208816 Men who perpetrate intimate partner violence: Associations with health care service use, prior family violence, and substance use disorders

Tuesday, November 10, 2009: 10:45 AM

Vijay Singh, MD, MPH, MS , Robert Wood Johnson Clinical Scholars Program, University of Michigan, Ann Arbor, MI
Rebecca Cunningham, MD , Department of Emergency Medicine, Injury Research Center, University of Michigan, Ann Arbor, MI
Richard M. Tolman, PhD, MSW , School of Social Work, University of Michigan, Ann Arbor, MI
Objectives: Intimate partner violence (IPV) results in approximately 2 million injuries to women annually in the U.S. Few studies have addressed how physicians can identify and treat men who perpetrate IPV. To begin addressing this public health problem, this study (1) assessed the prevalence of physical IPV perpetration in a nationally-representative sample of men, and (2) examined the associations of IPV perpetration with health care use, demographics, prior family violence, and measures of physical and mental health. Methods: Bivariate and multivariate logistic regression analyses were performed on data from the 2001-2003 National Comorbidity Survey-Replication, in which interviews were conducted with non-institutionalized U.S. adults older than 18 years. Results: Of 1200 married or cohabiting men ≥21 years old in the sample, 188 (15.7%) of men (mean age 43) reported IPV perpetration. 62 (33.3%) witnessed IPV between their parents, and 48 (26.7%) had a history of any IPV as young adults. 49 (26.1%) had a substance use disorder (SUD), and 96 (71.1%) had a doctor for routine care, with 82 (62.7%) having ≥1 routine health visit in the past year. In multivariate analyses, witnessing parental abuse (OR 2.06), any prior IPV (OR 2.22), or a SUD (OR 1.73) predicted IPV perpetration in a current relationship. Conclusions: Male IPV perpetrators seek routine medical services, thus providing an opportunity for primary care providers to identify at-risk men. To prevent future violence, physicians can screen for IPV among and offer treatment to men who have a SUD, prior IPV, or history of witnessing parental abuse.

Learning Objectives:
1. Define the prevalence of intimate partner violence perpetration by men in a nationally-representative sample. 2. List the health care service use of male intimate partner violence perpetrators 3. Describe the associations of intimate partner violence perpetration with men’s prior family violence and substance use disorders.

Keywords: Domestic Violence, Violence Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a board-certified family physician, and I received a BA in Biology and MD from Northwestern University. I completed an MPH and post-doctoral training at the Johns Hopkins School of Public Health. I served my family medicine residency at UCLA. Currently in the Robert Wood Johnson Clinical Scholars Program at the University of Michigan, I am a Clinical Lecturer in the Department of Family Medicine, research fellow in the Department of Internal Medicine, and graduate student. At the University of Michigan I lecture social work and medical students on identifying and treating male patients for domestic violence perpetration. I recently co-wrote an invited commentary/editorial, “Health service collaborations in the engagement of intimate partner violence perpetration,” at http://www.annfammed.org/cgi/eletters/7/1/47#10494.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.