Enhanced Definitions of Intimate Partner Violence for DSM‐5 and ICD‐11 May Promote Improved Screening and Treatment

• Author: Heather M. Foran,Richard E. Heyman,Amy M. Smith Slep
• Published date: 01 March 2015
• DOI: http://doi.org/10.1111/famp.12121
• Date: 01 March 2015

Enhanced Definitions of Intimate Partner Violence

for DSM-5 and ICD-11 May Promote Improved

Screening and Treatment

RICHARD E. HEYMAN*

AMY M. SMITH SLEP*

HEATHER M. FORAN

†

Nuanced, multifaceted, and content valid diagnostic criteria for intimate partner

violence (IPV) have been created and can be used reliably in the field even by those with lit-

tle-to-no clinical training/background. The use of such criteria such as these would likely

lead to more reliable decision making in the field and more consistency across studies.

Further, interrater agreement was higher than that usually reported for individual mental

disorders. This paper will provide an overview of (a) IPV’s scope and impact; (b) the reli-

able and valid diagnostic criteria that have been used and the adaptation of these criteria

inserted in the latest Diagnostic and Statistical Manual of Mental Disorders (DSM) and

another adaptation proposed for the forthcoming International Statistical Classification of

Diseases and Related Health Problems (ICD); (c) suggestions for screening of IPV in

primary care settings; (d) interventions for IPV; and (e) suggested steps toward globally

accepted programs.

Keywords: Intimate Partner Violence; Partner Abuse; Partner Physical Abuse; Partner

Emotional Abuse; Partner Sexual Abuse; Partner Neglect

Fam Proc 54:64–81, 2015

Intimate relationships are exhilarating and humbling experiences. They are exhilarat-

ing for the sexual excitement, warmth, support, and security they bring, among the

many peaks charted by scientists, poets, and pop song lyricists. They are humbling

because strong attachments also evoke strong (often self-justifying) negative emotions

that provide ample opportunity for individuals to hurt those they love. Beyond the shores

of early exhilaration lie the shoals of negotiation, conflict, shared responsibilities , child

care, and interpersonal reward erosion that can expose relationships to reefs and rifts and

can incite partners to fall far short of their own beliefs about how they should behave.

One such danger is intimate partner violence (IPV), comprising physical, verbal/

symbolic, or sexual acts that cause—or have reasonable potential to cause—harm to

an intimate partner. This paper will provide an overview of (a) IPV’s scope and

impact; (b) nuanced, multifaceted, and content valid diagnostic criteria that have been

used reliably in the field even by those with little-to-no clinical train ing/background,

and the adaptation of these criteria inserted in the latest Diagnostic and Statistical

Manual of Mental Disorders (DSM; American Psychiatric Association, 2013) as well as

*Family Translational Research Group, New York University, New York, NY.

†

Psychology, Technical University of Braunschweig, Braunschweig, Germany.

Correspondence concerning this article should be addressed to Richard E. Heyman, Family Transla-

tional Research Group, New York University, New York, NY 10010. E-mail: richard.heyman@nyu.edu.

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Family Process, Vol. 54, No. 1, 2015 ©2015 Family Process Institute

doi: 10.1111/famp.12121

another adaptation proposed for the forthcoming International Statistical Classification

of Diseases and Related Health Problems (ICD); (c) suggestions for screening of IPV

in primary care settings; (d) interventions for IPV; and (e) suggested steps toward

globally accepted programs. Although the primary focus of this admittedly broad

synopsis of assessment and treatment will be on improved operationalized criteria for

IPV, these criteria have implications for prevalence estimation, screening, assessment,

prevention, clinical practice, and research, so we will touch on these implicated areas

as well.

OVERVIEW OF IPV’S SCOPE AND IMPACT

Prevalence in Adult Populations

Physical IPV has a yearly prevalence of 15% in several nationally representative stud-

ies of U.S. adults (e.g., Schafer, Caetano, & Clark, 1998). The lifetime and yearly preva-

lences from the 2010 CDC National Intimate Partner and Sexual Violence Survey

(Breiding, Chen, & Black, 2014), which are lower, can be found in Table 1. CDC collected

reports from individuals, whereas the Schafer et al. study interviewed couples (one of

many methodological differences). Table 1 also shows the CDC prevalences—for any phys-

ical IPV, impactful IPV, partner rape (a form of sexual abuse)—adjusted with Heyman

and Schlee’s (1997) correction factors for what prevalences would be if both partner s had

been assessed (because both men and women underreport victimization vs. couple

reports).

Prevalence rates vary substantially across countries. In the first European Union-wide

survey of IPV against women, 42,000 women across the 28 member states were surveyed

and lifetime rates of physical IPV ranged from 12% in many countries such as Spain and

Poland to 31% in Latvia (European Union Agency for Fundamental Rights, 2012). In the

World Health Organization (WHO) Multicountry Study on Women’s Health and Domest ic

Violence Against Women (Garcia-Moreno, Jansen, Ellsberg, Heise, & Watts, 2006) lifetime

reports of physical IPV ranged from 13% in urban Japan to 27% in urban Brazil to

between 40% and 50% in Samoa, rural Bangladesh, rural Tanzania, rural Ethiopia, rural

Peru, and 61% in urban Peru.

In the United States, physical IPV is the main source of violence in the lives of adoles-

cents and emerging adults (with about half of adolescents in U.S. samples reporting dating

physical IPV [reviewed by Glass et al., 2003] and between 29–57% of U.S. engaged couples

TABLE 1

IPV Prevalences from CDC’s 2010 National Intimate Partner and Sexual Violence Survey

Type of IPV

Women (%) Men (%)

Lifetime Last year Lifetime Last year

(1) Physical IPV 32.9 4.0 28.2 4.7

(1) with Heyman and Schlee (1997)

couples correction factor applied

46.0 5.6 42.3 7.1

(2) Stalking 10.7 2.8 2.1 0.5

(3) Rape 9.4 0.6

(1) (2), and/or (3) 35.6 5.9 28.5 5.0

(1) (2), and/or (3) with impact 28.8 –9.9 –

(1) (2), and/or (3) with impact with

Heyman and Schlee (1997) couples

correction factor applied

48.96 15.84

Psychological IPV 48.4 13.9 48.8 18.1

Fam. Proc., Vol. 54, March, 2015

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