Identifying intimate terrorism and situational couple violence in abused Chinese women

Abstract

Introduction: Intimate partner violence (IPV) is a prevalent public health problem that brings many adverse outcomes to individuals and societies. Understanding, preventing, and reducing IPV is important to minimize the consequences. Instead of studying IPV as a single phenomenon, Johnson’s typology of domestic violence suggests that there are four types of IPV which have differential effects on survivors’ health. Violence and coercive control used by individuals in the relationship are the key components to categorizing the types of IPV. Hence before applying this categorization to the Chinese context, it is first essential to examine the coercive control.

Aims: This study aimed (a) to examine pattern of coercive control in Chinese intimate relationships, (b) to establish a cut-off score on the Chinese version of the Revised Controlling Behaviors Scale (C-CBS-R) to differentiate the use of coercive control, and (c) to identify Intimate Terrorism (IT) and Situational Couple Violence (SCV) in Johnson’s typology and their impact on the mental health of women survivors.

Methods: A cross-sectional, mixed-methods design study was conducted. Chinese women aged 18 or above who reported being physically abused by an intimate partner in the past 12 months were recruited from shelter and community settings. The study consisted of three parts: (a) semi-structured, in-depth individual interviews to examine the coercive control used in Chinese intimate relationships, (b) qualitative and quantitative data to establish a cut-off score on C-CBS-R, and (c) a survey using a researcher-administered questionnaire to categorize types of IPV and examine their mental health effects. A set of questionnaires was used to elicit participants’ experiences of IPV, frequency of physical violence used, controlling behaviors, depressive symptoms, post-traumatic stress disorder (PTSD) symptoms, and demographic characteristics.

Results: In Part 1 of the study, a pattern of coercive control was identified in the abusive intimate relationships from the interviews of 20 physically abused women. Then a cut-off score of C-CBS-R was identified as greater than 1.145 to differentiate control with and without a pattern in Part 2 of the study. Finally, a total of 334 physically abused women were recruited with 133 (40%) being identified as IT survivors while 137 (41%) were SCV survivors. IT women survivors were found to experience a significantly higher frequency of physical violence, physical injuries, and use of medical services than SCV survivors. The age difference between the woman and her partner, expressed fear of her partner, experience of financial hardship, and sexual coercion by an intimate partner in the previous year were significantly associated with the occurrence of IT. Using linear regression model analysis, IT women survivors were found to report more severe depressive and PTSD symptoms than SCV survivors with and without confounding by other factors.

Conclusion: This study developed a cut-off score on C-CBS-R to differentiate the use of control and identified IT and SCV based on the use of control and violence by individuals according to Johnson’s typology. IT women survivors were found to experience more severe mental health impacts than SCV survivors, showing the differential effect on women survivors’ health.