income Under the category of income 8 categories were used as defined by the research tool. Twenty percent of the women (A1O%)(N1O%) reported having an annual household income less than $9400. Twenty one percent (A13%)(N9%) had income between $9401 and $16000. The remaining gradations of income occur in ten thousand dollar increments into which the rest of the participants fall. The mean income range was $16000-$23000 for all respondents. The literature speaks to the issue of poverty in relationships as providing for increased stress and therefore, contributing to abuse. It should be domestic VIOLENCE/ASSESSMENT 33 noted with this Population that a full 42% of the total population came from a household whose income was less than $16,000. Average ARI scores were the highest for those in Group A (62.67) for those with income of less than $9400. This information is presented in Table 5. TABLE 5 Characteristics of the Sample n=50 Characteristics Group A Annual Household Income $0 - $9400 $ 9401 - $16000 $16001 - $23000 $23001 - $30000 $30001 - $37000 $37001 - $44000 > $44000 Mean Income n=50 Group N 10 13 8 6 5 4 4 $16000 - $23000 10 9 6 9 3 6 7 for both groups Education The mean years of education for abused women was slightly less at 11.62 years than for those women who were not abused (12.28). However, it should be noted that this indicates that fewer in Group A finished high school much less sought post secondary education. Their partners' education included 12.00 years of education for Group A and 12.22 for Group N. finished Thus the men from both groups high school and were equally educated. domestic VIOLENCE/ASSESSMENT 34 See Table 6 fop presentation of this data. TABLE 6 Characteristics of the Sample n=50 Characteristics Group A Education . O1 Summary of Data Analysis The characteristics of the sample population included in the present study indicated a young, White population with the majority of the subjects of less than single and having an annual income $23,000. DOMESTIC VIOLENCE/ASSESSMENT 39 The results of the t TEST analysis demonstrated that there was a significant difference between the means of the abused and nonabused women (p=<.01). Based upon this data analysis this tool could be useful to identify women who were victims of current abuse by their male intimate partners. DOMESTIC VIOLENCE/ASSESSMENT 40 Chapter 5 Conclusions and Summary The purpose of this study was to identify women who were current victims of abuse or were at risk of abuse by their male intimate partners. Literature review has shown that there had been difficulty identifying abused women unless they sought help for the abuse. Help had usually been sought after physical injury was severe or advanced mental disorders were established. Survey results from this study appeared to be consistent with findings from other studies that looked at interpersonal relations to identify battered women (Lewis, 1985; Yegidis, 1989; Bagwell, 1986; and Choate, 1990). Data analysis did show a significant difference between Group A and Group N at the p<.01 level. Twenty-two percent of the abused group scored below 50 on the ARI. The mean ARI scores for Group A was 58.46 compared with similar groups: 68.00 (Yegidis, 1989), or 75.36 (Bagwell, 1896). In a study by Hudson (1992), the results of the classification analysis showed that 88.1% of 193 cases were correctly classified based on ARI scores alone. This percentage was higher than the 78% for this current study. So it would DOMESTIC VIOLENCE/ASSESSMENT 41 seem that even without the questions 13 or 15 (Physical abuse and Rape) on the demographic survey to aid in the selection of groupings, the majority of women would have scored over 50 on the ARI. Information on the Length of Relationships showed that those women in Group A had the highest ARI scores as the length of their relationships increased. The data is limited, however, since the years in which the highest ARI averages occur contain only two respondents. In a study by Choate (1990) there was no significance for duration of relationships between the abused and nonabused groups in that study. The data does not support this finding in the current study. Group A, the length of relationship was shorter than that Group N. Statistical analysis was not performed but perhaps the difference of less than 1 year is not significant. Sixty-seven percent of the current people in the It study were in a relationship between 1-3 years. ARI scores is not surprising that the highest mean 10 and 13. would be included in Group A for years This supported the conclusion found in the literature that abuse is a chronic condition and deepens in severity as the length of the However, the finding is relationship increases. DOMESTIC VIOLENCE/ASSESSMENT 42 consistent with a study done by Bagwell (1986) that found that abused women have relationships of longer duration. Perhaps another study done with a more evenly distributed population for length of relationship would show different results. Another variable looked at was income level. Studies by Dobash (1985) and Kirchner (1982) were supported by the findings of the current study. Even though women of Group A had the highest ARI scores for income between $0-$9400, the mean scores of both groups was the only one in this category that was over 50 (52.52). The average income for the geographic area in which this study was done was $11,750 per household. As such the study was qualified with the population used. Validity studies (Yegedis, 1989) cautioned that the ARI was tested on women of low socioeconomic backgrounds and should be used primarily on this population until further research is completed. Race was not an issue since the population had few non-White respondents. It should be noted that Chautauqua County, in which this study took 6% minority for Race and place has only a total of Hispanic backgrounds. DOMESTIC VIOLENCE/ASSESSMENT 43 An area that was striking to the researcher was that of child abuse. It has long been known that child abuse has longlasting consequences. While 36% of Group A admitted they were abused, the corresponding ARI scores were higher compared to overall Group A averages of 58.21. Surprisingly abused women who didn 't know if they were abused as a child had the highest ARI scores. The question of "do the women know what constitutes abuse" surfaces. The ARI scores for Group N admitting to being abused as a child were almost equal to their general population mean. Less than half of the partners of Group A were reported as abused compared with 28 of the women. However, the participants did not know this information for 21 of the men. Group A had more affirmative answers for this topic, almost 2 to 1 for abuse for the women as children and over 4 to 1 for the men. Having a relationship of one year duration was one of the criterion for taking part in the study. It would seen then that within the last year 37 women were physically abused; 41 were emotionally abused and ten reported as being raped by their current partners for those in Group A. None of or raped. women in Group N were physical abused report being More than seven times as many women DOMESTIC VIOLENCE/ASSESSMENT 44 emotionally abused as those in Group N where only 5 were present. In conclusion. emotional abuse did not exist without either physical abuse or rape. Group A also had a higher frequency of reporting for physical and emotional abuse and rape from males other then their current partner, to include family members than those from Group N. It would seem that having a history of abuse for a woman would make her at risk for entering into abusive relationships. In all three categories of abuse, yes responses were present at least 2 1/2 times more frequently for those abused than not. Perhaps this is the key to the problem of the etiology of abusive relationships. In the current study there was no delineation of who abused the women when they were children: male or female. However, the rate of abuse was less than that reported than for that of abuse from other males. Children present in the home are also at risk of abuse. Research has shown that children from abusive homes are more likely to become abusive adults. Given the serious effects of violence for both women and children, it is desirable to have a method for identifying women so that appropriate protect them and other measures can be taken to DOMESTIC VIOLENCE/ASSESSMENT 45 abused women. The data collected regarding the mothers of the participants again identifies Group A members as having almost twice as many yes answers both for self and more than twice as many for their partners. This would support the literature's findings that abuse is learned in the home and the interactions are continued into many relationships. In conclusion, the ARI was a useful tool in determining if a woman has been abused. At this point it seems simplistic to say that to identify a woman as abused one may "just ask" as does the research questionnaire and not perform assessment with a tool such as the ARI. It must be remembered that domestic violence has an almost furtive quality about it and few women would willingly admit to being abused. anonymously. The current study was done However, the results showed a significant difference between the two groups and added validity to using the ARI alone for the identification of abused women. Re co:110 Hlendations This research project was limited to a family planning clinic in a rural area of Western New York where the population was homogeneous for such DOMESTIC VIOLENCE/ASSESSMENT 46 variables as Race and Income Levels. I would rec­ ommend that replication of the study be done with another group from the same family planning clinic. This would strengthen the validity of the screening tool at this site. It should be noted that the clinic provided services on a sliding scale based on income. Therefore, the clientele necessarily had lower incomes and were not representative of a greater population. This finding may suggest that the ARI tool could be valid for assessment of those of lower socioeconomic backgrounds. A study of this nature would then take on greater significance. There is a need for continual assessment of women in health settings in response to the changes . in our society. Women at risk present frequently at nonacute settings for vague complaints. General practitioners and family practice offices see women for the many somatic complaints that have an etiology of abuse at their source. I recommend that women be assessed for abuse at a multiple of health provider sites routinely. Further studies into the interplay of the variable of emotional abuse is recommended. While the current study documented the presence of emotional abuse along with physical abuse and rape there was no mention of which came first, the DOMESTIC VIOLENCE/ASSESSMENT 47 emotional abuse or the physical. The literature (Makepeace, 1984; Schulman, 1986) finds that domestic violence is a continuum with emotional abuse occurring first followed by more observable consequences. Identification tools should be used routinely to screen women for abuse initially on intake at a health office but also at regular intervals. Identification is only the beginning, however. Research on assessment and identification will hopefully initiate the beginning of treatment programs for women before the abuse escalates to The dynamics of family the point of serious harm. violence have been sited as part of the Research Survey used with the ARI. The enmeshment of the variables of child abuse and partner abuse cannot be separated. The mean population of the family planning clinic was young and single. It goes without saying that many of these young women may be living a lifestyle that is high at risk for abuse. Questions on the ARI speak to the issues of partner use of drugs and alcohol but not for themselves. Intervention at an early age for women may preclude them from forming abusive relationships. DOMESTIC VIOLENCE/ASSESSMENT 48 Confronting women with the fact that their inventory scores indicate that they may be at risk for being in an abusive relationship could be the impetus to seek assistance for the problem of current abuse. If the women are not abused but score in a high range, nursing intervention strategies could be aimed at helping women reassess their relationships by providing them with a directory of appropriate sources. Finally, abuse is not unidirectional. Liter- ature review has shown that accountability for the relationship also lies with women. Success in identification of battered women must be followed by successful treatment for the cycle of abuse to stop. An evaluation tool as versatile as the ARI could then be used to evaluate the effectiveness of treatment strategies. DOMESTIC VIOLENCE/ASSESSMENT ’ ' ' 49 appendix a A CONCEPTUAL FRAMEWORK fCR NURSING SOCIAL SYSTEMS (Society} / I \ I INTERPERSONAL SYSTEMS (Groups) f ! \ ! PERSONAL SYSTEMS j (individuals) * f i i L._____ I--- J I I I J i I I I i I I 7 I I \ i / \ A conceptual framework for nursing: dynamic interacting systems. I. M. King, Toward a Theory for Nursing, New York, John Wiley & Sons, 1971, p. 20. DOMESTIC VIOLENCE/ASSESSMENT 50 APPENDIX B ABUSE RISK INVENTORY 4anic Date / / / My husband/partner. 1. finds the role of breadwinner satisfying 2 3 4 2. is frustrated about our economic situation 1 2 3 4 3. accuses me of deliberately trying to attract other men. 1 2 3 4 4. starts arguments with me about matters in the home- 1 2 3 4 slaps or pushes me during a fight---------- --- ------------ _1 2 3 4 —1 2 3 4 1 2 3 4 has problems with sexual functioning-------------------- ____ 1 2 3 4 9. accepts changes I make in our homelife routine------- 1 2 3 4 ____ 1 2 3 4 1 2 3 4 5. 6. uses drugs (like marijuana or pills) 7. gets along well with others 8. 10. drinks alcoholic beverages 11. slapped or shoved me while we were dating----------12. tells me I'm inferior as a homemaker or mother— -1 2 3 4 13. is considerate of my sexual needs _1 2 3 4 14. changes jobs or is out of work------- --- -.......... 1 2 3 4 .15. shows concern for my health needs — .........----------- 1 2 3 4 1 2 3 4 ---------------- —— ^4y husband/partner and I: 16. maintain close contact with our families 17. discuss problems when they arise 1 2 3 4 18. get upset if we don't have enough money to do the things we enjoy 1 2 3 4 19. have satisfying sexual relationships with each other 1 2 3 4 20. argue a lot 1 2 3 4 21. share recreational activities 1 2 3 4 22. discuss minor problems lx*forc they blow up 1 2 3 4 argue alxiut trivial or silly matters 1 2 3 4 I’.Ct upset Ixvause we don't have enough money t<» buy (he (hinjy; we nml .......................................... I 2 3 4 pl.m for 3 4 23. 24. ?'i fa ‘ I. ............. APPENDIX C DOMESTIC VIOLENCE/ASSESSMENT 51 CONSENT FORM Hello, I am conducting a research study about women and their relationships. The information that is collected from you will be used by myself in an attempt to understand women and their husbands or partners. I am asking that you complete a survey consisting of 25 questions. This should not take longer than 10-15 minutes to complete. You will remain anonymous in the study as your name will not appear on any of the forms. The consent will not be attached to the survey that you will complete. This allows you to fill out the survey without anyone knowing which information you provided. You Are not obligated to participate in the study. Whether you participate in the study or not has no influence in the care you will receive today. Thank you for agreeing to participate in the survey. Barbara Nunn, RN I have read the above information and agree to participate in the research study. Signature Date DOMESTIC VIOLENCE/ASSESSMENT appendix d RESEARCH SURVEY This questionnaire is to be used in conjunction with the Interpersonal Relationship Survey and is designed for research purposes only to obtain additional information regarding your current marital or intimate relationship together with basic sociodemographic information. All responses are strictly confidential. 1. Current marital status. Circle one. a. Single b. Married c. Separated d. Divorced e. Widowed 9. Were you physically abused as a child? Yes If yes, by whom? 2. Number of years married or involved in current relationship:years Yes No Yes Don't know No 12. Was your husband or partner's mother ever physi­ cally abused by her husband? Yes Don't know No 13. Within the last year, have you been hit, kicked, punched or physically assaulted in other ways by your husband or partner? 5. Race Husband or partner’s race 6. Annual household income. Circle one. e. $20,001 -$37,000 a. $ 0 - $9,400 f. $37,001-$44,000 b. $ 9,401 - $16,000 g. $44,001-$50,000 c. $16,001 - $23,000 h. Over $50,000 d. $23,001 - $30,000 Yes Yes No What is your occupation or profession? No 14. Within the last year, have you been emotionally abused (verbal threats, put-downs) by your husband or partner? Yes 7. Highest grade completed No 15. Within the last year, have you been raped (forced to have sexual intercourse or other forms of sexual penetration) by your husband or partner? Yes No 16. Have you ever been raped, emotionally abused, or physically abused by a husband, male partner or other male relative? 8. Your husband or partner's highest grade completed Is he employed? Don't know 11. Was your mother ever physically abused by your father? Husband or partner’s age Are you employed? 10. Was your husband or partner physically abused as a child? If yes, by whom? 3. With whom do you live? Circle one. a. Husband b. Male partner c. Live alone d. Husband with children e. Male partner with children f. Parents g. Other (please specify) 4. Age Don't know No Yes What is his occupation or profession? No For rape Yes No For emotional abuse Yes No For physical abuse Yes No DOMESTIC VIOLENCE/ASSESSMENT 53 APPENDIX E RESEARCH SURVEY CODED AS P QUESTIONS GROUP 1 p QUESTIONS GP i NUM ARI i 2 3 4 5 8 7 1 82 i 7 18 W 1 2 58 i 6 15 W 6 9 3 86 i 3 6 16 W B IO 4 80 i 1 19 W 1 5 58 i 17 B 2 6 59 i 1 55 5 2 8 8 49 1 2 18 9 62 1 1 2 20 IO 45 1 5 6 22 67 1 3 5 20 12 54 5 2 21 5 28 6 4 1 1 1 1 2 1 1 3 3 3 3 3 12 IO 3 3 3 1 IO 12 1 3 3 3 3 1 1 3 3 3 1 1 11 13 56 1 4 14 72 2 IO 15 48 2 1 5 19 16 45 1 7 20 17 42 1 8 6 22 18 64 3 2 3 23 19 57 1 4 2 19 20 53 1 5 6 18 H 1 21 48 1 6 16 3 9 22 65 1 6 18 w w 6 23 50 1 5 IB H 24 40 1 6 16 w w w w w w w w w 25 62 26 52 27 54 1 66 1 40 79 1 58 1 2 2 2 1 2 2 1 3 2 1 2 2 2 2 1 2 2 2 2 2 3 12 12 2 5 18 14 2 2 2 1 12 14 2 2 2 3 1 12 12 2 2 2 3 2 2 2 3 2 1 2 2 2 12 12 1 2 3 1 3 2 1 1 1 1 2 2 2 1 1 2 2 1 1 1 2 2 2 3 12 12 2 2 2 2 2 1 2 1 2 2 3 12 12 2 2 2 2 2 1 2 2 1 2 6 12 12 1 1 1 1 2 2 2 9 2 1 2 1 1 2 2 2 1 2 IO 1 3 2 1 2 1 2 1 1 2 2 8 2 3 2 1 1 2 2 2 2 1 IO 9 1 1 2 1 2 2 1 1 3 9 12 1 2 1 2 2 2 2 2 8 IO 12 2 2 1 2 2 1 2 2 1 1 2 1 1 2 2 1 1 2 1 2 2 2 2 1 1 1 2 2 2 1 2 2 2 1 1 2 2 2 1 1 1 1 1 14 16 2 2 2 2 1 2 2 2 2 1 3 14 16 2 2 2 2 1 1 2 2 1 1 6 13 16 2 2 2 2 2 2 2 1 2 23 W 1 12 12 2 21 W 3 12 12 1 2 22 W 3 12 12 2 2 38 W 8 18 16 1 1 18 W 1 IO 1 1 12 2 3 32 3 3 22 11 1 3© 5 6 2 2 2 2 1 2 1 1 2 1 1 1 2 2 2 1 2 2 1 2 3 1 1 1 2 2 1 1 1 1 1 1 1 1 1 2 1 3 3 3 3 2 1 2 2 1 1 1 2 2 1 1 1 1 1 3 1 1 2 1 1 1 3 1 1 1 1 1 1 2 1 1 1 1 2 2 2 1 1 3 2 1 2 2 1 1 2 3 1 1 2 2 1 1 2 2 3 1 1 2 2 1 1 2 2 3 1 2 2 2 1 1 1 6 15 W 8 6 16 8 7 19 w w 1 12 IO 3 3 3 3 8 19 B 2 12 12 1 3 3 W 1 11 12 1 1 1 w w w w w w 5 12 12 1 2 1 12 12 2 1 3 3 3 12 12 2 3 2 7 16 13 2 2 1 12 15 2 12 12 2 42 5© 43 55 1 2 6 18 44 49 1 1 2 20 45 62 1 1 2 20 46 45 1 6 6 24 47 67 1 3 5 27 48 54 1 3 2 25 6 9 2 3 1 2 12 64 57 2 12 32 38 2 12 67 39 2 2 1 31 1 2 2 1 8 82 1 1 2 2 37 3 3 3 1 49 4 1 3 1 3 1 30 5 3 2 18 20 1 2 3 46 2 IO 12 2 8 2 1 2 1 5 58 1 12 1 47 2 11 2 36 1 1 3 1 35 2 2 2 4 3 1 1 2 58 1 1 2 73 3 2 2 29 1 1 1 1 IO 6 58 2 9 2 55 1 2 12 17 33 1 1 16 4 19 2 34 1 15 2 8 2 28 2 14 13 1 2 12 W 12 11 12 w w w w w w w w w w w w 2 IO 9 IO 17 W 34 8 3 1 17 IB DOMESTIC VIOLENCE/ASSESSMENT APPENDIX GP NUM E ARI 2 3 49 46 1 2 6 50 72 2 13 4 Avg : 58.46 1.90 2.32 54 oont . 1.38 5 30 W 8 W 2 3.50 1.26 1.24 P QUESTIONS 6 3 9 IO 12 4.90 1.80 12 15 2 2 2 2 1 12 1 3 1 3 2 21.40 1.68 3.52 1.18 13 2 11.62 14 15 IB 2 2 1 2 1 1 1 2 12 1.70 17 18 2 . IO 1.34 RESEARCH SURVEY CODED AS P QUESTIONS GROUP 2 P QUESTIONS GP 2 NUM ARI 1 4 3 2 5 6 8 51 54 1 2 5 16 W 52 48 1 4 5 18 W 53 33 1 1 6 16 W 6 54 33 1 1 6 W 8 55 38 1 1 6 23 W 1 56 36 1 1 3 20 2 57 31 1 1 6 16 W W 1 9 IO 13 14 15 10 2 2 2 2 2 2 2 1 2 1 1 3 2 2 2 2 2 2 1 2 1 3 2 2 2 2 1 1 13 1 2 1 3 2 2 2 2 1 3 3 3 2 2 2 2 IO 12 9 12 9 9 2 12 12 13 12 2 12 2 IO 12 1 1 3 3 3 2 2 2 1 1 1 3 3 3 2 2 2 1 2 2 58 36 1 6 19 W 3 12 12 2 2 2 3 2 2 2 2 1 59 48 1 12 7 37 W 3 12 12 2 2 2 3 2 2 2 2 2 2 60 35 1 1 6 18 W 4 12 12 2 2 2 3 2 2 2 2 2 2 61 40 1 1 22 W 1 16 14 2 2 2 3 2 2 2 2 1 2 62 33 1 6 5 33 W 2 12 12 1 2 1 1 2 2 2 2 1 1 63 37 1 1 2 18 1 2 2 1 1 2 2 2 2 2 2 18 W W 84 39 2 1 65 51 4 1 2 24 W 22 2 12 12 1 3 1 1 2 2 2 1 1 1 12 12 2 3 3 1 2 2 2 2 1 2 14 12 2 3 3 1 2 2 2 2 2 2 13 1 2 1 2 2 2 2 2 1 1 W 2 W 4 W 2 14 12 1 2 1 2 2 2 2 2 1 1 24 W 1 13 12 2 2 1 2 2 2 2 2 2 2 J. 66 39 2 5 4 67 45 1 2 6 68 41 1 3 3 22 69 34 1 3 70 41 2 5 28 W 3 13 2 1 2 2 2 2 2 2 1 41 2 2 1 22 W 4 12 12 1 2 2 2 2 2 2 1 1 1 72 42 1 1 6 18 W 12 IO 3 2 2 2 2 2 2 2 2 2 73 37 1 2 2 20 W 7 14 14 2 2 2 2 2 2 2 2 2 2 4 13 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 1 2 2 2 2 2 2 2 2 2 2 2 2 74 75 76 78 1 3 6 19 W 47 1 2 2 21 W 3 14 34 3 3 5 20 W 1 12 39 2 6 1 31 W 5 14 12 2 2 2 2 2 2 2 2 2 2 34 1 2 28 W 1 12 12 2 2 2 2 2 2 2 2 2 2 W 2 12 12 2 2 2 2 2 2 2 2 2 2 43 IO 79 27 1 2 21 80 34 1 2 2 22 W 2 12 12 2 2 2 2 2 2 2 2 2 2 81 35 2 12 1 29 W 2 12 12 2 2 2 2 2 2 2 2 2 2 82 34 2 5 1 23 W 3 12 12 2 2 2 2 2 2 2 2 2 2 1 e 19 W 4 12 12 2 2 2 2 2 2 2 2 2 2 2 28 W 4 12 12 2 2 2 2 2 2 2 2 2 2 1 44 W 12 12 2 2 2 2 2 2 2 2 2 2 83 40 1 84 37 1 85 31 2 21 18 DOMESTIC VIOLENCE/ASSESSMENT 55 86 APPENDIX 29 W 30 2 3 H cont; . 87 36 2 12 88 26 2 23 89 44 1 4 90 40 1 2 91 34 6 92 36 6 12 12 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 30 W 6 12 12 45 S 12 5 19 W W 2 9 12 12 2 2 2 2 2 2 6 6 12 12 2 2 2 2 2 2 2 2 2 1 3 18 W 19 W 6 12 12 2 2 2 2 2 2 2 2 2 2 1 2 3 24 W a 16 14 2 2 2 2 2 2 2 2 2 2 5 13 13 2 2 2 2 2 2 2 2 12 13 2 2 2 2 2 2 2 2 2 2 4 93 45 1 8 19 W 94 31 1 2 6 20 W 95 33 20 W 4 14 14 2 2 2 2 2 2 2 2 2 2 38 1 2 2 96 IO 1 32 W 6 15 14 2 2 2 2 2 2 2 2 2 2 25 W 3 13 13 2 2 2 2 2 2 2 2 2 2 W 8 11 15 2 2 2 2 2 2 2 1 2 2 2 2 2 1 97 46 98 35 1 2 6 99 41 1 5 6 28 W 8 16 16 2 2 2 2 2 2 1OO 40 1 4 2 21 W 1 IO 12 1 3 2 2 2 2 2 2 2 2 Avg : 38.04 2 . IO 1.92 3 4 . IO 1.38 2 . IO 2 2 2 4.02 1.90 23 . IB 1.68 3.70 1.76 12.28 12.22 2 1.82 DOMESTIC VIOLENCE/ASSESSMENT 56 APPENDIX F ARI scores of respondents NUM GP ARI 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 .21 22 23 24 25 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 82 58 66 80 58 59 55 49 62 45 67 54 56 72 48 45 42 64 57 53 48 65 50 40 62 NUM GP ARI NUM GP ARI 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 52 54 58 73 49 67 64 58 55 47 58 82 57 66 79 58 59 55 49 62 45 67 54 46 72 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 54 48 33 33 38 36 31 36 48 35 40 33 37 39 51 39 45 41 34 41 41 42 37 43 47 n=100 NUM GP ARI 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 34 39 34 27 34 35 34 40 37 31 30 36 26 44 40 34 36 45 31 33 38 46 35 41 40 DOMESTIC VIOLENCE/ASSESSMENT 57 appendix g TABLE 1 Characteristics of the Sample Characteristics Abused n=50 Nonabused n=50 Age <18 18-21 22-25 26-30 >30 Mean years 11 22 7 13 7 21.40 Partner's Age <18 18-21 22-25 26-30 >30 Mean years 6 21 6 10 7 23.68 Marital Status Single Married Sep./Divorced Widowed Longevity of Relationship 1-3 years 4-6 years >6 years Mean years 6 13 18 8 5 23.18 3 14 10 10 13 25.72 35 12 3 0 39 7 3 1 33 11 6 3.50 34 8 8 4.10 Race African/American Hispanic White 2 2 48 0 0 50 Partner 's Race African/American Hispanic Caucasian 4 1 45 2 0 48 DOMESTIC VIOLENCE/ASSESSMENT 58 Appendix G cont.' Characteristic Abusive n=50 Living Arrangement Husband Male Partner Alone Husband/Child. Male Part./Child. Parents Other 1 6 3 5 10 20 5 Annual Household Income $0 - $9400 $ 9401 - $16000 $16001 - $23000 $23001 - $30000 $30001 - $37000 $37001 - $44000 > $44000 Mean Income 10 13 8 6 5 4 4 $16000 - $23000 Education Mean years Physical Abuse as a Child Yes No Don't know Partner's Physical Abuse as a Child Yes No Don't know Mother Physically Abused by Male Partner Yes No Don't know 15 26 5 4 11.62 Nonabusive n=50 10 9 7 2 6 15 1 10 9 6 9 3 6 •7 for both groups 5 31 11 1 12.28 24 6 4 2 12.0 7 30 10 2 12.22 18 28 4 10 39 1 18 28 4 10 39 1 16 23 11 9 39 2 DOMESTIC VIOLENCE/ASSESSMENT 59 Appendix G cont.' Characteristic Abusive n=50 Nonabusive n=50 Par tn er 's Mo th er Physi cal ly Abused by Male Partner Yes No Don't know 9 16 25 5 35 10 Physically Abused within Last Year Yes No 37 13 0 0 Emotionally Abused within the last year Yes No 38 12 5 45 Raped within the Last Year Yes No 10 40 0 0 Raped. Emotionally, or Physically Abused by Any Other Male Including Family Members Rape Yes No 16 34 5 45 Emotional Abuse Yes No 41 9 16 34 Physical Abuse Yes No 33 17 12 38 DOMESTIC VIOLENCE/ASSESSMENT 60 APPENDIX H ARI MEANS FOR SELECTED VARIABLES Length of Relationships Years Group 1 1 2 3 4 5 6 8 10 11 12 13 14 20 21 23 57.72 56.13 63.57 64.83 49.75 45.00 45.50 72.00 64.00 Group 2 37.31 39.58 38.00 41.25 38.00 36.00 31.00 26.00 48.12 46.20 51.77 55.40 44.71 39.00 45.50 55.00 64.00 39.67 72.00 37.00 58.00 31.00 26.00 38.04 48.25 38.00 39.67 72.00 37.00 58.00 58.46 Mean Mean Annual Income Income 0 $9401 $16001 $23001 $30000 $37001 $44001 - $9400 - $16000 - $23000 - $30000 - $37000 - $44000 -$50000 > $50000 Mean Group 2 Mean 62.67 61.50 53.20 57.67 52.67 61.60 47.00 58.17 37.30 36.44 42.00 40.40 41.33 34.20 39.50 34.20 52.52 46.47 49.00 44.38 47.00 47.90 43.25 47.27 58.46 38.04 48.25 Group 1 DOMESTIC VIOLENCE/ASSESSMENT 61 Appendix H cont.' 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