Title: Prevalence, Incidence, and Consequences of
Violence Against Women: Findings From the National
Violence Against Women Survey.
Series: Research in Brief
Author: Patricia Tjaden and Nancy Thoennes
Published: November 1998
Subject: Domestic violence, rape and sexual
assault
33 pages
59,000 bytes

------------------------------

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------------------------------

U.S. Department of Justice
Office of Justice Programs
National Institute of Justice

National Institute of Justice
Centers for Disease Control and Prevention

Research in Brief
November 1998

Prevalence, Incidence, and Consequences of
Violence Against Women: Findings From the National
Violence Against Women Survey

by Patricia Tjaden and Nancy Thoennes

-----------------------------

The findings from this second in a series of
reports issued jointly by the National Institute
of Justice and Centers for Disease Control and
Prevention paint a picture of the violence against
women as seen daily by emergency room, law
enforcement, and court professionals. 

Accurate information of the kind presented in this
Research in Brief and in the full report
contributes to our Nation's efforts to stop
violence against women and alleviate the suffering
of its victims, much of which occurs in the
privacy of homes rather than in public. 

This information will help the U.S. Department of
Justice direct and evaluate efforts to work within
the legal system to protect Americans and provide
justice for those who violate the rights of
others. This knowledge also will help the U.S.
Department of Health and Human Services direct
efforts toward preventing the physical injury and
psychological abuse that results from violence.
Ultimately, the knowledge gained from surveys like
this one has the power to call the Nation's
attention to how pervasive the problem is and how
many women face dangers in our communities. 

Jeremy Travis, Director
National Institute of Justice

Mark Rosenberg, Director
National Center for Injury Prevention and Control,
Centers for Disease Control and Prevention

------------------------------

Issues and Findings

Discussed in this Brief: Results of a nationally
representative telephone survey of 8,000 women and
8,000 men about their experiences with rape,
physical assault, and stalking cosponsored by the
National Institute of Justice and the Centers for
Disease Control and Prevention and conducted by
the Center for Policy Research.

Key issues: This study provides empirical data on
the prevalence and incidence of rape, physical
assault, and stalking; the prevalence of
male-to-female and female-to-male intimate partner
violence; the prevalence of rape and physical
assault among women of different racial and ethnic
backgrounds; the rate of injury among rape and
physical assault victims; and injured victims' use
of medical services.

Key findings and policy implications: Although the
survey sampled both women and men, this report
focuses on women's experiences with violence.
Analysis of survey data produced the following
results:

--Using a definition of physical assault that
includes a range of behaviors, from slapping and
hitting to using a gun, the survey found that
physical assault is widespread among American
women: 52 percent of surveyed women said they were
physically assaulted as a child by an adult
caretaker and/or as an adult by any type of
perpetrator; 1.9 percent of surveyed women said
they were physically assaulted in the previous 12
months. Based on these estimates, approximately
1.9 million women are physically assaulted
annually in the United States. More research is
needed to understand the relationship between
physical assault experienced in childhood and
physical assault experienced in adulthood. 

--Using a definition of rape that includes forced
vaginal, oral, and anal intercourse, the survey
found that rape is a crime committed primarily
against youth: 18 percent of women surveyed said
they experienced a completed or attempted rape at
some time in their life and 0.3 percent said they
experienced a completed or attempted rape in the
previous 12 months. Of the women who reported
being raped at some time in their lives, 22
percent were under 12 years old and 32 percent
were 12 to 17 years old when they were first
raped. Given these findings, research and
intervention strategies should focus on rapes
perpetrated against children and adolescents.

--Among women of different racial and ethnic
backgrounds, the difference in the prevalence of
reported rape and physical assault is
statistically significant: American Indian/Alaska
Native women were most likely to report rape and
physical assault victimization, while
Asian/Pacific Islander women were least likely to
report rape and physical assault victimization.
Hispanic women were less likely to report rape
victimization than non-Hispanic women. More
research is needed to determine how much of the
difference can be explained by the respondent's
willingness to report information to interviewers
and how much by social, demographic, and
environmental factors. 

--Women experience significantly more partner
violence than men do: 25 percent of surveyed
women, compared with 8 percent of surveyed men,
said they were raped and/or physically assaulted
by a current or former spouse, cohabiting partner,
or date in their lifetime; 1.5 percent of surveyed
women and 0.9 percent of surveyed men said they
were raped and/or physically assaulted by such a
perpetrator in the previous 12 months. According
to survey estimates, approximately 1.5 million
women and 834,700 men are raped and/or physically
assaulted by an intimate partner annually in the
United States. Because women are also more likely
to be injured by intimate partners, research aimed
at understanding and preventing partner violence
against women should be stressed. 

--Violence against women is primarily partner
violence: 76 percent of the women who were raped
and/or physically assaulted since age 18 were
assaulted by a current or former husband,
cohabiting partner, or date, compared with 18
percent of the men. It is therefore imperative
that strategies for preventing violence against
women should focus on ways of protecting women
from risks posed by current and former intimates. 

--Women are significantly more likely than men to
be injured during an assault: 32 percent of the
women and 16 percent of the men who were raped
since age 18 were injured during their most recent
rape; 39 percent of the women and 25 percent of
the men who were physically assaulted since age 18
were injured during their most recent physical
assault. About one in three women who were injured
during a rape or physical assault required medical
care. To better meet the medical needs of women
who are victims of violence, medical professionals
should receive comprehensive training on the
physical consequences of violence against women
and appropriate treatment strategies. 

--Using a definition of stalking that requires the
victim to feel a high level of fear, the survey
found that stalking is more prevalent than
previously thought: 8 percent of surveyed women
and 2 percent of surveyed men said they were
stalked at some time in their life; 1 percent of
surveyed women and 0.4 percent of surveyed men
said they were stalked in the previous 12 months.
According to survey estimates, approximately 1
million women and 371,000 men are stalked annually
in the United States. Given these findings,
stalking should be considered a serious criminal
justice and public health concern. 

Target audience: Criminal justice and public
health researchers and practitioners, legislators,
policymakers, and intervention planners at all
levels of government. 

------------------------------

Violence against women first came to be viewed as
a serious social problem in the early 1970s, in
part because of the re-emergence of the Women's
Movement.[1] In unprecedented numbers, scholars
trained in such diverse disciplines as philosophy,
literature, law, and sociology began to examine
violence against women in the context of a
feminist ideology.[2] Despite the resulting
outpouring of research on violence against women,
particularly in the areas of rape and intimate
partner violence, many gaps remain in our
understanding of violence against women.[3] 

Until now, empirical data on the relationship
between certain types of violence against women,
such as childhood victimization and subsequent
adult victimization, have been limited. Reliable
information on minority women's experiences with
violence and on the consequences of violence
against women, including rates of injury and use
of medical services, is also limited.[4]

To further an understanding of violence against
women, the National Institute of Justice (NIJ) and
the Centers for Disease Control and Prevention
(CDC) jointly sponsored--through a grant to the
Center for Policy Research--a national telephone
survey on violence against women, which was
conducted from November 1995 to May 1996. To
provide a context in which to place women's
experiences, the National Violence Against Women
(NVAW) Survey sampled both women and men. Thus the
survey provides comparable data on women's and
men's experiences with violent victimization. 

Respondents to the NVAW Survey were queried about:

--Physical assault they experienced as children by
adult caretakers.

--Physical assault they experienced as adults by
any type of perpetrator.

--Forcible rape or stalking they experienced at
any time in their life by any type of perpetrator. 

Respondents who disclosed victimization were asked
detailed questions about the characteristics and
consequences of their victimization, including
injuries sustained and use of medical services
(see "Survey Screening Questions," page 13 and
"Survey Methodology," page 14). 

Several features set the NVAW Survey apart from
other victimization surveys:

--State-of-the-art techniques protected
confidentiality and minimized the potential for
retraumatizing victims of violence and
jeopardizing the safety of respondents. In
addition to lessening the possibility that
respondents would be harmed by their participation
in the survey, these techniques increased the
quality of the information being gathered. 

--Information about both the prevalence (lifetime
and annual) and incidence of violence was
gathered. Thus victimization estimates from the
NVAW Survey can be compared with victimization
estimates from a wide variety of other surveys. 

--Behaviorally specific questions screened
respondents for rape, physical assault, and
stalking victimization. These questions were
designed to leave little doubt in the respondents'
minds as to the type of information being sought. 

--Detailed information about the characteristics
and consequences of victimization for each type of
perpetrator identified by the respondents was
gathered. While this approach created a very
complicated data set, it also created the
opportunity to track victimizations by the same
perpetrator (e.g., the victim's first ex-husband).

This Research in Brief summarizes the survey's
findings on the prevalence and incidence of rape,
physical assault, and stalking; the rate of injury
among rape and physical assault victims; and
injured victims' use of medical services. Complete
details about men's and women's experiences with
stalking are contained in an earlier report. This
Research in Brief therefore focuses primarily on
rape and physical assault. The full report
detailing the prevalence, incidence, and
consequences of violence against women will be
available through the CDC (see "Other Publications
in the Series"). 

Rape: Prevalence and incidence

Using a definition of rape that includes forced
vaginal, oral, and anal sex, the survey found that
1 of 6 U.S. women and 1 of 33 U.S. men has
experienced an attempted or completed rape as a
child and/or an adult; specifically, 18 percent of
surveyed women and 3 percent of surveyed men said
they experienced a completed or attempted rape at
some time in their life (see exhibit 1). These
findings are similar to findings from the National
Health and Social Life Survey, which found that 22
percent of surveyed women and 2 percent of
surveyed men had been "forced to do something
sexual" at some time in their lifetime.[5]

The survey also found that 0.3 percent of surveyed
women and 0.1 percent of surveyed men said they
experienced a completed or attempted rape in the
previous 12 months.[6] These estimates equate to
approximately 302,100 women and 92,700 men who are
forcibly raped each year in the United States (see
exhibit 2). 

Because some rape victims experienced more than
one rape in the 12 months preceding the survey,
the incidence of rape (number of separate
victimizations) exceeded the prevalence of rape
(number of rape victims). Specifically, women who
were raped in the previous 12 months averaged 2.9
rapes, while men averaged 1.2 rapes. According to
survey estimates, approximately 876,100 rapes were
perpetrated against women and approximately
111,300 rapes were perpetrated against men in the
United States during the 12 months preceding the
survey (see exhibit 3).

The annual rape victimization estimates generated
by the NVAW Survey are higher than comparable
victimization estimates generated by the Bureau of
Justice Statistics (BJS) National Crime
Victimization Survey (NCVS). The NCVS estimates
for 1994--the most recent year for which estimates
are available--are 432,100 rapes and sexual
assaults of women age 12 and older and 32,900
rapes and sexual assaults of men age 12 and
older.[7] However, direct comparisons between the
NVAW Survey and the NCVS are difficult to make.
Estimates reported by the two surveys refer to
somewhat different populations and sexual
victimizations. Moreover, the two surveys differ
substantially with respect to other methodological
issues.

Specifically, the NVAW Survey estimates include
victimizations against persons age 18 and older,
while the NCVS estimates include victimizations
against persons 12 years of age and older. The
NVAW Survey estimate for forcible rape is being
compared to an NCVS estimate that includes rape
and other forms of sexual assault, such as
grabbing, fondling, and verbal threats of a sexual
nature.

In addition, the screening questions used by the
two surveys differ substantially. The NVAW Survey
uses five questions to screen respondents for rape
victimization, while the NCVS uses only two
questions.[8] Although empirical data on this
issue are limited, some researchers assume that
increasing the number of screening questions
increases disclosure rates.[9] Furthermore, the
NVAW Survey screening questions are more explicit
than those used by the NCVS.[10] 

Moreover, published NCVS estimates count series
victimizations--reports of six or more crimes
within a 6-month period for which the respondent
cannot recall details of each crime--as a single
victimization. Thus, published NCVS estimates of
the number of rape and sexual assault
victimizations are lower than would be obtained by
including all incidents reported to its survey
interviewers. To produce NCVS estimates for direct
comparison with the NVAW Survey estimates, each
crime in a series of victimizations reported to
the NCVS interviewers would have to be counted
separately.

Finally, the sampling errors associated with the
estimates from the NVAW Survey and the NCVS would
have to be compared. This is important given the
relatively high margin of error associated with
NVAW Survey estimates of the average number of
rape victimizations experienced by male and female
victims (see footnote in exhibit 3). Comparisons
of sampling errors would help determine whether
the estimates are actually different or whether
apparent differences are not statistically
significant.

A study now under way and funded by NIJ, BJS, and
CDC will provide more comprehensive information
about the differences between the two surveys,
including error ranges for the estimates. Using
data from the two surveys, the study is
calculating estimates using the same counting
rules and the same age populations. The results of
this detailed comparison will be published in
early 1999.

Physical assault: Prevalence and incidence 

The NVAW Survey used a modified version of the
Conflict Tactics Scale[11] to query respondents
about a variety of physical assaults they may have
suffered. Responses revealed that physical assault
is widespread in American society: 52 percent of
surveyed women and 66 percent of surveyed men said
they were physically assaulted as a child by an
adult caretaker and/or as an adult by any type of
perpetrator. 

For both women and men, the most frequently
reported physical assault was slapping and
hitting, followed by pushing, grabbing, shoving,
and hitting with an object. Relatively few
respondents reported that an adult caretaker or
other adult pulled their hair or threw something
at them that could hurt. Still fewer reported that
an adult caretaker or other adult choked or almost
drowned them, kicked or bit them, beat them up,
threatened them with a gun or knife, or used a gun
or knife on them (see exhibit 1).

The NVAW Survey also found that 1.9 percent of
surveyed women and 3.4 percent of surveyed men
said they were physically assaulted in the
previous 12 months. These estimates equate to
approximately 1.9 million women and 3.2 million
men who are physically assaulted annually in the
United States (see exhibit 2). Female victims
averaged 3.1 assaults and male victims averaged
2.5 assaults per year, which equate to
approximately 5.9 million physical assaults
perpetrated against women and 7.9 million physical
assaults perpetrated against men in the 12 months
preceding the survey (see exhibit 3). These
estimates probably underestimate the number of
physical assaults perpetrated against women and
men annually because the NVAW Survey categorized
victimizations involving both rape and physical
assault only as rapes. 

The NVAW Survey estimates of annual physical
assaults are greater than the NCVS estimates. The
NCVS estimate for 1994 is 4.1 million aggravated
and simple assaults of women age 12 and older and
5.7 million aggravated and simple assaults of men
age 12 and older.[12] Comparisons between the NVAW
Survey and NCVS estimates of physical assault are
confounded by the same methodological differences
discussed earlier and are being addressed in
ongoing research funded by NIJ, BJS, and CDC that
is comprehensively reviewing the two surveys'
estimates for physical violence.

The risk of violence varies among minority women

The survey found that American Indian/Alaska
Native women were significantly more likely to
disclose rape and physical assault victimization
than women of other racial/ethnic backgrounds,
while Asian/Pacific Islander women were
significantly less likely to report rape and
physical assault victimization (see exhibit 4). 

These findings must be viewed with caution,
however, given the relatively small numbers of
American Indian/ Alaska Native and Asian/Pacific
Islander women included in the sample. Because
information on violence against American
Indian/Alaska Native women is limited, it is
difficult to explain why they report more rape and
physical assault victimization. A previous study
found that Native-American couples were
significantly more violent than their white
counterparts.[13] Another study found that the
overall homicide rates for Native Americans were
approximately two times greater than U.S. national
rates.[14] Information from this study published
elsewhere shows that Native-American women report
significantly more stalking victimization than do
women of other racial/ethnic backgrounds.[15] Thus
there is some evidence that Native Americans are
at significantly greater risk of violence than
other Americans. 

How much of the difference in rape and physical
assault prevalence can be explained by differences
in willingness to report victimization to
interviewers and how much can be explained by
actual victimization experiences is unclear and
requires further study. Research is also needed to
ascertain how social, environmental, and
demographic factors intersect with race and
ethnicity to produce differences in rape and
physical assault prevalence. Finally, research is
needed to determine whether victimization rates
vary significantly among women of diverse American
Indian tribes and Alaska Native communities. 

Because information is also lacking on violence
against Asian/Pacific Islander women, it is
unclear why they report less rape and physical
assault victimization. Information from focus
groups and nonrandom samples of Asian-American
women suggests that intimate partner violence is a
major concern among these women.[16] However,
there are no accurate estimates of intimate
partner violence among Asian-American or Pacific
Islander women, and the differences between
Asian-American and Pacific Islander women in rape
and physical assault prevalence also may be
significant. Such differences, however, cannot be
discerned from the NVAW Survey because data on
these two groups were combined. Clearly, more
research is needed on violence against
Asian-American and Pacific Islander women. 

The survey found that Hispanic women were less
likely to report rape victimization than were
non-Hispanic women (see exhibit 5). Previous
studies comparing violence prevalence among
Hispanic and non-Hispanic women have produced
contradictory conclusions;[17] hence, findings
from the NVAW Survey neither confirm nor
contradict earlier findings. 

Rape is primarily a crime against youth

It has been previously reported that rape in
America is a "tragedy of youth" because the
majority of rapes occurs against children and
adolescents.[18] Results from the survey support
this assertion: More than half (54 percent) of the
female rape victims identified by the survey were
under 18 years old when they experienced their
first rape (see exhibit 6). Of the women
disclosing rape, 22 percent were under 12 years
old when they experienced their first rape, while
32 percent were 12 to 17 years old.

Several authors have reported that women who are
sexually assaulted as children and adolescents are
at greater risk of being sexually assaulted as
adults.[19] Results from the NVAW Survey provide
further evidence of the link between sexual
assault as a minor and subsequent sexual assault
as an adult: 18 percent of the women who reported
being raped before age 18 said they were also
raped after the age of 18, compared with 9 percent
of the women who did not report being raped before
the age of 18. 

Women experience more partner violence than men do

The NVAW survey found that women are significantly
more likely to be assaulted by an intimate partner
than men are. Twenty-five percent of surveyed
women, compared with 8 percent of surveyed men,
said they were raped and/or physically assaulted
by a current or former spouse, cohabiting partner,
or date at some time in their life; 1.5 percent of
all surveyed women compared with 0.9 percent of
all surveyed men said they were raped and/or
physically assaulted by such a partner in the
previous 12 months. Based on U.S. Census estimates
of the number of women and men in the country,
these findings equate to approximately 1.5 million
women and 834,700 men who are raped and/or
physically assaulted by an intimate partner
annually in the United States (see exhibit 7). 

Results from the survey show that most physical
assaults perpetrated against women by intimate
partners consist of pushing, grabbing, shoving,
slapping, and hitting. Fewer women reported that
an intimate partner threw something at them that
could hurt, pulled their hair, kicked or bit them,
hit them with an object, or beat them up.
Relatively few reported that an intimate partner
threatened them with a knife or gun. Only a
negligible number reported that an intimate
partner actually used a knife or gun on them (see
exhibit 8).

It is important to note that differences between
women's and men's rates of physical assault by an
intimate partner become greater as the seriousness
of the assault increases. For example, women were
two to three times more likely than men to report
that an intimate partner threw something that
could hurt or pushed, grabbed, or shoved them.
However, they were 7 to 14 times more likely to
report that an intimate partner beat them up,
choked or tried to drown them, threatened them
with a gun, or actually used a gun on them (see
exhibit 8). 

The NVAW Survey finding that women are
significantly more likely than men to be
victimized by intimate partners contradicts
findings from some previous national surveys that
found men and women to be at nearly equal risk of
physical assault by an intimate partner.[20] The
finding, however, supports data from the NCVS,
which have consistently shown women to be at
greater risk of intimate partner violence.[21]

Violence against women is primarily partner
violence. The survey confirms previous reports
that U.S. women are primarily raped and/or
physically assaulted by intimate partners:[22] 76
percent of the women who were raped and/or
physically assaulted since the age of 18 were
assaulted by a current or former husband,
cohabiting partner, or date; 17 percent were
victimized by an acquaintance, such as a friend,
neighbor, or coworker; 14 percent were victimized
by a stranger; and 9 percent were victimized by a
relative other than a husband (see exhibit 9). By
comparison, the survey found that U.S. men are
primarily raped and physically assaulted by
strangers and acquaintances, not intimate
partners. 

Violence against women is primarily male violence.
The survey also found that most violence
perpetrated against adults is perpetrated by
males: 93 percent of the women and 86 percent of
the men who were raped and/or physically assaulted
since the age of 18 were assaulted by a male. In
comparison only 11 percent of these women and 23
percent of these men were assaulted by a female
(see exhibit 10). Given these findings, adult
violence prevention strategies should focus
primarily on the risks posed by male perpetrators. 

Rate of injury among rape and physical assault
victims

To generate information on
violence-related injuries, respondents disclosing
rape and physical assault were asked whether they
were injured during their most recent
victimization. The survey found that women who
were raped since age 18 were nearly twice as
likely as their male counterparts to report an
injury other than the rape itself (32 and 16
percent, respectively) (see exhibit 11).
Similarly, women who were physically assaulted
since age 18 were significantly more likely than
their male counterparts to report that they were
injured during their most recent physical assault
(39 and 25 percent, respectively). When only
physical assaults by intimates are considered, the
difference between injury rates for women and men
is even greater (41 and 19 percent, respectively). 

Most of the adult rape and physical assault
victims (both men and women) who reported being
injured sustained relatively minor injuries, such
as scratches, bruises, and welts. Relatively few
sustained more serious types of injuries, such as
broken bones, dislocated joints, concussions,
lacerations, or bullet wounds (see exhibit 12).

Victims' use of medical services. The survey found
that 36 percent of the women injured during their
most recent rape since age 18 and 30 percent of
the women injured during their most recent
physical assault since age 18 received some type
of medical treatment (e.g., ambulance/paramedic
services, treatment in a hospital emergency
department, physical therapy) (see exhibit 11).
Some medically treated victims received more than
one type of medical treatment (e.g.,
hospitalization as well as outpatient physical
therapy). Others received one type of medical
treatment more than once--for example, three
nights in the hospital or 10 physical therapy
sessions. Hence, the annual number of medical
treatments provided to rape and physical assault
victims exceeds the annual number of rapes and
physical assaults that resulted in treatment.

Exhibit 13 provides estimates of the average
number of nights spent in the hospital or the
average number of visits made to specific medical
providers by rape and physical assault victims.
These estimates are based on responses from
victims who received the specific type of medical
care considered. For example, the estimate of the
average number of nights spent in the hospital by
female rape victims (3.6) is based only on
responses by female rape victims who were treated
in a hospital on an inpatient basis. It should be
noted that some of these average frequency
estimates have a relatively high margin of error
(see footnotes c through e in exhibit 13) and
should be viewed with caution.

Exhibit 14 presents estimates of the number of
female rapes and physical assaults resulting in
injuries annually, as well as estimates of the
number of specific types of medical treatment to
these victims annually. It is important to note
that because women are primarily raped and
physically assaulted by intimate partners, the
injury and medical utilization estimates for women
presented in exhibits 13 and 14 pertain mostly to
rapes and physical assaults perpetrated by current
and former husbands, cohabiting partners, dates,
and boyfriends. Because men are primarily raped
and physically assaulted by male strangers and
acquaintances, the injury and medical utilization
estimates for men pertain primarily to violence
perpetrated by men other than intimate partners.
According to estimates generated by the NVAW
Survey, hospital emergency department personnel
treated approximately 1.3 million adults for
injuries related to rapes and physical assaults in
the 12 months preceding the survey (128,700 female
rape victims, 546,900 female physical assault
victims, and 588,300 male physical assault
victims). This figure is somewhat lower than an
estimate generated from the Study of Injured
Victims of Violence (SIVV), a hospital
record-extraction study conducted for the Bureau
of Justice Statistics by the U.S. Consumer Product
Safety Commission. The SIVV found that during
1994, hospital emergency department personnel
treated an estimated 1.4 million people for
injuries from confirmed or suspected interpersonal
violence.[23] 

Included in the SIVV estimate (but excluded from
the NVAW Survey estimate) are hospital emergency
department treatments to victims of all ages
(including children and adolescents), victims of
suspected interpersonal violence, male rape
victims, and male and female sexual assault and
robbery victims. Because these groups were
excluded from the NVAW Survey estimate, it is not
surprising that it is lower than the SIVV estimate
of 1.4 million.

Stalking is a significant social problem 

Using a definition of stalking that requires
victims to feel a high level of fear, the survey
found that stalking is much more prevalent than
previously thought: 8 percent of surveyed women
and 2 percent of surveyed men said they were
stalked at some time in their life; 1 percent of
surveyed women and 0.4 percent of surveyed men
said they were stalked in the previous 12 months.
Based on U.S. Census estimates of the number of
women and men in the country, these findings
equate to approximately 1 million women and
371,000 men who are stalked annually in the United
States (see exhibit 15).

If a less stringent definition of stalking is
used, one requiring victims to feel only somewhat
frightened or a little frightened of their
assailant's behavior, the lifetime stalking
prevalence rate increases from 8 to 12 percent for
women and from 2 to 4 percent for men; the annual
stalking prevalence rate increases from 1 to 6
percent for women and from 0.4 to 1.5 percent for
men. Based on these higher prevalence rates,
approximately 12.1 million women and 3.7 million
men are stalked at some time in their life, and an
estimated 6 million women and 1.4 million men are
stalked annually. 

Stalking prevalence estimates generated by the
NVAW Survey are higher than previous nonscientific
stalking estimates. In 1992, when asked by a
reporter to estimate the extent of stalking in
America, forensic psychiatrist Park Dietz guessed
that 5 percent of U.S. women are stalked at some
time in their lifetime and 200,000 U.S. women are
stalked annually.[24] The NVAW Survey estimate
that 8 percent of women have been stalked at some
time in their life is nearly two times greater
than Dietz's earlier guess, and the survey's
estimate that 1 million women are stalked annually
is five times greater than Dietz's earlier guess.
Given the high rate of stalking victimization
uncovered by the NVAW Survey, it is imperative
that stalking be treated as a legitimate criminal
justice problem and public concern. 

Policy implications

The NVAW Survey provides compelling data on the
prevalence, incidence, and physical consequences
of violence against women, as well as victims'
utilization of medical services. Information
presented in this report can help inform policy
and intervention directed at violence against
women. Based on findings from the survey, the
authors conclude the following:

1. Violence against women should be treated as a
significant social problem. The survey data
validate opinions held by many professionals about
the pervasiveness of violence against women. More
than half the surveyed women reported being
physically assaulted as a child by an adult
caretaker and/or as an adult by another adult, and
nearly one-fifth reported being raped at some time
in their lives. Further, 2 percent of the surveyed
women reported being raped, physically assaulted,
or both in the 12 months preceding the survey.
This equates to an estimated 2.1 million U.S.
women who are raped and/or physically assaulted
annually. Because some rape and physical assault
victims experience multiple victimizations per
year, an estimated 876,000 rapes and 5.9 million
physical assaults are perpetrated against U.S.
women annually (see exhibit 14). Given the
pervasiveness of rape and physical assault among
American women, it is imperative that violence
against women be treated as a major criminal
justice and public health concern. 

2. Rape should be viewed as a crime committed
primarily against youth. The survey confirms
previous reports that most rape victims are
children or adolescents. Eighteen percent of
surveyed women reported being the victim of a
completed or attempted rape at some time in their
lives. Of these, more than half (54 percent) were
raped before the age of 18. The survey also found
that women who are raped before the age of 18 are
significantly more likely to be raped as adults.
Given these findings, rape prevention strategies
should focus on rapes perpetrated against minors,
and rape research should focus on the long-term
effects of rape occurring at an early age. 

3. Studies are needed to determine why the
prevalence of rape and physical assault varies
significantly among women of different racial and
ethnic backgrounds. The survey found that American
Indian/Alaska Native women were most likely to
report rape and physical assault victimization,
while Asian/Pacific Islander women were least
likely to report rape and physical assault
victimization. The survey also found that Hispanic
women were less likely to report rape
victimization than non-Hispanic women.

It is unclear from the survey data whether the
differences in prevalence rates among women of
different racial and ethnic groups are caused by
differences in reporting practices or differences
in actual victimization experiences. It is also
unclear how social, environmental, and demographic
factors intersect with race and ethnicity to
produce differences in rape and physical assault
prevalence among women of different racial and
ethnic backgrounds. Thus more research is needed
to establish the degree of variance in prevalence
among women of different racial and ethnic groups
and to determine how much of the variance may be
explained by differences in willingness to
disclose information and how much by social,
environmental, and demographic factors. Research
is also needed to determine whether differences
exist in rape and physical assault prevalence
among women of diverse Asian/Pacific Islander
groups, American Indian tribes, and Alaska Native
communities. 

4. Women are at greater risk of partner violence
than men. The survey found that women were
significantly more likely than men to report being
raped and physically assaulted by a current or
former intimate partner, whether the timeframe
considered was the person's lifetime or the 12
months preceding the survey. Moreover, women who
were raped or physically assaulted by a current or
former intimate partner were significantly more
likely to sustain injuries than men who were raped
or physically assaulted by a current or former
intimate partner. Given these findings, intimate
partner violence should be considered first and
foremost a crime against women.

5. Violence against women is predominantly partner
violence. Data from the survey confirm previous
reports that violence against women is
predominantly intimate partner violence. Of the
women who reported being raped and/or physically
assaulted since the age of 18, three-quarters (76
percent) were victimized by a current or former
husband, cohabiting partner, date, or boyfriend.
Given these findings, violence-against-women
intervention strategies should focus on the risks
posed to women by current and former husbands,
cohabiting partners, dates, and boyfriends.

6. America's medical community should receive
comprehensive training about the medical needs of
female victims of crime. The injury and medical
utilization data generated by the NVAW Survey
provide compelling evidence of the physical and
social costs associated with violence against
women. 

The survey found that in about one-third of all
rapes and physical assaults perpetrated against
women, the victim sustains an injury. Further, in
about one-third of all such injury victimizations,
the victim receives some type of medical care
(e.g., paramedic care, emergency room treatment,
dental care, or physical therapy). Thus, of the
estimated 6.8 million rapes and physical assaults
perpetrated against U.S. women annually, 2.6
million will result in an injury to the victim and
792,200 will result in the victim receiving some
type of medical care. Because many rape and
physical assault victims receive multiple forms of
care for the same injury victimization, medical
personnel in the United States treat literally
millions of rape and physical assault
victimizations annually. 

Given the high number of injury victimizations
perpetrated against women annually and the
extensiveness of medical treatment to female
victims of violence, it is imperative that medical
professionals receive information about the
physical consequences of violence against women
and the medical needs of female victims. 

7. Stalking should be treated as a significant
social problem. Using a definition of stalking
that requires victims to feel a high level of
fear, the survey found that stalking is more
widespread than previously thought. Eight percent
of women and 2 percent of men reported being
stalked at some time in their lives, and 1 percent
of women and 0.4 percent of men reported being
stalked in the 12 months preceding the survey.
Thus an estimated 1.4 million people are stalked
annually in the United States. Given the high
number of stalking victims, it is important that
stalking be treated as a legitimate criminal
justice and public health concern. 

------------------------------

Survey Screening Questions

Rape was defined as an event that occurred without
the victim's consent, that involved the use or
threat of force to penetrate the victim's vagina
or anus by penis, tongue, fingers, or object, or
the victim's mouth by penis. The definition
included both attempted and completed rape. The
following questions were used to screen
respondents for rape victimization:[1]

--[Female respondents only] Has a man or boy ever
made you have sex by using force or threatening to
harm you or someone close to you? Just so there is
no mistake, by sex we mean putting a penis in your
vagina. 

--Has anyone, male or female, ever made you have
oral sex by using force or threat of force? Just
so there is no mistake, by oral sex we mean that a
man or boy put his penis in your mouth or someone,
male or female, penetrated your vagina or anus
with their mouth.

--Has anyone ever made you have anal sex by using
force or threat of harm? Just so there is no
mistake, by anal sex we mean that a man or boy put
his penis in your anus. 

--Has anyone, male or female, ever put fingers or
objects in your vagina or anus against your will
or by using force or threats? 

--Has anyone, male or female, ever attempted to
make you have vaginal, oral, or anal sex against
your will, but intercourse or penetration did not
occur?

Physical assault was defined as behaviors that
threaten, attempt, or actually inflict physical
harm. A modified version of the Conflict Tactics
Scale[2] was used to screen respondents for
physical assault they experienced as a child at
the hands of an adult caretaker and physical
assault they experienced as an adult at the hands
of another adult:

--[Physical assault as a child] When you were a
child did any parent, step-parent, or guardian
ever . . .

--[Physical assault as an adult] Not counting any
incidents you have already mentioned, after you
became an adult did any other adult, male or
female, ever . . . 

--Throw something at you that could hurt? 

--Push, grab, or shove you? 

--Pull your hair? 

--Slap or hit you? 

--Kick or bite you? 

--Choke or attempt to drown you? 

--Hit you with some object? 

--Beat you up? 

--Threaten you with a gun? 

--Threaten you with a knife or other weapon? 

--Use a gun on you? 

--Use a knife or other weapon on you?

Stalking was defined as a course of conduct
directed at a specific person that involves
repeated visual or physical proximity; non-
consensual communication; verbal, written, or
implied threats; or a combination thereof that
would cause fear in a reasonable person (with
repeated meaning on two or more occasions). The
survey used the following questions to screen for
stalking victimization: 

--Not including bill collectors, telephone
solicitors, or other salespeople, has anyone, male
or female, ever . . . 

--Followed or spied on you? 

--Sent you unsolicited letters or written
correspondence? 

--Made unsolicited phone calls to you?

--Stood outside your home, school, or workplace? 

--Showed up at places you were even though he or
she had no business being there?

--Left unwanted items for you to find? 

--Tried to communicate in other ways against your
will? 

--Vandalized your property or destroyed something
you loved? 

Respondents who answered yes to one or more of
these questions were asked whether anyone had ever
done any of these things to them on more than one
occasion and whether they felt frightened or
feared bodily harm as a result of these behaviors.
Only respondents who reported being victimized on
more than one occasion and who were very
frightened or feared bodily harm were counted as
stalking victims.

------------------------------

Notes

1. Rape screening questions were adapted from
those used in The National Women's Study, see Rape
in America: A Report to the Nation, National
Victim Center and the Crime Victims Research and
Treatment Center, 211 Wilson Boulevard, Suite 300,
Arlington, Virginia 22201, April 23, 1992, p.15.

2. Straus, Murray, "Measuring Intrafamily Conflict
and Violence: The Conflict Tactics (CT) Scale,"
Journal of Marriage and the Family 41 (February
1979): 75-88.

------------------------------

Other Publications in the Series

To obtain other publications in the series from
the National Violence Against Women Survey:

--Stalking in America: Findings From the National
Violence Against Women Survey, Research in Brief,
by Patricia Tjaden and Nancy Thoennes, Washington,
D.C.: U.S. Department of Justice, National
Institute of Justice, April 1998 (NCJ 169592). 

Visit NIJ's Web site at
http://www.ojp.usdoj.gov/nij or contact the
National Criminal Justice Service at P.O. Box
6000, Rockville, MD 20849-6000, (800) 851-3420 or
(301) 519-5500, or send an e-mail message to
askncjrs@ncjrs.org.

--Final Report on Prevalence, Incidence, and
Consequences of Violence Against Women by Patricia
Tjaden and Nancy Thoennes, Atlanta, GA: Centers
for Disease Control and Prevention, National
Center for Injury Prevention and Control,
forthcoming 1998.

Learn about the availability of the Final Report
and other CDC family and intimate violence
prevention activities by visiting the National
Center for Injury Prevention and Control's Web
site at http://www.cdc.gov/ncipc/dvp/fivpt.

Additional reports in the series are forthcoming. 

-----------------------------

Survey Methodology

The National Violence Against Women (NVAW) Survey
was conducted from November 1995 to May 1996 by
interviewers at Schulman, Ronca, and Bucuvalas,
Inc. (SRBI), under the direction of John Boyle.[1]
The authors of this report designed the survey and
conducted the analysis.

The national sample was drawn by random-digit
dialing from households with a telephone in all 50
States and the District of Columbia. The sample
was administered by U.S. Census region. Within
each region, a simple random sample of working
residential "hundreds banks" of phone numbers was
drawn. (A hundreds bank is the first eight digits
of any 10-digit telephone number; e.g., 301-608-
38xx.) A randomly generated two-digit number was
appended to each randomly sampled hundreds bank to
produce the full 10-digit, random-digit number.
Separate banks of numbers were generated for male
and female respondents. These random-digit numbers
were called by SRBI interviewers from their
central telephone facility, where nonworking and
nonresidential numbers were screened out. Once a
residential household was reached, eligible adults
(i.e., women and men 18 years of age and older) in
each household were identified. In households with
more than one eligible adult, the adult with the
most recent birthday was selected as the
designated respondent. 

A total of 8,000 women and 8,005 men 18 years and
older were interviewed using a computer-assisted
telephone interviewing system. (Five completed
interviews with men were subsequently eliminated
from the sample during data editing due to an
excessive amount of incongruous data.) Only female
interviewers surveyed female respondents. For male
respondents, approximately half of the interviews
were conducted by female interviewers and half by
male interviewers. 

A Spanish-language translation was administered by
bilingual interviewers for Spanish-speaking
respondents.

To determine the representativeness of the sample,
select demographic characteristics of the NVAW
Survey sample were compared with demographic
characteristics of the general population as
measured by the U.S. Census Bureau's 1995 Current
Population Survey of adult men and women. Sample
weighting was considered to correct for possible
biases introduced by the fact that some households
had multiple phone lines and multiple eligibles,
and for over- and under-representation of selected
subgroups. Although there were some instances of
over- and under-representation, the overall
unweighted prevalence rates for rape, physical
assault, and stalking were not significantly
different from their respective weighted rates. As
a result, sample weighting was not used in the
analysis of the NVAW Survey data. 

A technical report describing the survey methods
in more detail and recording sample
characteristics and prevalence rates using
weighted and unweighted data is available from the
authors.[2] 

Data were analyzed using SPSS Base 7.0 for Windows
software. Measures of association (e.g., Lambda)
were calculated between nominal-level independent
and dependent variables, and the chi-square
statistic was used to test for statistically
significant differences between men and women
(p-value  .05). Any estimates based on five or
fewer responses were deemed unreliable and
therefore were not tested for statistically
significant differences between groups and not
presented in the tables. Because estimates
presented in this report generally exclude "don't
know," "refused," and other invalid responses,
sample and subsample sizes (n's) vary from table
to table.

The estimates from this survey, as from any sample
survey, are subject to random sampling error.
Exhibit 16 presents the estimated standard errors
multiplied by the z-score (1.96) for specified
sample and subsample sizes of 16,000 or less at
different response distributions of dichotomous
variables (e.g., raped/not raped, injured/not
injured). These estimated standard errors can be
used to determine the extent to which sample
estimates will be distributed around the
population parameter (i.e., the true population
distribution). As exhibit 16 shows, larger sample
and subsample sizes produce smaller estimated
standard errors. Thus the estimated standard error
at the 95-percent confidence level for a sample or
subsample of 8,000 (the number of women and men,
respectively, on which lifetime and annual
prevalence rates are based) is 1.1 percentage
points if the response distribution is a 50/50
split, while the standard error at the 95-percent
confidence level for a sample or subsample of 50
is 14 percentage points if the response
distribution is a 50/50 split.

------------------------------
Notes

1. John Boyle, Ph.D., is senior vice president and
director of the Government and Social Research
Division at SRBI. Dr. Boyle, who specializes in
public policy research in the area of health and
violence, also manages the firm's Washington,
D.C., area office.

2. To obtain copies of the National Violence
Against Women Survey Methodology Report, call or
write to the Center for Policy Research, 1570
Emerson Street, Denver, Colorado, 80218; 303-837-
1555.

-----------------------------

Notes

1. Kennedy, Leslie W., in Foreword to Dangerous
Domains: Violence Against Women in Canada by Holly
Johnson, Scarborough, Ontario: International
Thomas Publishing, 1996.

2. Wilson, Carolyn F., Violence Against Women: An
Annotated Bibliography, Boston: G.K. Hall & Co.,
1981.

3. National Research Council, Understanding
Violence Against Women, Washington, D.C.: National
Academy Press, 1996: 40-44.

4. Ibid.

5. Michael, Robert T., John H. Gagnon, Edward O.
Lauman, and Gina Kolata, Sex in America: A
Definitive Survey, New York: Warner Books, 1994:
223.

6. The NVAW Survey was conducted from November
1995 to May 1996 (see "Survey Methodology," page
14). Respondents reported on events that spanned
the 12 months prior to their interview. For
example, a person who was interviewed in November
1995 reported on events that occurred between
November 1994 and November 1995; a person who was
interviewed in May 1996 reported on events that
occurred between May 1995 and May 1996. 

7. Craven, Diane, Sex Differences in Violent
Victimization, 1994, Special Report, Washington,
D.C.: U.S. Department of Justice, Bureau of
Justice Statistics, September 1997, NCJ 164508.

8. The two rape/sexual assault screening questions
used in the NCVS are as follows: (1) (Other than
any incidents already mentioned,) has anyone
attacked or threatened you in any of these ways: .
. . (e) Any rape, attempted rape, or other type of
sexual attack? (2) (Other than any incidents
already mentioned,) have you been forced or
coerced to engage in unwanted sexual activity by
(a) someone you didn't know before, (b) a casual
acquaintance, or, (c) someone you know well?

9. See, for example, Helton, A.M., "The Pregnant
Battered Women," Responses to Victimization of
Women and Children 9. (1) 1986: 22-23; Koss, Mary
P., "Detecting the Scope of Rape: A Review of
Prevalence Research Methods," Journal of
Interpersonal Violence 8 (2) (June 1993): 198-222.

10. See "Survey Screening Questions," page 13.

11. Straus, Murray, "Measuring Intrafamily
Conflict and Violence: The Conflict Tactics (CT)
Scale," Journal of Marriage and the Family 41
(February 1979): 75-88.

12. Craven, Sex Differences in Violent
Victimization, 1994.

13. Bachman, Ronet, Death and Violence on the
Reservation: Homicide, Family Violence, and
Suicide in American Indian Populations, Westport,
CT.: Auburn House, 1992.

14. Wallace, L.J.D., A.D. Calhoun, K.E. Powell, J.
O'Neill, and S.P. James, Homicide and Suicide
Among Native Americans 1979-1992, Violence
Surveillance Summary Series, No. 2, Atlanta, GA:
Centers for Disease Control and Prevention,
National Center for Injury Prevention and Control,
1996.

15. Tjaden, Patricia, and Nancy Thoennes, Stalking
in America: Findings From the National Violence
Against Women Survey, Research in Brief,
Washington, D.C.: U.S. Department of Justice,
National Institute of Justice, April 1998, NCJ
169592.

16. Ho, C.K., "An Analysis of Domestic Violence in
Asian American Communities: A Multicultural
Approach to Counseling," in Diversity and
Complexity in Feminist Therapy, ed. L.S. Brown and
M. Root, New York: Harrington Park, 1996: 129-150;
Huisman, K.A., "Wife Battering in Asian American
Communities," Violence Against Women 2 (1996):
260-283.

17. Sorenson, S.B., J.A. Stein, J.M. Siegel, J.M.
Golding, and M.A. Burnam, "The Prevalence of Adult
Sexual Assault: The Los Angeles Epidemiologic
Catchment Area Project," American Journal of
Epidemiology 126: 154-164, 1987; Sorenson, S.B.,
and C.A. Tells, "Self-Reports of Spousal Violence
in a Mexican American and a Non-Hispanic White
Population," Violence and Victims 6 (1991): 3-16.

18. See National Victim Center and the Crime
Victims Research and Treatment Center, Rape in
America: A Report to the Nation, 211 Wilson
Boulevard, Suite 300, Arlington, Virginia 22201,
April 23, 1992.

19. See, for example, Browne, Angela, and David
Finkelhor, "Initial and Long-term Effects: A
Review of the Research," in Sourcebook on Child
Sexual Abuse, ed. David Finkelhor, Beverly Hills:
Sage Publications, 1986: 158; Miller, J., D.
Moeller, A. Kaufman, P. Divasto, P. Fitzsimmons,
D. Pather, and J. Christy, "Recidivism among
Sexual Assault Victims," American Journal of
Psychiatry 135 (1978): 1103-1104; and Russel,
D.E.H., The Secret Trauma: Incest in the Lives of
Girls and Women, New York: Basic Books, 1986.

20. See, for example, Morse, Barbara, "Beyond the
Conflict Tactics Scale: Assessing Gender
Differences in Partner Violence," Violence and
Victims 10 (Winter 1995): 251-272; Straus, Murray,
and Richard Gelles, "Societal Change and Change in
Family Violence From 1975 to 1985 as Revealed by
Two National Studies," Journal of Marriage and the
Family 48 (August 1986): 465-479. 

21. See, for example, Bachman, Ronet, Violence
Against Women: A National Crime Victimization
Survey Report, Washington, D.C.: U.S. Department
of Justice, Bureau of Justice Statistics, NCJ
145325; Bachman, Ronet, and Linda Saltzman,
Violence Against Women: Estimates From the
Redesigned Survey, Special Report, Washington,
D.C.: U.S. Department of Justice, Bureau of
Justice Statistics, August 1995, NCJ 154348;
Gaquin, Diedre, "Spouse Abuse: Data From the
National Crime Survey," Victimology 2 (1977-1978):
634-643; and Klaus, Patsy, and Michael Rand,
Family Violence, Special Report, Washington, D.C.:
U.S. Department of Justice, Bureau of Justice
Statistics, April 1984, NCJ 093449.

22. See, for example, Langan, Patrick A., and
Christopher A. Innes, Preventing Domestic Violence
Against Women, Special Report, Washington, D.C.:
U.S. Department of Justice, Bureau of Justice
Statistics, 1986, NCJ 102037; Timrots, Anita D.,
and Michael R. Rand, Violent Crime by Strangers
and Nonstrangers, Special Report, Washington,
D.C.: U.S. Department of Justice, Bureau of
Justice Statistics, January 1987, NCJ 103702. 

23. Rand, Michael, Violence-Related Injuries
Treated in Hospital Emergency Departments, Special
Report, Washington, D.C.: U.S. Department of
Justice, Bureau of Justice Statistics, August
1997, NCJ 156921.

24. See Puente, Maria, "Legislators Tackling the
Terror of Stalking: But Some Experts Say Measures
Are Vague," USA Today, July 21, 1992: A9.

-----------------------------

Patricia Tjaden, Ph.D., and Nancy Thoennes, Ph.D.,
are with the Denver-based Center for Policy
Research.

This research was supported by grant number 93-IJ-
CX-0012, awarded to the Center for Policy Research
by the National Institute of Justice (NIJ) and
sponsored jointly by NIJ and the Centers for
Disease Control and Prevention (CDC).

The authors thank Lois Mock at NIJ and Linda
Saltzman at the CDC for their advice and support
in completing this project. The authors also thank
anonymous reviewers and Steven Leadbetter and
Marcie-jo Kresnow, mathematical statisticians at
the CDC, who provided helpful comments on drafts
of this report.

------------------------------ 

The National Institute of Justice is a component
of the Office of Justice Programs, which also
includes the Bureau of Justice Assistance, the
Bureau of Justice Statistics, the Office of
Juvenile Justice and Delinquency Prevention, and
the Office for Victims of Crime.

------------------------------

NCJ 172837

Findings and conclusions of the research reported
here are those of the authors and do not
necessarily reflect the official position or
policies of the U.S. Department of Justice or the
U.S. Department of Health and Human Services.