April 4, 2011– For women, having a male partner who exhibits controlling behaviors such as limiting contact with friends and insisting on knowing one's whereabouts at all times, may be associated with increased physical and sexual relationship violence. However, young women experiencing these behaviors are more hesitant to answer questions about relationship violence—a fact that presents challenges for healthcare providers and others seeking to assist woman who are at risk.
The study conducted at Columbia University's Mailman School of Public Health is published in the April issue of Archives of Pediatrics and Adolescent Medicine, one of the JAMA/Archives journals.
"High rates of relationship violence have been reported among adolescents and young adults," said Marina Catallozzi, MD, of the Mailman School of Public Health and assistant professor at Columbia University's College of Physicians & Surgeons. "We wanted to explore the correlation between controlling behaviors by male partners and relationship violence."
To do so, the authors conducted an anonymous audio computer-assisted self-interview including 603 female patients in relationships the previous year, the ages of 15 to 24, in a reproductive health center in New York City. The women were asked about relationship violence. Controlling behaviors by the women's partners in the past 12 months was assessed using seven items from the 2003 World Health Organization's Multi-Country Study on Women's Health and Domestic Violence against Women: Tries to keep me from seeing my friends, tries to restrict contact with my family, insists on knowing where I am at all times, ignores me and treats me indifferently, gets angry if I speak with another man, is often suspicious before seeking health care for myself.
Overall, 411 women (68%) reported experiencing one or more episodes of controlling behavior; 38.1% reported experiencing only controlling behavior; 11.4% and 10% reported receiving controlling behaviors plus physical or sexual victimization respectively; and 8.6% reported all forms of relationship violence. The most commonly reported forms of controlling behavior exerted by the male partner were suspiciousness of infidelity (40.5%); anger if the woman spoke to another man (40.8%) and insistence on knowing the woman's location at all times (45.9%). Also common were attempts to keep the women from seeing friends (26.5%) and being ignored or treated indifferently (24.7%).
The authors found that being a younger adolescent (between the ages of 15 and 18), Hispanic ethnicity, childhood exposure to domestic violence, having reported one or more pregnancies, recent physical or sexual victimization, and being uncomfortable asking for condom use were all significantly associated with increased episodes of controlling behaviors by a partner.
"These data demonstrate the high frequency of controlling behaviors in the relationships of adolescents and young adults and support a nuanced approach to universal screening of controlling behaviors," stated Dr. Catallozzi, first author of the study.
"This awareness of the high rates of controlling behavior and the overlap with relationship violence, particularly for young people, may affect how they view health care provider-based screening and how honestly they might answer screening questions," noted Leslie Davidson, MD, MSc, professor of Clinical Epidemiology and Clinical Pediatrics, a director at the Mailman School's Center for the Prevention of Youth Violence, and principal investigator. "Awareness that young women may not be comfortable disclosing information honestly should prompt carefully crafted, repeated, and novel screening to improve identification, referral and treatment."
The study was supported by a cooperative agreement from the Centers for Disease Control and Prevention.
Journal
Archives of Pediatrics and Adolescent Medicine