Partner controlling behaviors appear to be associated with relationship violence

Having a significant other who exhibits controlling behaviors appears to be associated with increased physical and sexual relationship violence, according to a report in the April issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals. However, young women experiencing these behaviors are more hesitant to answer questions about relationship violence.

"High rates of relationship violence have been reported among adolescents and young adults," writes Marina Catallozzi, M.D., of the Mailman School of Public Health, Columbia University, New York, and colleagues as background information in the article. To examine the correlation between controlling behaviors and relationship violence, the authors conducted an anonymous audio computer-assisted self-interview with female patients in a reproductive health center. A total of 603 women between the ages of 15 and 24 years participated.

In the population examined, 411 women (68 percent) reported experiencing one or more episodes of controlling behavior; 38.1 percent reported experiencing only controlling behavior; 11.4 percent and 10 percent reported receiving controlling behaviors plus physical or sexual victimization respectively; and 8.6 percent reported all forms of relationship violence.

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.

Of women reporting controlling behaviors, approximately one in ten reported receiving all forms of victimization – sexual and physical aggression and controlling behaviors by a partner; however the proportion of women reporting controlling behaviors varied across the types of behaviors exhibited. For example, 22 women (3.7 percent) reported that their partner expected them to ask his permission before seeking health care, and 38 women (6.3 percent) reported that their partner tried to restrict their contact with family. Conversely, 149 women (24.7 percent) reported that their partner ignored or treated them indifferently and 160 women (26.5 percent) reported that their partner tried to keep them from seeing friends.

"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," the authors conclude. "In addition, 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. An 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."

(Arch Pediatr Adolesc Med. 2011;165[4]:313-319. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: This study was supported by a cooperative agreement from the Centers for Disease Control and Prevention. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

To contact Marina Catallozzi, M.D., call Stephanie Berger at 212-305-4372 or e-mail sb2247@columbia.edu.

For More Information: Contact the JAMA/Archives Media Relations Department at 312-464-JAMA or email: mediarelations@jama-archives.org.