Violent lives of women: critical points for intervention--phase I focus groups.

PROBLEM. To identify critical developmental periods, experiences, and events in women's lives associated with violence to guide a larger study. METHODS. Two focus groups of 10 women each (N = 20) were conducted to determine the critical times when girls and women might be exposed to violence. FINDINGS. Broad themes in the data were developmental periods, abusers, staying in the relationship, leaving the relationship, parenting, and living with violence. The women in these focus groups clearly identified times of increased risk for violence in their lives: establishing intimate relationships, pregnancy, childrearing years, and times when substance abuse is occurring. CONCLUSIONS. While clinicians should be vigilant for the presence of domestic violence with all clients, it is important to know when a woman experiences increased risk for violence. The findings indicate a need for education for communities, those who provide care for women and children, and people in whom victims may confide. Search terms: Focus groups, intimate partner violence, risks It is well documented that domestic violence is a significant health problem in the United States. Violence between adult partners occurs in all socioeconomic groups, all ethnic groups, and in heterosexual and homosexual relationships. Partner violence includes acts of physical and sexual violence and is often accompanied by extreme emotional and verbal abuse, as well as extreme controlling behavior. Though the incidence of male victimization by women is increasing, male-to-female violence is often more repeated and is more likely than female-to-male violence to result in injury or death (Schafer, Caetano, & Clark, 1998). Among women who experience partner violence, the majority (77%) experience physical violence, with the remainder experiencing nonphysical abuse (Coker, Smith, McKeown, & King, 2000). An estimated 4 million American women are beaten by their intimate partners each year (Tjaden & Thoenes, 2000). Violence in intimate relationships often begins in adolescence, with approximately 25% of female adolescents experiencing physical or sexual violence in their dating relationships (Martin, Clark, Lynch, Kupper, & Cilenti, 1999; Molidor, Tolman, & Kober, 2000). In fact, women are most vulnerable to sexual victimization are their adolescent and young adult years (Zweig & Vicary, 2000). This problem is exacerbated by the finding that young people subscribe to a belief in male dominance and tend to view women as sexual objects (Kershner, 2000). Women who are pregnant experience abuse at a higher rate than those who are not. Abuse during pregnancy is often more severe than at other times, as well as more frequent (Anderson, 2002; Greenberg, McFarlane, & Watson, 1997). The majority of postpartum women use well-baby care with private physicians, indicating that pediatric practices may be an important setting for screening women for violence (Martin, Mackie, Kupper, Buescher, & Moracco, 2001). Abused adolescent mothers gave birth to infants with significantly lower birthweights than did adolescent mothers who are not abused (Renker, 1999). Social support factors such as shelter, family support, self-care agency, and prenatal care were significant predictors of infant weight in adolescent mothers (Renker). Adolescent mothers who are abused are significantly more likely to experience other forms of violence (e.g., verbal abuse, assault by family members), fear of being hurt by other teens, and witnessing violence (Wiemann, Agurcia, Berenson, Volk, & Rickert, 2000). Pregnant teens who experience abuse are far more likely than nonvictims to use cigarettes, alcohol, and illicit drugs, with victims of physical and sexual violence being the most likely to use these substances (Martin et al., 2001; Quigley & Leonard, 2000). Partner substance abuse is a strong risk factor for perpetration of partner violence (Chermack, Fuller, & Blow, 2000; Coker et al. …