Mental health of perpetrators of intimate partner violence
| Pages | 221-239 |
| DOI | https://doi.org/10.1108/MHRJ-08-2017-0028 |
| Date | 10 December 2018 |
| Published date | 10 December 2018 |
| Author | Kristina Sesar,Arta Dodaj,Nataša Šimić |
| Subject Matter | Health & social care,Mental health |
Mental health of perpetrators of intimate
partner violence
Kristina Sesar, Arta Dodaj and NatašaŠimić
Abstract
Purpose –Intimate partner violence (IPV) represents a widespread social and public health problem.
Researchers have been shown association between IPV and mental health problems. The purpose of this
paper is to present a review of the literature on relationship between wide ranges of mental health problems.
Design/methodology/approach –Research papers related to mental health problems among IPV
perpetrators and published in leading academic journals in UK and abroad from 1987 to 2017 were identified
and reviewed.
Findings –Although there were some equivocal findings, the authors found that most of the available
research suggests that there is a variety of psychological health problems among IPV perpetrators.
Specifically, there was evidence of a significant relationship between anger problems, anxiety, depression,
suicidal behaviour, personality disorders, alcoholism or problem gambling and perpetration of IPV. Results
from analysed studies identified high rates of co-morbid disorders in IPV perpetrators.
Practical implications –The findings highlight the need for treatment services to undertake screening and
assessment of wide range of psychological difficulties to be able to provide best treatment approaches.
Originality/value –To the best of our knowledge, this is the first systematic review that has included studies
evaluating various psychological health problems among perpetrators of IPV.
Keywords Intimate partner violence, Mental health, Perpetrators
Paper type Literature review
Introduction
Intimate partner violence (IPV) represents a widespread social and publichealth problem that has
economic consequences. It is definedas the physical, sexual andpsychological harm causedby a
current or formerpartner or spouse (Saltzman et al., 2002). Thetraditional belief is that women are
more oftenthe victims of IPV. However,recent studies have shownthat women are perpetratorsof
IPV just as much as men (Desmarais et al., 2012; Dutton et al., 2005; Straus, 2011).
Langhinrichsen -Rohling et al. (2012) found that nearly half of the couples in their study reported
reciprocal partner violence. In a quarter of the couples, it was only the men that were violent
towards their intimate partners. The remaining quarter reported only female violent behaviour
towards the intimatepartner. These results are consistent for both mild and severeforms of violent
behaviour, as well as for different types of romanticrelationships (dating relationship,cohabitation
or marriage) (Dutton et al., 2005). In recent decades, some of the studies regarding IPV have
focused on the causesof violence in romantic relationships. Such research has alsoexamined the
role of mental healthproblems in IPV (Holtzworth-Munroeand Stuart, 1994; Kessler et al.,2001).
These problemswere recorded as both riskfactors and consequences of violentbehaviour (Lipsky
et al., 2011; Saltzmanet al., 2002; Shorey et al., 2012). Themost common mental health problems
include mood disorders, various forms of anxiety disorders, personality disorders, psychotic
spectrumsymptoms and an increased riskof suicidal behaviour. In viewof the foregoing, this study
aimed to examine recent or current literature about mental health problems among IPV
perpetrators by using literature review method.
The relevant literature included in this literature review consists primarily of studies examining
specific variables correlated with mental health problems and mental disorders of perpetrators of
Received 3 August 2017
Revised 11 May 2018
26 June 2018
Accepted 2 July 2018
Kristina Sesar is based at the
Center for Mental Health,
Široki Brijeg Health Care
Center, Široki Brijeg, Bosnia
and Herzegovina.
Arta Dodaj is based at the
Department of Psychology,
University of Zadar, Zadar,
Croatia.
NatašaŠimic
´is Associate
Professor at the Department of
Psychology, University of
Zadar, Zadar, Croatia.
DOI 10.1108/MHRJ-08-2017-0028 VOL. 23 NO. 4 2018, pp. 221-239, © Emerald Publishing Limited, ISSN 1361-9322
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IPV. Papers are organised in terms of specific groups of mental health problems and disorders
associated with perpetration of IPV –psychological internalised negative emotions, suicidal
ideation and suicidal behaviour, personality disorders, alcoholism and gambling.
Before we start with literature review we would like to define the distinction between mental health
problems and mental disorders.
Mental health problems range from the worries we all experience as part of everyday life to serious
long-term conditions. The majority of people who experience mental health problems can get
over them or learn to live with them, especially if they get help early on. A psychological disorder,
also known as a mental disorder, is a pattern of behavioural or psychological symptoms that
impact multiple life areas and create distress for the person experiencing these symptoms.
The latest edition of the American Psychiatric Association’s diagnostic manual, the DSM-5
(American Psychiatric Associations, 2013), defines a mental disorder as: “[…] a syndrome
characterised by a clinically significant disturbance in an individual’s cognitive, emotion regulation,
or behaviour that reflects a dysfunction in the psychological, biological, or developmental process
underlying mental functioning. Mental disorders are usually associated with significant distress in
social, occupational, or other important activities”. The DSM-5 also notes that expected
responses to a common stressor such as the death of a loved one are not considered mental
disorders. The DSM also suggests that behaviours that are often considered at odds with social
norms are not considered disorders unless these actions are the result of some dysfunction.
Methodology
We conducted a literature review of published studies on mental health of perpetrators
of IPV. The review was performed according to the guidelines outlined in Grant and
Booth (2009) review article. Inclusion criteria were: original scientific papers that covered
cross-sectional and longitudinal population-based and clinical studies; literature reviews; or
books; that analysed the mental health of perpetrators of IPV, with a clearly described
methodology; papers with target population that included the young adults, adults and elderly;
papers published in national and international journals. Letters, opinion papers, experience
reports, case studies, and conference presentations were excluded. There were no restrictions
regarding or language.
The search for papers was carried out in PubMed, Google Scholar, ResearchGate, and
Academia.edu databases. The search terms were as follows: “Intimate Partner Violence”or
“Spouse abuse”and “Mental Health”or “Perpetrators of Intimate Partner Violence”and “Mental
Health”or “Psychopath”or “Suicidal Ideation”or “Depression”or “Anxiety disorders”or
“Gambling”or “Alcoholism”or “Personality Disorders”. The search was conducted from January
1987 to April 2017. In total, 137 papers were identified in the searched databases and analysed.
Internalised negative emotions
Anger and hostility
Although most studies have described specific characteristics of IPV perpetrators
(Holtzworth-Munroe et al., 1997; Tolman and Bennett, 1990), relatively few of them have
examined the relationship between internalised negative emotional states and IPV (Dutton and
Karakanta, 2013; Julian and McKenry, 1993; Maiuro et al., 1988; Pan et al., 1994). Internalised
negative emotionsinclude negative feelings and negative emotionality. Negativefeelings represent
the experience ofnegative emotions, while negativeemotionality includes anxiety,sadness, anger,
irritability and negative mood reactivity (Moffitt et al., 2001; Shiner and Caspi, 2003).
According to some studies findings (Eckhardt et al., 1997; Gilchrist et al., 2017; Guay et al., 2016;
Norlander and Eckhardt, 2005; Schumacher et al., 2001) anger has been found to be a risk factor
for IPV perpetration. Male perpetrators of IPV show elevated anger traits, an increased tendency
to outwardly express anger and decreased anger control. Their problems with anger have been
linearly related with more severe and more frequent violent behaviour in intimate partner
relationships (Holtzworth-Munroe et al., 2000). However, other studies have not found significant
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