W♀men at Risk: Domestic Violence and Women's Health
“Women at Risk brilliantly recasts the debate about violence against women and makes a major contribution to feminist thinking about women's health. Practitioners and theorists who want to understand women's health issues from a stunning new perspective must read this book.” --Heidi Hartmann, Ph.D., President, Institute for Women's Policy Research, Washington, DC “Women at Risk is a unique and important blend of research, practice, and advocacy. This volume makes a significant contribution to the health care profession's understanding of violence against women. This is a long-awaited book by two major scholars and practitioners in the field of violence against women.” --Richard J. Gelles, Ph.D., Director, Family Violence Research Program, University of Rhode Island “Women at Risk is a thought-provoking investigation of the violence that may ...
- Front Matter
- Back Matter
- Subject Index
Part I: Theoretical Perspectives
- Chapter 1: Medicine and Patriarchal Violence
- The Study: Abuse in a Medical Setting
- Medicine Constructs the Battering Syndrome
- Toward a Theory of Social Causation
- Chapter 2: Imagining Woman Battering: Social Knowledge, Social Therapy, and Patriarchal Benevolence
- Frances Cobbe's Dilemma—Circa 1870
- The Evolution of Benevolence: 1870–1970
- England: Mugging, Battering, and the Cycle of Deprivation
- America: The Social Construction of the Violent Family
- Conclusion: Cobbe's Dilemma Reconsidered
- Postmortem: Social Therapy
Part II: Health Consequences
- Chapter 3: Women and Children at Risk: A Feminist Perspective on Child Abuse
- Child Abuse and Woman Battering: Gender Politics or Female Pathology?
- Battering and Child Abuse: A Study
- A Feminist Approach to Battering and Child Abuse
- Chapter 4: Killing the Beast within: Woman Battering and Female Suicidality
- The Research Study
- Discussion and Conclusions
- Implications for Intervention
- Chapter 5: Preventing Gendered Homicide
- Primary Homicide: Empirical Dimensions
- Models of Violence, Theories of Homicide
- Gendered Homicide
Part III: Clinical Interventions
- Chapter 6: Personal Power and Institutional Victimization: Treating the Dual Trauma of Woman Battering
- Defining Terms: Domestic Violence, Abuse, and Woman Battering
- The Battering Syndrome: From Injury to Coercive Control
- Reconsidering Traumatization Theory
- Treating the Dual Trauma of Wife Battering
- Chapter 7: Clinical Violence Intervention: Lessons from Battered Women
- Clinical Violence Intervention
- Chapter 8: Discharge Planning with Battered Women
- The Background of Medical Concern
- The Challenge to Discharge Planning
- The Patient-Centered Interview
- Safety Planning
- Chapter 9: Physicians and Domestic Violence: Challenges for Prevention
- Definition and Classification
- Clinical Violence Intervention
- The Message to Physicians
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Library of Congress Cataloging-in-Publication Data
Women at risk: Domestic violence and women's health / authors, Evan Stark, Anne Flitcraft.
Includes bibliographical references and index.
ISBN 0-8039-7040-4 (acid-free paper). — ISBN 0-8039-7041-2 (pbk.: acid-free paper).
1. Wife abuse—United States. 2. Family violence—United States. 3. Abused wives—Medical care—United States. 4. Abused women—Medical care—United States. 5. Patriarchy—United States.
I. Flitcraft, Anne, 1948- . II. Title.
This book is printed on acid-free paper.
97 98 99 10 9 8 7 6 5 4 3 2
Sage Production Editor: Tricia K. Bennett
The articles and chapters adapted for this book reflect the support of two decades of coworkers and friends.
The idea of analyzing the medical dimensions of woman battering was conceived while we were participants in two lively group efforts, the East Coast Health Discussion Group (ECHDG), a radical collaboration to revise theories of health and medical care, and the New Haven Project for Battered Women (NHPBW), one of the early shelters for battered women in the United States. ECHDG participants Sally Guttmacher and her husband, the late Eric Holtzman, Joann Lakumnick, Meredith Turshen, Alonzo Plough Jr., and Janette Valentine became our intellectual mentors as well as lifelong friends. Vicente Navarro added a key element to friendship and intellectual guidance by opening the pages of the International Journal of Health Services to our work at a time when feminist, radical, and more conventional academic publications showed little interest in the problem. From the original NHPBW the friendships of Sophie Turner, Patricia Dillon, and Patricia Weel have been particularly important.
The research reported in Chapter 1 was supervised by Dr. William Frazier, then a young specialist in plastic surgery and director of the [Page x]emergency department at Yale. In addition to providing research staff and computer support, Frazier introduced us to Steve Record, a methodologist who grasped the challenge of identifying domestic violence in a system that routinely looked past its evidence. The larger trauma study at Yale—the basis for Chapters 3 and 4—was supported by research grants from NIMH (MH 30868) and overseen by Tom Lalley, Director of the Crime and Antisocial Behavior Division. As a consistent advocate for research on women, he helped focus our concerns, demanded the highest level of rigor, and assisted with advice at key stages in the work. Early and ongoing support for our work also came from Mark Rosenberg at the Centers for Disease Control and the Office of Domestic Violence under President Carter. Charles Lindblom and Ted Marmour provided a home for the work at the Institution for Social and Policy Studies, and Gary Tischler supported Anne with an NIMH postdoctoral fellowship. Sociologist Terence Hopkins honed the theoretical framework of our work as supervisor of Evan's Ph.D. dissertation at SUNY-Binghamton. Chapter 2 was written while Evan was on a Fulbright at the University of Essex where the intellectual companionship of Nikki Hart, Mick Mann, Karl Figlio, Paul Thompson, and Peter Townsend helped us through a difficult period.
Reconstructing the experience of battered women from the evidence in medical records was akin to an archaeological dig. Records were handwritten, filed in vast shelves beneath the hospital, and accessed only through manual requests. We owe an enormous debt to our core research staff of Anne Grey and Judy Robison (later joined by Karen Barr and Dr. Marty Roper). For 4 years, they retrieved, deciphered, and coded thousands of women's medical histories, maintaining their capacity for humor and objectivity in the face of work that was as exhausting emotionally as it was physically. All the while Corky Simoes remained unflappable, extending her numerous duties as administrative secretary to counseling (albeit without license) friends, staff, and wayfarers. The success of our team also depended on a vast army at Yale-New Haven Hospital and Yale Medical School's Department of Surgery, including staff of the medical records department, data entry clerks, social work staff, and nurses in the emergency room.
The chapters in Parts II and III reflect our efforts over the past decade to bring violence prevention and intervention into contemporary clinical practice. A Henry Rutgers Fellowship, a sabbatical, and support from Ray Caprio, Marcia Wicker, and other Public Administration colleagues have allowed Evan to maintain an agenda that includes training, clinical work, and advocacy alongside traditional scholarship. One result is the [Page xi]growing interest in child protection, mental health, psychiatry, and social work reflected in Chapters 3, 4, and 6. Whatever insight these chapters offer into mothers of abused children, women who attempt suicide, or battered women in the mental health setting is due, in no small part, to the mentoring (and friendship) of Laurie Harkness, Joyce and Rudy Duncan, Jack Sternbach, Jean Hay, Enid Peterson, and Susan Schechter, social workers all.
The support and enthusiasm—and flexibility—of colleagues at the University of Connecticut's Outpatient Services at the Burgdorf Health Center have enabled Anne to expand her efforts in clinical violence prevention while maintaining her inner-city practice and teaching in general internal medicine. We are profoundly grateful for the help of Marie Begley, R.N., and Drs. Aida Vega, Harry Katz-Pollack, Ellen Nestler, Bruce Gould, Ken Abriola, and Claudia McClintock.
Chapters 7, 8, and 9 have their genealogy in the work of the Domestic Violence Training Project (DVTP), which we codirect. Identified as the main provider of health training in Connecticut, the program has been running since its inception by Kate Paranteau, a lifelong advocate for women whose wisdom, tenacity, and professional skill have earned her—and DVTP—a national reputation. But it is for Kate's friendship—along with the support from fellow DVTP staff Carol Marci and Robyn Tousey-Ayers—that we are most thankful. Grants from Connecticut's Department of Health and the Commonwealth Foundation have allowed us to practice what we preach, that is, system change through professional education, training, and advocacy.
It would be disingenuous not to acknowledge that our critical stance on policy and practice—including the practice of the battered women's movement with which we strongly identify—has created special problems in legitimacy. If we stand up to be counted in this climate, it is because of the courage we have witnessed in the hundreds of battered women with whom we have worked and because of the support we received from our parents and from Heidi Hartmann, Sharon Vaughan, Elaine (Carmen) Hilberman, Eve Buzawa, Barbara Hart, Lucy Freidman, Ken Fox, Carla DeGerolomo, and so many others whose commitment to women's liberation is matched by a stubborn unwillingness to be politically correct.
Owing so much to so many, it is finally to one another and to our children, Aaron, Sam, Daniel, and Rachel, that we owe the most important debt.
In 1975, en route from California to New Haven, we stopped in St. Paul to see an old friend, Sharon Vaughan. Several days of searching produced a work address at a large Victorian house in a not yet gentrified section of the city. We knocked and a woman opened, then quickly closed the door. A second knock—this time with Evan holding our young son—got us admitted.
Women were everywhere: answering phones in a small office; meeting in huddled groups behind half-closed sliding doors; preparing lunch in the kitchen; and moving, with children in tow, up and down the stairs and in and out the back door. In an alcove at the top of the first landing, two women were sitting, their heads hung on one another's shoulders, their arms loosely draped around each other, audibly sobbing.
After several minutes, Sharon descended the stairs and buoyantly announced she had just completed her first grant proposal. Then, with all the grace of Kathryn Hepburn, she waved her hand in a gallant sweep and introduced Women's Advocates, the first American shelter for battered women. “What do you think?” she asked, breaking into a broad smile.
[Page xiv]Answering Sharon's question occupied a good portion of the next two decades. The chapters collected in this volume are products of this work.
A year after the visit to St. Paul, we were living in New Haven, housing women on the run and working with a small group to plan a 24-hour hotline and shelter. We both had been exposed to violence in the community during the 1960s—Anne as a VISTA volunteer in Cleveland and Evan as a community organizer in Minneapolis. But the levels of coercion these women described were beyond anything we had seen or read about. The physical results of dozens, sometimes hundreds, of assaultive episodes were appalling. The women who used our home as a safe house were as likely to be middle class as poor, as likely to be white as black or Hispanic. Regardless of race or background, the women had all gone to tremendous lengths simply to survive. There was one more thing. They recounted long and complicated histories of frustrated help seeking. The medical, criminal justice, and social service professionals, it seemed, had either ignored their plight or done things that actually made it worse.
During the summer of 1976, a grant to visit shelters in Europe brought us to the Chiswick section of London. We walked past a stone wall with the words “A HOUSE FOR WOMEN” scrawled in large letters and knocked at the door of Chiswick Women's Aid, the best known battered women's refuge in the world. Erin Pizzey answered. Without hesitation, the founder of Women's Aid waved us into an extraordinary scene of noise and chaos. There were 90 women and children staying in the six-bedroom house. “If they can manage this,” Pizzey quipped, “they can handle anything.”
That night, led by a Jamaican lawyer who had just escaped from her abuser, a group of us took rolls of wallpaper and a portable toilet, crossed town in an old bus that belonged to the shelter, and “seized” an abandoned railroad hotel. Twenty-four hours later, the hotel was ready to host its first battered women.The Research Base
These images of women doing for themselves framed our thinking when, in 1977, Anne asked Dr. William Frazier, director of the emergency [Page xv]room at Yale-New Haven Hospital, if she could do her medical school thesis on battered women who used the surgical emergency service.
“What's a battered woman?” Dr. Frazier asked.
Dr. Frazier was only the first of several skeptics who listened to us patiently and then gave us unselfish support. At the time, there was no evidence that domestic violence was a common health problem. What we had to offer, besides the partnership between a physician and a sociologist, was experience with shelters and hotlines that demonstrated that male violence against partners was epidemic. It seemed inconceivable that this epidemic could have bypassed the medical gaze.
So began our 20-year collaboration to identify the medical dimensions and health consequences of domestic violence.
In taking up this work, we faced two methodological challenges. When we began the research, there were few services or protections for battered women. It was commonly believed that asking patients directly about violence might expose them to further danger, and therefore, interview studies were ethically suspect. The next best source of information were women's medical histories. But using these records posed the problem Kempe, Silverman, Steele, Droegemueller, and Silver (1962) had faced in attempting to document child abuse in the early 1960s. The phenomena we wanted to study were officially invisible. Like Kempe et al., we needed an index of suspicion to uncover cases of domestic violence that had not been designated as such. We addressed this problem by postulating that, like child abuse cases, the injury patterns and context of battering could be used to distinguish domestic violence from accidental injury.
Starting with a sample of 520 records of women's visits to the surgical emergency service (the basis for Chapter 1), our research eventually encompassed the clinical histories of 4,500 women who used the hospital in the late 1970s and early 1980s, including more than 1,000 battered women, emergency room patients, mothers of abused children, women who attempted suicide, rape victims, psychiatric emergency patients, and women using the hospital's obstetrical service. Our initial goal was simply to document the extent of domestic violence and its significance for women's health. Only gradually, as we analyzed the notes, diagnoses, treatment strategies, and referrals compiled over the years by hundreds of physicians, nurses, social workers, and psychiatrists, did a third goal emerge: to evaluate the appropriateness of the clinical response and suggest ways to improve it.
[Page xvi]Originally published between 1978 and 1995, the papers collected here report the major findings of these studies.
The chapters in Part I review the empirical findings from the early research, show how domestic violence and the medical response converge in the evolution of a battering syndrome, and link this process to larger social and historical currents. The theoretical framework developed in these chapters draws on feminism and Marxism as well as on more conventional sociological and psychiatric paradigms. We situate woman battering in the struggles that surround sexual inequality, emphasizing the social (rather than the psychological or interpersonal) dimensions of male domination and female subordination. Women are battered in this schema not because individual men use violence or other inappropriate means to stifle their subjectivity but because male resistance to women's personal and political liberation is reinforced by the very systems to which women turn for help, including organized medicine. This part also emphasizes how the key dimensions of battering—from its prevalence and dynamics in a given population to the paradigms used to explain domestic violence in different societies—take shape amidst class, race, and sexual struggles for the most fundamental material, social, and psychic resources.
Part II views the overall significance of domestic violence for women's health through the prism of child abuse, female suicidality, and homicide, three of its most extreme outcomes. The chapter on mental health that introduces the part on clinical interventions (Part III) reframes prevailing models of treatment in terms of recent knowledge regarding the coercive elements in battering. Part III also traces the implications of the theory and data for improved practice in medicine, social work, and community health.
For 5 years, our small research staff diligently abstracted millions of bits of information on women and their health problems from records that ranged in size from a few pages to several volumes. In addition to the usual information on complaints, examination results, diagnoses, prescriptions, and referrals, the charts often included extensive commentary as clinicians struggled to explain why a population of previously normal women developed a complex psychosocial and medical history subsequent to a series of “accidents.”
[Page xvii]The initial conclusion of our research was that more women sought medical treatment for injuries resulting from domestic violence than for any other cause. This finding was used to support political initiatives on behalf of battered women, including the controversial Violence Against Women portion of President Bill Clinton's 1994 Crime Bill. Conservative writers and syndicated journalists critiqued our “gender feminist” orientation and dubbed our conclusions “guesstimates” and “noble lies” (Sommers, 1994, p. 202). Meanwhile, in the wake of expanded services and the commitment of medical resources, direct interview and questionnaire studies continued to document substantially the same or higher figures than we uncovered. For example, a recent survey of 648 randomly sampled women who sought treatment at four emergency departments in Denver found that more than half (54.2%) had been threatened or physically injured by a husband or boyfriend at some time in their lives (Abbott, Johnson, Koziol-McLain, & Lowenstein, 1995). This is about 250% higher than our estimate that one female injury victim in five had a history of domestic violence.
Our empirical claims about the importance of domestic violence as a source of female injury are supported by data presented in Chapter 1 as well as in Chapters 3, 4, and 5. Although it has momentous implications for women's health as well as for the allocation of resources, the conclusion should not surprise persons familiar with domestic violence or its effects on systems other than medicine. When we began our work, Parnas (1967) had already reported that police received more calls regarding “domestics” than murder, aggravated assault, battering, and all other serious crimes combined. The key factor here—often missed by our critics—is the historical nature of battering relationships, the extent to which the perpetrator's continued access to his victim creates a cumulative burden of injury on the community that is unique in our society. Some sense of this burden can be garnered from a recent London survey (Mooney, 1993) that reveals that victims of domestic violence had suffered an average of 7.1 assaults during the previous 12 months, resulting in an average of 4.3 injuries and an annual assault incidence rate of 85 per 100. Although further historical and cross-sectional data may negate these findings, it is hard to imagine a source of female injury, accidental or otherwise, that is more common. To appreciate our more limited claim about medically relevant injury, readers need only compare the fact that, whereas nonbattered adults may make one injury visit to an emergency service in their lifetime, battered women average more than one such visit each year.
[Page xviii]A second important finding of our work involved the links of domestic violence to a range of family and women's health problems, including child abuse, homicide, alcohol and drug abuse, rape, poor pregnancy outcomes, and female suicide attempts. Battered women (or their children) suffer a disproportionate risk of these problems only after the onset of domestic violence. The composite picture that emerges is of a battering syndrome that, if not curtailed through early intervention, evolves through predictable stages into a pattern of entrapment that is as devastating as the trauma of physical assault.
Equally important, as the chapters in Part II document, domestic violence is a major cause of these problems, accounting for half of all child abuse, for instance, a third of female suicide attempts (and half of those by black women), 40% of primary homicides, and equally significant proportions of rape, female alcoholism, drug use, and depressive illness. In the world of social and medical science, evidence that problems are statistically correlated often has little practical importance or else is neglected because it implies that sacred academic or professional boundaries should be bridged. We have known for a decade that deliberate childhood injury and fatality commonly result when a batterer extends his violence to the child. But the child protection establishment has only recently opened a dialogue with the battered women's community. Even fewer inroads have been made into psychiatry or substance abuse treatment.
A third major conclusion of this work is that the medical response to abuse directly contributes to the isolation and entrapment that are hallmarks of the battering syndrome. Although the chapters in Part I provide an elaborate theoretical explanation for this seeming paradox at the micro- and macrolevels, each part of the volume considers how current ways of understanding and treating domestic violence contribute to its perpetuation. So significant are the effects of medical neglect, minimization, labeling, and victim blaming that, in Chapter 6, we conceptualize battering as a dual trauma constituted from parallel strains of male coercion and clinical mistreatment.
Recent support for communitywide violence prevention by federal health and justice agencies and professional medical associations are important steps in remedying the dual trauma of interpersonal violence. Coupled with these efforts, the massive use of health services by battered women offers clinicians a window of opportunity for early intervention and prevention. The chapters in Parts II and III provide the information needed to take advantage of this opportunity by routinely identifying, [Page xix]assessing, and referring domestic violence victims at all health care sites, psychiatric and medical, primary as well as emergent.
Major changes in the status of domestic violence have occurred since we began our work. An enormous body of specialized literature on the problem has appeared and the response to battered women has burgeoned into an international network of services that extends from Boston to Cape Town and includes an extensive state-run regulatory apparatus in addition to thousands of community-based programs. Virtually invisible to medicine two decades ago, today domestic violence is recognized as a major problem by virtually every medical, nursing, and public health organization in the United States.
The chapters in this volume have been substantially revised and updated to reflect these developments, including our own growing commitment to professional education and to make the theoretical argument and presentation of data more accessible to the large number of students and general readers interested in the problem. It would have taken a completely different book, however, to integrate fully the vast specialized literature or to revise our theoretical conceptions to account for all the current political changes, including the new commitment by medicine. Indeed, by conserving many of the original references in the early essays, we hope to acknowledge important early work and emphasize its relevance to current concerns.
We are cautiously optimistic about recent developments in the domestic violence field. At the same time, the critical tone of the early essays resonates with our deep concern that the most vital political elements in the movement by and for battered women will be compromised if state protection and the provision of service to victims are overemphasized.
The clinical issues domestic violence presents are similar to those presented by a range of other social ills. Nevertheless, the scope and political context of domestic violence require a broad reframing of women's health, as well as the changes in medical response outlined in Parts II and III.
In our view, male violence against partners in contemporary society is a defensive response to women's progressive liberation from maternity and domestic servitude, a liberation that is as inevitable in an expanding capitalist economy as it is inconceivable apart from women's [Page xx]self-activity across a broad terrain. That women will be “free” yet must always free themselves is no less true in individual relationships than in society as a whole, and this paradox is the immediate source of the suffering that concerns us here.
We have chosen health as the focus of inquiry because that is where we work, because it is in the medical system that the most physical and behavioral consequences of assault are seen most vividly, and because we believe that viewing domestic violence through the prism of women's health throws new light on medical practice, not only on domestic violence. If we criticize medical practice (and say little about the negative effects of legal, criminal justice, or social work intervention), this is because, more than the other services, medicine's identification with science and healing symbolizes its central role as an interpreter of the human condition.
The most dramatic evidence in these chapters concerns the physical injury and death women and children suffer as the direct result of male violence. This reflects our initial belief that horrendous criminal acts of violence lay at the heart of woman battering. It was this belief that led us to emphasize shelter for women, that brought us to the emergency room as the site of research, and that is reflected in our early emphasis on injury. What we have learned since—in no small part from the hundreds of battered women with whom we have worked—is that our initial belief was wrong. In fact, the clinical dimensions of battering—from repeated injury to addiction, suicidality, child abuse, severe mental illness, and homicide—are best understood less as the product of male violence than as the cumulative result of women's entrapment by an extreme (though common) form of male domination. Violence is a necessary condition in trapping women in battering relationships. But it is rarely sufficient to explain the level of harm, degradation, or pathology that follows domestic violence. The medical, psychiatric, and behavioral problems presented by battered women arise because male strategies of coercion, isolation, and control converge with discriminatory structures and institutional practices to make it extremely difficult, sometimes impossible, for women to escape from abusive relationships when they most want or need to.
The distinction between violence and coercion may seem too subtle to have practical implications. On the contrary, however, shifting the emphasis from violent acts to the ways in which male control converges with larger processes of discrimination has enormous importance in identifying who is being victimized, which strategies we define as [Page xxi]criminal, where and how we intervene, and how we balance advocacy for women's liberation with the important emphasis on personal safety through police protection and shelter. It is impossible to study the health of battered women without discerning their desire to share in power, not simply to be protected from its excesses. Nor is this a concern only for health providers. Keeping our “mind on freedom,” as the old civil rights song put it, remains the greatest challenge as the battered women's movement seeks to protect women from individual injury by forging working alliances with the very political, legal, economic, and service systems once believed to be the primary source of women's social injury.[Page xxii]
References[Page 221]1995). Domestic violence against women: Incidence and prevalence in an emergency department population. Journal of the American Medical Association, 273, 1763–1767. http://dx.doi.org/10.1001/jama.1995.03520460045033, , , & (1953). Rudolf Virchow. Madison: University of Wisconsin Press.(1978). Group treatment for children in shelters for battered women. In A.R.Roberts (Ed.), Battered women and their families: Intervention strategies and treatment programs (pp. 49–61). New York: Springer., & (American Humane Society. (1978). National analysis of official child neglect and abuse reporting. Denver, CO: Author.American Medical Association Council on Ethical and Judicial Affairs. (1992). Physicians and domestic violence: Ethical considerations. Journal of the American Medical Association, 267, 267–3190.American Medical Association Council on Scientific Affairs. (1992). Violence against women: Relevance for medical practitioners. Journal of the American Medical Association, 267, 267–3184.1980). The battered woman syndrome. Annals of Emergency Medicine, 9(2), 84–91. http://dx.doi.org/10.1016/S0196-0644%2880%2980336-2(1992). Suicide attempts among Greek and Danish women and the quality of their relationships with husbands and boyfriends. Acta Psychiatrica Scandinavica, 85(3), 189–195. http://dx.doi.org/10.1111/j.1600-0447.1992.tb08593.x, , , , & (1973). False promises. New York: McGraw-Hill.([Page 222]1976). At risk: An account of the work of the battered child research department. Boston: Routledge Kegan Paul.et al. (1976). Toward a new psychology of women. Boston: Beacon.(1977). People who deliberately poison or injure themselves: Their problems and contacts with helping agencies. Psychological Medicine, 7, 7–289. http://dx.doi.org/10.1017/S0033291700023114, , , , & (1982). 'Til death do us part: A study of spouse murder. Bulletin of the American Academy of Psychiatry and Law, 10(1), 271–280., , , & (1992). Physical and sexual abuse as predictors of substance use and suicide among pregnant teenagers. Journal of Adolescent Health, 13(2), 128–132. http://dx.doi.org/10.1016/1054-139X%2892%2990079-Q, , & (1991). Female homicides in United States workplaces, 1980–1985. AmericanJournal of Public Health, 81(6), 729–732. http://dx.doi.org/10.2105/AJPH.81.6.729(1978). Authority and the family revisited: Or a world without father?New German Critique, 13, 13–35.(1991). Drug abuse and other risk factors for physical abuse among white, non-Hispanic, black, and Hispanic women. American Journal of Obstetrics and Gynecology, 164, 164–491. http://dx.doi.org/10.1016/0002-9378%2891%2991428-Y, , , & (1986). Changing spectrum of serious child abuse. Pediatrics, 77(1), 113–116., , & (1991). Suicide attempts by battered wives. Acta Psychiatrica Scandinavica, 83, 83–380. http://dx.doi.org/10.1111/j.1600-0447.1991.tb05560.x, & (1993). What the scientific evidence shows: On the average we can do no better than arrest. In R.Gelles & D.R.Loseke (Eds.), Current controversies on family violence (pp. 323–337). Newbury Park, CA: Sage.(1975). A larger perspective on the Flexner Report. International Journal of Health Services, 5(4), 573–592. http://dx.doi.org/10.2190/F31Q-592N-056K-VETL(1987, April). Women and anger: Cultural prohibitions and the feminine ideal. Paper presented at Learning From Women: Theory and Practice, Boston.(1978, February 14). Testimony before the Committee on Science and Technology (DISPAC Subcommittee), U.S. House of Representatives.(1982). The cost of inequality: Metropolitan structure and violent crime. American Sociological Review, 47, 47–114., & (1992). American Indian—Alaska Native youth health. Journal of the American Medical Association, 267(12), 1637–1644. http://dx.doi.org/10.1001/jama.1992.03480120075036, , , , & (1978). On changes in psychiatric diagnosis over time. American Psychologist, 33(11), 1017–1103. http://dx.doi.org/10.1037/0003-066X.33.11.1017(1986). A feminist examination of family systems models of violence against women in the family. In M.Ault-Richie (Ed.), Women and family therapy (pp. 84–107). Rockville, MD: Aspen.(1988). On the relationship between wife beating and child abuse. In K.Yllö & M.Bograd (Eds.), Feminist perspectives on wife abuse (pp. 158–176). Newbury Park, CA: Sage., , & (1987). The medical treatment of battered wives. Women's Health, 12, 12–25., & ([Page 223]1983). The new scholarship on family violence. Signs: Journal of Women and Culture in Society, 8(3), 490–531. http://dx.doi.org/10.1086/493987, & (1978). Social origins of depression—A study of psychiatric disorder in women. London: Tavistock., & (1984). Stressful life events and psychiatric symptoms in black females. Journal of Adolescent Research, 4, 4–140., , & (1987). Women who kill. New York: Free Press.(1975). Against our will. New York: Simon & Schuster.(1987). Childhood sexual and physical abuse as a factor in adult psychiatric illness. American Journal of Psychiatry, 144, 144–1426., , , & (1989). Violence against women as a health care issue. Family Medicine, 21, 21–368.(1992). State of the union address. Washington, DC: Government Printing Office.(1990). Domestic violence: The criminal justice response. Newbury Park, CA: Sage., & (1986). Violent transactions. London: Basil Blackwell., & (1989). A rest of two explanatory models of women's response to battering. Nursing Research, 38, 38–18. http://dx.doi.org/10.1097/00006199-198901000-00004(1989). Suicidal persons and their partners: Individual and interpersonal dynamics. Suicide and Life-Threatening Behavior, 19(3), 237–248., , & (1985). The scapegoating of mothers: A call for change. American Journal of Orthopsychiatry, 55(4), 344–353., & (1984). Victims of violence and psychiatric illness. American Journal of Psychiatry, 141, 141–378., , & (1995). Introduction. In S.Schechter & A.Ganley (Eds.), Domestic violence: A national curriculum for family preservation practitioners (pp. vii–xi). San Francisco: Family Violence Prevention Fund.(1974). Imperialism, the family and cultures of resistance. Socialist Revolution, S, 20.(Centers for Disease Control. (1983). Homicide surveillance. Atlanta, GA: U.S. Department of Health and Human Services.Centers for Disease Control. (1988). Premature mortality due to homicide—United States, 1968–1985. Morbidity and Mortality Weekly Review, 37, 37–543.1984). Race, socioeconomic status and domestic homicide, Atlanta, 1971–72. American Journal of Public Health, 74, 74–813. http://dx.doi.org/10.2105/AJPH.74.8.813(1971). Women as psychiatric and psychotherapeutic patients. Journal of Marriage and the Family, 33(4), 746–759. http://dx.doi.org/10.2307/349448(1972). Cruelty in English divorce: Some empirical findings. Journal of Marriage and the Family, 34(4), 706–712. http://dx.doi.org/10.2307/350323, & (1985). Gender relation and difference in psychoanalytic perspective. In H.Eisenstein & A.Jardine (Eds.), The future of difference (pp. 3–20). New Brunswick, NJ: Rutgers University Press.(1964). Method and measurement in sociology. New York: Free Press.(1967). The social organization of juvenile justice. New York: John Wiley.([Page 224]1960). Delinquency and opportunity. Glencoe, IL: Free Press., & (1878). Wife torture in England. Contemporary Review, 32, 32–55.(Committee on Cultural Psychiatry. (1989). Suicide and ethnicity in the United States. In Report of the Group for the Advancement of Psychiatry (pp. 1–131; No. 128). Washington, DC: U.S. Public Health Service.Committee on Trauma Research. (1985). Injury in America: A continuing health problem. Washington, DC: National Academy of Medicine.Commonwealth Fund. (1993). The Commonwealth Fund survey of women's health. New York: Louis B. Harris Associates.Connecticut Task Force on Abused Women. (1978). Household violence study, north central and capital regions. Hartford: Connecticut Coalition Against Domestic Violence.1981). Clinical issues in domestic violence. Social Casework, 62(1), 3–12.(1971). The death of the family. London: Penguin.(1977). The bonds of womanhood: “Women's sphere” in New England 1780–1835. New Haven, CT: Yale University Press.(1977). You are dangerous to your health: The ideology and politics of victim blaming. International Journal of Health Services, 7(4), 663–680. http://dx.doi.org/10.2190/YU77-T7B1-EN9X-G0PN(1991). Homicide followed by suicide—Kentucky, 1985–1990. Mortality Morbidity Weekly Review, 40(38), 652–653.(1975). Violence, race and culture. Lexington, MA: Lexington Books.(1967). Spearheads for reform: The social settlement and the progressive movement, 1890–1914. New York: Oxford University Press.(1994). Murder in families. Washington, DC: U.S. Department of Justice., & (1991). Biological and genetic contributors to violence: Widom's untold tale. Psychological Bulletin, 109, 109–125. http://dx.doi.org/10.1037/0033-2909.109.1.125, & (1977). The mermaid and the minotaur. New York: Harper & Row.(1977, August). Violence between men and women within the family setting. Paper presented at the VIII World Congress of Sociology, Toronto, Canada., & (1977–1978). Wives: The appropriate victims of marital violence. Victimology: An International Journal, 2(3–4), 426–442., & (1979). Violence against wives. New York: Free Press., & (1992). Women, violence and social change. London: Routledge Kegan Paul. http://dx.doi.org/10.4324/9780203450734, & (1977). La police des families. Paris: Editions de Minuit.(1968). Man, medicine and environment. New York: Praeger.(1951). Suicide: A study in sociology. Glencoe, IL: Free Press.(1993). Emotional attachments in abusive relationships: A test of traumatic bonding theory. Violence and Victims, 105(8), 139–155., & (1992). Understanding women's response to domestic violence: A redefinition of battered woman's syndrome. Hofstra Law Review, 21, 1191.(1991). Suicide in minority groups: Epidemiologic and cultural perspectives. In S.J.Blumenthal & D.J.Kupfer (Eds.), Suicide over the life cycle: Risk factors, assessment and treatment of suicidal patients (pp. 571–598). Washington, DC: American Psychiatric Press., , & ([Page 225]1979). For her own good: 150 years of expert advice. New York: Anchor., & (1970). Sanity, madness and the family. Middlesex, UK: Penguin., & (1976). Captains of consciousness. New York: Vintage.(Family Violence Reporting Program. (1993). Family violence arrests—Annual report, 1993. Meriden: Connecticut Department of Public Safety.1978). The wretched of the earth. New York: Grove.(1975). Women and their families on the overland trail, 1842–1867. Feminist Studies, 2, 2–150., & (1992). Post-traumatic stress disorder: Relationship with various traumatic events. Violence Update, 2(9), 1, 8–12.(1985). The traumatic impact of child sexual abuse: A conceptualization. American Journal of Orthopsychiatry, 55, 55–530., & (1985). License to rape. New York: Holt, Rinehart & Winston., & (1985). The stresses and coping behavior of battered women. Social Casework, 66, 66–341.(1985). Mother-daughter relationships: Psychodynamics, politics and philosophy. In H.Eisenstein & A.Jardine (Eds.), The future of difference (pp. 20–41). New Brunswick, NJ: Rutgers University Press.(1977). Battered women: An emergency room epidemiology with a description of a clinical syndrome and critique of present therapeutics. Unpublished doctoral dissertation, Yale University School of Medicine.(1993). Physicians and domestic violence: Challenges for prevention. Health Affairs, 12(4), 154–161. http://dx.doi.org/10.1377/hlthaff.12.4.154(1995). Clinical violence intervention: Lessons from battered women. Journal of Health Care for the Poor and Underserved, 6(2), 187–197. http://dx.doi.org/10.1353/hpu.2010.0583(1977). Recent findings related to wife abuse. Social Casework, 58, 58–13.(1973). The birth of the clinic: A technology of medical perception (A. M. SheridanSmith, Trans.). New York: Pantheon.(1963). The feminine mystique. New York: Dell.(1963). Mourning and melancholia. In S.Freud, General psychological theory: Papers on metapsychology (pp. 164–180). New York: Collier.(1983). Biological explanations. In L.Friedman (Ed.), Crimes of violence (Vol. 13, pp. 7–20). New York: Chelsea.(1992). Inquiry about victimization. Archives of Internal Medicine, 152, 152–1186. http://dx.doi.org/10.1001/archinte.1992.00400180056008, , , , & (1980). High risk neighborhoods and high risk families: The human ecology of child maltreatment. Child Development, 52(1), 188–198. http://dx.doi.org/10.2307/1129606, & (1993). Aggression, substance use and suicidal behaviors in high school students. American Journal of Public Health, 83(2), 179–184. http://dx.doi.org/10.2105/AJPH.83.2.179, , , & (1975a). Battered wives. Medicine, Science and the Law, 15(4), 237.(1975b). Wife battering: A preliminary survey of 100 cases. British Medical Journal, 25(1), 194–197. http://dx.doi.org/10.1136/bmj.1.5951.194(1976). Ten types of battered wives. Welfare Officer, 1, 1–5.(1974). The violent home. Beverly Hills, CA: Sage.([Page 226]1975). Violence and pregnancy: A note on the extent of the problem and needed services. The Family Co-ordinator, 24(1), 81–86. http://dx.doi.org/10.2307/583055(1988). Violence and pregnancy: Are pregnant women at greater risk of abuse?Journal of Marriage and the Family, 50(3), 841–847. http://dx.doi.org/10.2307/352652(1988). Intimate violence: The causes and consequences of abuse in the American family. New York: Simon & Schuster., & (1986). Alcohol consumption, cognition and context: Examining tavern violence. In A.Cambell & J.Gibbs (Eds.), Violent transactions (pp. 133–152). London: Basil Blackwell.(1988). The new morbidity: Homicide, suicide, accidents, and life-threatening behaviors. In J.T.Gibbs (Ed.), Young, black and male in America: An endangered species (pp. 258–288). Dover, MA: Auburn.(1973). Violence against children: Physical abuse in the United States. Cambridge, MA: Harvard University Press.(1985). In a different voice: Women's conceptions of self and morality. In H.Eisenstein & A.Jardine (Eds.), The future of difference (pp. 274–317). New Brunswick, NJ: Rutgers University Press.(1935). The living of Charlotte Perkins Gilman: An autobiography. New York: D. Appleton-Century.(1991). Prevalence of domestic violence among patients in three ambulatory care internal medicine clinics. Journal of General Internal Medicine, 6, 317–322. http://dx.doi.org/10.1007/BF02597429, , , , & (1975). Some recent changes in American families. Current population reports (Series P-23, No. 52). Washington, DC: U.S. Bureau of the Census.(1990). Psychiatric response to family violence: Identifying and confronting neglected danger. Lexington, MA: Lexington Books.(1971). Force and violence in the family. Journal of Marriage and the Family, 33(4), 624–636. http://dx.doi.org/10.2307/349435(1993). Violence against women: Mental health effects: 2. Conceptualizations of posttraumatic stress. Applied and Preventive Psychology, 2, 2–123., , & (1988). Heroes of their own lives: The politics and history of family violence. New York: Viking.(1991). The female fear. Chicago: University of Illinois Press., & (1972). Sex, marital status and suicide. Journal of Health and Social Behavior, 13, 13–204. http://dx.doi.org/10.2307/2136902(1973). The family life cycle: Internal dynamics and social consequences. Sociology and Social Research, 57, 57–182., & (1980). Personality characteristics of battered women. Dissertation Abstracts International, 40(7-B), 3395.(1980). Advances in the epidemiology of injury as a basis for public policy. Public Health Report, 95, 95–411.(1979). Policing the crisis: Mugging, the state, and law and order. London: Macmillan., , , , & (1986). Prevalence of domestic violence in community practice and rate of physician inquiry. Family Medicine, 24, 24–283., , & ([Page 227]1991). Clinical correlates of intent in attempted suicide. Acta Psychiatrica Scandinavica, 83(5), 406–411. http://dx.doi.org/10.1111/j.1600-0447.1991.tb05565.x, , & (1987). Family violence and homicide in the black community—Are they linked? In R.L.Hampton (Ed.), Violence in the black family (pp. 133–156). Lexington, MA: Lexington Books.(1977). Battered women: A study of women who live with violent alcohol-abusing men. American Journal of Orthopsychiatry, 47(2), 291–306. http://dx.doi.org/10.1111/j.1939-0025.1977.tb00984.x, & (1986). Autonomy and gender: Some questions for therapists. Psychotherapy, 25(2), 205–212. http://dx.doi.org/10.1037/h0085599, & (1976). Capitalism, patriarchy, and job segregation by sex. Signs: Journal of Women in Culture and Society, 1(3), 137–169. http://dx.doi.org/10.1086/493283(1986). Longitudinal-situational approaches to understanding black on black homicide. Report of the Secretary's Task Force on Black and Minority Health (Vol. 5). Washington, DC: U.S. Department of Health and Human Services.(1987). Devalued lives and racial stereotypes: Ideological barriers to the prevention of family violence among blacks. In R.L.Hampton (Ed.), Violence in the black family (pp. 189–207). Lexington, MA: Lexington Books.(Health Policy Advisory Center. (1970). The American health empire. New York: Random House.1976). Basic issues concerning prediction. In R.E.Heifer & C.H.Kempe (Eds.), Child abuse and neglect: The family and the community (pp. 362–373). Cambridge, MA: Ballinger.(1987). Battering during pregnancy: Intervention strategies. Birth, 14, 14–142. http://dx.doi.org/10.1111/j.1523-536X.1987.tb01476.x, & (1978). The battered wife. American Journal of Nursing, 78(4), 650–653., , & (1984). Changing the subject: Psychology, social regulation and subjectivity. London: Methuen., , , , & (1964). Suicide and homicide. New York: Free Press., & , (1986). Histories of violence in an outpatient population: An exploratory study. American Journal of Orthopsychiatry, 56(1), 137–141. http://dx.doi.org/10.1111/j.1939-0025.1986.tb01550.x(1987, April). Sexual violence. Paper presented at Learning From Women: Theory and Practice, Boston.(1992). Trauma and recovery. New York: Basic Books.(1980). Overview: The “wife-beater's wife” reconsidered. American Journal of Psychiatry, 137, 137–1336.(1977–1978). Sixty battered women. Victimology: An International Journal, 2(3–4), 460–470., & (1972). Authority and the family in critical theory (M. J.O'Connell, Trans.). New York: Herder & Herder.(1981). Status relationships in marriage: Risk factors in spouse abuse. Journal of Marriage and the Family, 43, 43–675., , & (1978). Pediatricians and mothers. In J.Ehrenreich (Ed.), The cultural crisis of modern medicine (pp. 201–211). New York: Monthly Review Press.([Page 228]1986). Women, families and larger systems. In M.Ault-Richie (Ed.), Women and family therapy (pp. 25–33). Rockville, MD: Aspen.(1977). Ce sexe wui n'en est pas un. Paris: Minuit.(1987). Assault experiences of 100 psychiatric inpatients: Evidence of the need for routine inquiry. American Journal of Psychiatry, 144, 144–908., & (1975). Social amnesia. Boston: Beacon.(1990). Children of battered women. Newbury Park, CA: Sage., , & (1971). Man's world, women's place: A study in social mythology. New York: Dell.(1991). Island in the street. Berkeley: University of California Press.(1985). The impact of battering and sheltering on select psychological states of battered women. Dissertation Abstracts International, 47, 376B.(1983). Acomparison of primary and secondary homicides in the U.S. American Journal of Epidemiology, 117(3), 309–319., , & , (1979). Durkheim revisited: Why do women kill themselves?Suicide and Life-Threatening Behavior, 9(3), 145–153.(1994). Next time she'll be dead. Boston: Beacon.(1992). When love goes wrong. New York: HarperCollins., & (1981). The District of Columbia's Firearms Control Regulation Act of 1975: The toughest handgun control act in the U.S.—Or is it?Annuals of the American Academy of Political Science, 455, 455–138.(1994). The beast in the boudoir: Petkeeping in nineteenth century Paris. Berkeley: University of California Press.(1987). Do abused children become abusive parents?American Journal of Orthopsychiatry, 57(2), 186–193. http://dx.doi.org/10.1111/j.1939-0025.1987.tb03528.x, & (1992). Gun ownership as a risk factor for homicide in the home. New England Journal of Medicine, 329, 329–1084.(1992). Men, women and murder: Gender-specific differences in rates of fatal violence and victimization. Journal of Trauma, 33(1), 1–5. http://dx.doi.org/10.1097/00005373-199207000-00001, & (1926). Craig's wife. New York: Samuel French.(1988). Surviving sexual violence. Cambridge, UK: Polity Press.(1975). The social nature of the definition problem in health. International Journal of Health Services, 5(4), 625–642. http://dx.doi.org/10.2190/X5H6-TC5W-D36T-K7KY(1962). The battered child syndrome. Journal of the American Medical Association, 181, 181–17. http://dx.doi.org/10.1001/jama.1962.03050270019004, , , , & (1976). Assessing family pathology. In R.E.Heifer & C.H.Kempe (Eds.), Child abuse and neglect: The family and the community (pp. 115–127). Cambridge, MA: Ballinger., & (1984). Family violence. Washington, DC: Bureau of Justice Statistics., & (1993). Spousal/partner assault: A protocol for the sentencing and supervision of offenders. Swampscott, MA: Production Specialties.([Page 229]1984). Suicide: Answering the cry for help. In F.J.Turner (Ed.), Differential diagnosis and treatment in social work (3rd ed., pp. 840–851). New York: Free Press., , & (1991). Foreword. In M.L.Rosenberg & M.A.Fenley (Eds.), Violence in America: A public health approach (pp. v–vi). New York: Oxford University Press.(1992). Somatic consequences of violence against women. Archives of Family Medicine, 1, 1–53. http://dx.doi.org/10.1001/archfami.1.1.53, & (1991). Deleterious effects of criminal victimization on women's health and medical utilization. Archives of Internal Medicine, 151, 151–342. http://dx.doi.org/10.1001/archinte.1991.00400020092019, , & (1984). A feminist analysis of child abuse and neglect. In D.Finkelhor, R.Gelles, H.Hotaling, & M.Straus (Eds.), The dark side of families (pp. 289–293). Beverly Hills, CA: Sage.(1974). Estimates of age specific divorce rates for females in the U.S., 1960–1969. Journal of Marriage and the Family, 36(2), 72–76. http://dx.doi.org/10.2307/350996, & (1988). Not so benign neglect: The medical response to battering. In K.Yllö & M.Bograd (Eds.), Feminist perspectives on wife abuse (pp. 249–266). Newbury Park, CA: Sage., & (1978). A theory of interpersonal conflict with application to industrial disputes. Unpublished discussion paper, Institute of Public Policy Studies, Ann Arbor, MI.(1959). The divided self. London: Tavistock.(1980). Sanity, madness and the family (Vol. 1). New York: Penguin., & (1993, June 3). Keynote address. Preventing Violence to Women: Integrating the Health and Legal Communities, Association of Trial Lawyers of America, Washington, DC.(1977). Haven in a heartless world. New York: Basic Books.(1988). Physical aggression between spouses: A social learning theory perspective. In R.L.Van Hasselt, A.S.Morrison, M.Bellack, & VN.Hersen (Eds.), Handbook of family violence (pp. 31–57). New York: Plenum.(1981). Prosecution of spouse abuse: Innovations in criminal justice response. Washington, DC: Center for Women's Policy Studies.(1984). Female dependency in context: Some theoretical and technical considerations. In P.Reiker & E.Carmen (Eds.), The gender gap in psychotherapy: Social realities and psychological processes (pp. 125–139). New York: Plenum.(1993). Invisible violence: Adolescent African American girls and street violence. Unpublished paper, University of Pennsylvania School of Medicine.(1975). Interparental violence and its effect on the children: A study of 50 families in general practice. Medicine, Science and the Law, 15(3), 172.(1965). Sources of marital dissatisfaction among applicants for divorce. American Journal of Orthopsychiatry, 36(5), 803–807. http://dx.doi.org/10.1111/j.1939-0025.1966.tb02407.x(1994, October 21). What penalty for killing in passion?New York Times, p. A18.(1965). La vida. New York: Vintage.([Page 230]1992). The battered woman and shelters. Albany: State University of New York Press.(1981). One with a gun gets you two: Mandatory sentencing and firearms violence in Detroit. Annals of the American Academy of Political Science, 455, 50–67. http://dx.doi.org/10.1177/000271628145500113, & (1977). Criminal homicide as a situational transaction. Social Problems, 25, 176–186. http://dx.doi.org/10.2307/800293(1977). Murder in space city: A cultural analysis of Houston homicide patterns. New York: Oxford University Press.(1929). Middletown: A study in contemporary American culture. New York: Harcourt Brace., & (1975). Violence at home: A review of the literature. American Journal of Orthopsychiatry, 45(3), 328–345. http://dx.doi.org/10.1111/j.1939-0025.1975.tb02544.x(1987). Black women who kill. In R.L.Hampton (Ed.), Violence in the black family (pp. 157–186). Lexington, MA: Lexington Books.(1992). Fighting bodies, fighting words: A theory and politics of rape prevention. In J.Butler & J.WScott (Eds.), Feminists theorize the political (pp. 385–403). New York: Routledge Kegan Paul.(1958). Eros and civilization. New York: Vintage.(1971). Deviance as therapy: The paradox of the self-destructive female. Journal of Health and Social Behavior, 12, 12–113. http://dx.doi.org/10.2307/2948518(1978). Sociological perspectives on family violence. In J.M.Martin (Ed.), Violence and the family (pp. 103–135). London: Wiley.(1977). Battered wives. New York: Pocket Books.(1983). Maternal and paternal abuse of children: Theoretical and research perspectives. In D.Finkelhor, R.Gelles, G.Hotaling, & M.Straus (Eds.), The dark side of families (pp. 293–305). Beverly Hills, CA: Sage.(1968). Theories of variation in the suicide rate. In J.Gibbs (Ed.), Suicide (pp. 74–95). New York: Harper & Row.(1967). Capital: A critique of political economy. New York: International Publishers.(1982). Cause of death-homicide: A research note on black females as homicide victims. Victimology: An International Journal, 7, 7–204.(1992). Assessing for abuse during pregnancy: Severity and frequency of injuries and associated entry into prenatalcare. Journal of the American Medical Association, 267, 267–3176., , , & (1977). The modern rise in population. New York: Academic Press.(1989). Victimization of mothers of abused children: A controlled study. Pediatrics, 84, 84–531., , & (1989). A study of women presenting in an emergency department. American Journal of Public Health, 79, 79–65. http://dx.doi.org/10.2105/AJPH.79.1.65, & (1953). Social change and cultural surrogates. In C.Kluckhohn & H.Murray (Eds.), Personality in nature, society and culture (pp. 651–662). New York: Knopf.(1982). Biology and violence. In M.E.Wolfgang & N.A.Weiner (Eds.), Criminal violence (pp. 21–80). Beverly Hills, CA: Sage., , , & ([Page 231]1982). Psychological determinants and correlates of criminal violence. In M.E.Wolfgang & N.A.Weiner (Eds.), Criminal violence (pp. 81–170). Beverly Hills, CA: Sage.(1988). The battered woman. American Family Physician, 37(1), 193–199., & (1989). Fatal violence among spouses in the U.S., 1976–1985. American Journal of Public Health, 79(5), 595–599. http://dx.doi.org/10.2105/AJPH.79.5.595, & (1982). Poverty, inequality and the urban homicide rate. Criminology, 20, 20–103. http://dx.doi.org/10.1111/j.1745-9125.1982.tb00450.x(1959). The sociological imagination. New York: Oxford University Press.(1978). Equity and changing patient characteristics in south central Connecticut, 1950–1975. Unpublished paper, Yale University, Department of Psychiatry., & (1993). Domestic violence in north London. Middlesex: Middlesex University, Centre for Criminology.(1979). Family interaction associated with abuse of children over five years of age. Child Abuse & Neglect, 3, 3–857., & (1995, July 25). Letter to the editor. New York Times, A14.(1967). Homicide in England. In M.E.Wolfgang (Ed.), Studies in homicide (pp. 29–36). New York: Harper & Row., & (1973). The politics of a guaranteed income. New York: Vintage.(1988). Impact of sexual and physical abuse on women's mental health. Lancet, 1, 1–841., , , & (1977). The formation of the state and the oppression of women. Review of Radical Political Economics, 9(3), 7–22. http://dx.doi.org/10.1177/048661347700900302(1988). Characteristics of childhood homicide in Ohio, 1974–1984. American Journal of Public Health, 78, 78–822. http://dx.doi.org/10.2105/AJPH.78.7.822(1984). The distribution of psychiatric morbidity in black Americans: Review and suggestions for research. Community Mental Health Journal, 20, 20–169.(1984). Making an issue of child abuse. Chicago: University of Chicago Press.(1983). Parental awareness and child abuse: A cognitive-developmental analysis of urban and rural samples. American Journal of Orthopsychiatry, 53(2), 512–524., & (1978). The medicalization and legalization of child abuse. American Journal of Orthopsychiatry, 48(4), 593–606. http://dx.doi.org/10.1111/j.1939-0025.1978.tb02564.x, & (New Jersey Network (Producer). (1985). Battered wives, shattered lives [Video]. Trenton, NJ: Public Broadcasting Service.1976). The abused wife problem. Social Casework, 57(1), 27–32.(1979). Spouse abuse, incidence and relationship to selected demographic variables. Victimology: An International Journal, 4, 4–131., & (1971). Violence in divorce prone families. Journal of Marriage and the Family, 692–698. http://dx.doi.org/10.2307/349443(O'Carroll, E (1991). Suicide. In J.M.Last (Ed.), Maxcy-Rosenau: Public health and preventive medicine (13th ed., pp. 1054–1062). New York: Appleton-Century-Crofts.[Page 232]1986). Woman abuse: Facts replacing myths. Albany: State University of New York Press.(1975). The social structure of violence in childhood and approval of violence as an adult. Aggressive Behavior, 1(3), 193–211. http://dx.doi.org/10.1002/1098-2337%281975%291:3%3C193::AID-AB2480010302%3E3.0.CO;2-K, & (1988). Black on black crime. Society, 25(5), 59–62. http://dx.doi.org/10.1007/BF02695743, & (Parliament. (1974–1975). Report from the Select Committee on Violence in Marriage. In Proceedings of the Committee: Report, Minutes of Evidence and Appendices (Vol. 2, H.C. 553-II). London: HMSO.1967). The police response to the domestic disturbance. Wisconsin Law Review, 2, 2–914.(1978). Violent families: Coping responses of abused wives. Child Welfare, 57(2), 101–111.(1989). Alcohol-related parasuicide among married people. South African Medical Journal, 75, 75–120., & (1974). Scream quietly or the neighbors will hear. London: Penguin.(1981). Choosing a violent relationship. New Society, 56(962), 23., & (1969). The childsavers: The invention of delinquency. Chicago: University of Chicago Press.(1977). Wife-beating in nineteenth century America. Unpublished paper, University of Michigan.(1987). Domestic tyranny: The making of American social policy against family violence from colonial times to the present. New York: Oxford University Press.(1980). A preliminary report on the prevalence of domestic violence among psychiatric inpatients. American Journal of Psychiatry, 137, 137–974., , , , , & (1972). Why blacks kill blacks. New York: Emerson Hall.(1989). The strengths model of case management: Results from twelve demonstrations. Psychosocial Rehabilitation Journal, 13(1), 23–32., & (1989). Rates of domestic violence against adult women by male partners. Journal of the American Board of Family Practice, 2, 2–227., , & (Reiker, P.P., & Carmen, E.H. (Eds.). (1984). The gender gap in psychotherapy. New York: Plenum. http://dx.doi.org/10.1007/978-1-4684-4754-51953). The lonely crowd. New York: Doubleday.(1978). Web of violence. London: Routledge Kegan Paul.(1986). An ongoing multifamily group in a woman's shelter. American Journal of Orthopsychiatry, 56(1), 120–131. http://dx.doi.org/10.1111/j.1939-0025.1986.tb01548.x, & (1980). Alcohol and wife abuse: The effect of alcohol on attributions of blame for wife abuse. Personality and Social Psychology Bulletin, 6, 6–51., & (1973). Suicide and marital status: A changing relationship?Journal of Marriage and the Family, 35(2), 239–244. http://dx.doi.org/10.2307/350652, & (1976). Police social workers: A history. Social Work, 21(4), 294–299.(1979). Characteristics of the families of abused children. Child Abuse & Neglect, 3, 861. http://dx.doi.org/10.1016/0145-2134%2879%2990118-2, & (1979). Rape and battering: An assessment of 100 cases. Unpublished paper, Department of Surgery, Yale Medical School., , & ([Page 233]1991). Responding to hidden abuse: A role for social work in reforming mental health systems. Social Work, 36(6), 408–413., , & (1978). Self-concept disturbances among mothers who abuse their children. Psychological Reports, 43, 43–323. http://dx.doi.org/10.2466/pr0.19126.96.36.1993(1981). Children: The unintended victims of marital violence. American Journal of Orthopsychiatry, 51(4), 692–699. http://dx.doi.org/10.1111/j.1939-0025.1981.tb01416.x, & (1991). Assaultive violence. In M.Rosenberg & M.A.Fenley (Eds.), Violence in America: A public health approach (pp. 14–50). New York: Oxford University Press., & (1986). Interpersonal violence: Homicide and spouse abuse. In J.M.Last (Ed.), Maxcy-Rosenau: Public health and preventive medicine (12th ed., pp. 1399–1426). New York: Appleton-Century-Crofts., , & (1993). Love & toil: Motherhood in outcast London 1870–1918. New York: Oxford University Press.(1977). Very common but difficult to reach. Unpublished paper, Connecticut Mental Health Center.(1977–1978). Battered women: A medical problem requiring detection. International Journal of Psychiatry in Medicine, 8(2), 191–202., & (1975). The traffic in women. In R.Reiter (Ed.), Toward an anthropology of women (pp. 157–211). New York: Monthly Review Press.(1970). The study of family power structure: A review, 1960–1969. Journal of Marriage and the Family, 33, 33–539.(1978, October). Psychic battering: The institutional response to battered women. Paper presented at Midwest Conference on Abuse of Women, St. Louis.(1982). Women and male violence. Boston: South End.(1955). Completed and attempted suicide: A comparative analysis. American Sociological Review, 20, 20–273. http://dx.doi.org/10.2307/2087385, & , (1993). Does arrest deter domestic violence?American Behavioral Scientist, 36(5), 601–610. http://dx.doi.org/10.1177/0002764293036005005, & (1979). Survey of spousal violence against women in Kentucky (Harris Study No. 7092701). Washington, DC: Government Printing Office.(1974). Battered wives. British Journal of Psychiatry, 125, 125–433. http://dx.doi.org/10.1192/bjp.125.5.433(1956). The stress of life. New York: McGraw-Hill.(1973). Hidden injuries of class. New York: Vintage., & (1978). Criminal violence, criminal justice. New York: Random House.(1978). Use of ambulatory health services by the near poor. American Journal of Public Health, 68(12), 1195–1202. http://dx.doi.org/10.2105/AJPH.68.12.1195, & (1976). Catherine Beecher: A study in American domesticity. New York: Norton.(1969). On the proletarian revolution and the end of political-economic society. Radical America, 3, 23–66.(1988). Handgun regulations, crime, assaults and homicide: A tale of two cities. New England Journal of Medicine, 319(19), 1256–1262. http://dx.doi.org/10.1056/NEJM198811103191905, , , , & (1975). The female world of love and ritual: Relations between women in 19th century America. Signs: Journal of Women and Culture in Society, 1(1), 1–31. http://dx.doi.org/10.1086/493203([Page 234]1964). The wifebeater's wife: A study of family interaction. Archives of General Psychiatry, 11, 11–107. http://dx.doi.org/10.1001/archpsyc.1964.01720260001001, , & (1994). Who stole feminism?New York: Simon & Schuster.(1989). Child abuse, neglect and adult behavior: Research design and findings on criminality, violence and child abuse. American Journal of Orthopsychiatry, 59, 59–355.(1978). Comparing battered and nonbattered women. Victimology: An International Journal, 3(1–2), 32–44.(1979). Psychosocial aspects of wife battering. Social Casework, 6, 6–479., , , & (1977). The epidemic as a social event. International Journal of Health Services, 7(4), 681–705. http://dx.doi.org/10.2190/RKRQ-WV6E-DV53-VATT(1984). The battering syndrome: Social knowledge, social therapy and the abuse of women. Unpublished doctoral dissertation, State University of New York, Binghamton.(1990). Rethinking homicide: Violence, race and the politics of gender. International Journal of Health Services, 20(1), 3–27. http://dx.doi.org/10.2190/2TN0-DAFW-8CPG-8VE5(1992). Framing and reframing battered women. In E.Buzawa (Ed.), Domestic violence: The criminal justice response (pp. 271–292). Westport, CT: Auburn.(1993). The myth of black violence. Social Work, 38(4), 485–491.(1994). Discharge planning with victims of domestic violence. Discharge Planning Update, 14(2), 1, 3–7.(1995). Killing the beast within: Woman battering and female suicidality. International Journal of Health Services, 25, 25–43. http://dx.doi.org/10.2190/H6V6-YP3K-QWK1-MK5D(1983). Social knowledge, social therapy, and the abuse of women: The case against patriarchal benevolence. In D.Finkelhor, R.Gelles, G.Hotaling, & M.Straus (Eds.), The dark side of families (pp. 330–349). Beverly Hills, CA: Sage., & (1988a). Personal power and institutional victimization: Treating the dual trauma of woman battering. In F.Ochberg (Ed.), Post-traumatic therapy and victims of violence (pp. 115–152). New York: Brunner/Mazel., & (1988b). Violence among intimates: An epidemiological review. In V.N.Hasselt, A.S.Morrison, M.Bellack, & V.N.Hersen (Eds.), Handbook of family violence (pp. 293–319). New York: Plenum., & (1988c). Women and children at risk: A feminist perspective on child abuse. International Journal of Health Services, 18(1), 97–118. http://dx.doi.org/10.2190/3K8F-KDWD-QYXK-2AX5, & (1991). Spouse abuse. In J.M.Last (Ed.), Maxcy-Rosenau: Public health and preventive medicine (13th ed., pp. 1040–1043). New York: Appleton-Century-Crofts., & (1992). Spouse abuse. In M.Zahn & M.Rosenberg (Eds.), Violence in America: A public health approach (pp. 123–158). New York: Oxford University Press., & (1979). Medicine and patriarchal violence: The social construction of a private event. International Journal of Health Services, 9(3), 461–493. http://dx.doi.org/10.2190/KTLU-CCU7-BMNQ-V2KY, , & (1981). Domestic violence: Wife abuse in the medical setting (Monograph No. 7). Washington, DC: Office of Domestic Violence., , , , , & ([Page 235]1976). Violence within the family. In R.E.Helfer & C.H.Kempe (Eds.), Child abuse and neglect: The family and the community (pp. 3–25). Cambridge, MA: Ballinger.(1974). A psychiatric study of parents who abuse infants and small children. In R.E.Heifer & C.H.Kempe (Eds.), The battered child (pp. 103–147). Chicago: University of Chicago Press., & (1974). Occupational environment in relation to physical punishment and dogmatism. In M.Straus & S.Steinmetz (Eds.), Violence in the family (pp. 116–172). New York: Harper & Row.(1977–1978). The battered husband syndrome. Victimology: An International Journal, 2(3–4), 499–509.(1973). The family as a cradle of violence. Society, 10(6), 50–58. http://dx.doi.org/10.1007/BF02695281, & (1974). General introduction. In S.Steinmetz & M.Straus (Eds.), Violence in the family (pp. 3–25). New York: Dodd, Mead., & (1980). Presidential address: Conceptual ambiguity and morality in modern psychiatry. In EP.Reiker & E.H.Carmen (Eds.), The gender gap in psychotherapy (pp. 5–14). New York: Plenum.(1971). Some social antecedents of physical punishment: A linkage theory interpretation. Journal of Marriage and the Family, 33, 33–658. http://dx.doi.org/10.2307/349438(1976). Sexual inequality, cultural norms, and wife-beating. Victimology: An International Journal, 1(1), 54–70.(1977–1978). Wife beating: How common and why. Victimology: An International Journal, 2(3–4), 443–459.(1986). Domestic violence and homicide antecedents. Bulletin of the New York Academy of Medicine, 62, 62–446.(1986). Societal change and change in family violence from 1975 to 1985 as revealed by two national surveys. Journal of Marriage and the Family, 48, 48–465. http://dx.doi.org/10.2307/352033, (1980). Behind closed doors: A survey of family violence in America. New York: Doubleday., , & (1994, July). Change in spouse assault rates from 1975–1992: A comparison of three national surveys in the United States. Unpublished paper presented at the Thirteenth World Congress of Sociology, Bielefeld, Germany., & (1992). Primary care physicians' response to domestic violence: Opening Pandora's box. Journal of the American Medical Association, 267, 3157–3160. http://dx.doi.org/10.1001/jama.1992.03480230049026, & (1974). Neither beauty nor beast: Female homicide offenders. International Journal of Criminology and Penology, 2, 2–23., & (1974). Differentials in the rate of fertility decline: 1960–1970. Family Planning Perspectives, 6, 6–103. http://dx.doi.org/10.2307/2134150(1983). Using couple data as a methodological tool: The case of marital violence. Journal of Marriage and the Family, 45, 45–633. http://dx.doi.org/10.2307/351668(1983). Spouse abuse in Texas: A study of women's attitudes and experiences. Huntsville, TX: Sam Houston State University, Criminal Justice Center., & ([Page 236]1992). The impact of formal, informal and societal support networks on the psychological well-being of black adolescent mothers, Social Work, 37(4), 322–328., & (1975). The cycle of deprivation: The history of a confused thesis. Unpublished paper, University of Essex, UK.(1984). Suicide. In F.Turner (Ed.), Adult psychopathology: A social work perspective (pp. 181–199). Glencoe, IL: Free Press.(1977). The political ecology of disease. Review of Radical Political Economics, 9(1), 45–60. http://dx.doi.org/10.1177/048661347700900104(U.S. Commission on Civil Rights. (1982). The federal response to domestic violence. Washington, DC: U.S. Department of Justice.1967). Static and dynamic “laws” of sex and homicide. In M.E.Wolfgang (Ed.), Studies in homicide (pp. 36–44). New York: Harper & Row.(1966). Personality characteristics of attempted suicide. American Journal of Psychiatry, 112, 112–1143.(1974). The exploitation of illness in capitalist society. New York: Bobbs-Merrill., & (1990). Family violence and the women's movement. Toronto: University of Toronto Press.(1977–1978). Battered women and learned helplessness. Victimology: An International Journal, 2(3–4), 525–534.(1979). The battered woman. New York: Harper & Row.(1983). The battered woman syndrome study. In D.Finkelhor, R.Gelles, G.Hotaling, & M.Straus (Eds.), The dark side of families (pp. 31–49). Beverly Hills, CA: Sage.(1984). The battered woman syndrome. New York: Springer.(1989). Limitations of the medical model in the care of battered women. Gender and Society, 3, 3–506. http://dx.doi.org/10.1177/089124389003004008(1968). Patriarchalism and patrimonialism. In G.Roth & C.Wittich (Eds.), Economy and society (pp. 1006–1070). New York: Bedminister.(1983). The depressed mother and her rebellious adolescent. In H.Morrison (Ed.), Children of depressed parents: Risk, identification and intervention (pp. 99–113). New York: Grune & Stratton.(1973). Hostility and depression associated with suicide attempts. American Journal of Psychiatry, 130(4), 450–455., , & (1994). Race matters. New York: Vintage.(1971). Violence potential in extramarital sexual responses. Journal of Marriage and the Family, 33(4), 683–691. http://dx.doi.org/10.2307/349442(1988). Ideology and violence prevention. Journal of the National Medical Association, 80(7), 737–743.(1956). Organization man. New York: Doubleday.(1980). Toward the eradication of child abuse and neglect at home. In G.Williams & J.Money (Eds.), Traumatic abuse and the neglect of children at home (pp. 588–605). Baltimore, MD: Johns Hopkins University Press.(1976). Research into battered women: Why we need research and why what exists is potentially dangerous—A reply to Dr. Jasper Gayford. London: National Women's Aid Federation.([Page 237]1983). What is to be done about violence against women?Harmondsworth, Middlesex: Penguin.(1985). Crime and human nature. New York: Simon & Schuster.(1987). The truly disadvantaged. Chicago: University of Chicago Press.(1956). Husband and wife homicides. Journal of Social Therapy, 2, 2–263.(1958). Patterns in criminal homicide. Philadelphia: University of Pennsylvania Press.(1967). The subculture of violence. London: Tavistock., & (1993). Posttraumatic stress in battered women: Does the diagnosis fit?Issues in Mental Health Nursing, 14, 14–173. http://dx.doi.org/10.3109/01612849309031615, & (1973). Capitalism, the family and personal life. Socialist Revolution, 3(1–2), 69–127.(1973). Psychiatric emergency services a decade later. Psychiatry in Medicine, 4(3), 273–290. http://dx.doi.org/10.2190/VMTF-F3BM-7H1B-2YRH, & (
About the Authors[Page 263]
Evan Stark and Anne Flitcraft are nationally recognized authorities on interpersonal violence, including woman battering, child abuse, and homicide. Since 1976 when they helped found one of the first shelters for battered women in the United States, they have worked as researchers, in direct service, and as advocates for the rights and needs of battered women and their children in policy debates and in the courts.
With a Ph.D. from the State University of New York and an M.S.W from Fordham University, Evan Stark is Associate Professor of Public Administration and Social Work at Rutgers University. A graduate of the Yale School of Medicine, Anne Flitcraft is an Associate Professor of Medicine at the University of Connecticut Health Center, where she teaches Primary Care Internal Medicine and maintains a clinical practice at the Burgorf Health Center in the North End Community of Hartford. Dr. Stark and Dr. Flitcraft codirect the Domestic Violence Training Project, an award-winning program dedicated to enhancing the health care system's response to domestic violence.
Twenty years ago, Dr. Stark and Dr. Flitcraft directed the first major federal research program on domestic violence in health care settings and identified domestic violence as a leading cause of female injury and [Page 264]the context for multiple medical and mental health problems. Former cochairs of the U.S. Surgeon General's Working Group on Domestic Violence and Public Health, the couple has served as consultants on domestic violence to the U.S. Civil Rights Commission, the Centers for Disease Control, the U.S. House and Senate, the National Institutes of Justice and the National Research Council.
For their efforts in bringing this issue to the attention of contemporary medicine and their leadership in the developing health care programs on domestic violence, Dr. Stark and Dr. Flitcraft received the National Health Council's Trendsetter Award and Connecticut's Governor's Victim Services Award. In addition, Dr. Flitcraft received the Elizabeth Blackwell Award, the highest honor bestowed by the American Medical Women's Association, and Dr. Stark received the Sanctity of Life Award from Brandeis University.
Dr. Flitcraft works with numerous state and national medical organizations to enhance access to care for battered women. Dr. Stark frequently testifies on behalf of battered women in criminal and civil cases.[Page 265]