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Abuse of spouse or partner occurs when one partner attempts to harm the other in a relationship in which the two people are dating, married, or living together. A recent study of girls in 9th through 12th grade found that one out of five girls was physically and/or sexually abused by a dating partner.

• Emotional abuse. In this type of abuse, the abuser might make angry remarks in private or public that cause the victim to feel worthless and ashamed.
• Physical abuse. This type of abuse can include hitting, slapping, punching, or beating.
• Sexual abuse. This type of abuse can mean forcing a partner to have sex against his or her will. It can also include making a partner do sexual acts that he or she finds degrading. Forcing a woman to risk pregnancy or sexually transmitted disease is another form of sexual abuse.

What are the signs and symptoms of the injury?

• bone fractures
• injuries on different parts of the body, in various stages of healing
• unexplained cuts, head injuries, or bruises

• depression
• feelings of anxiety
• low self-esteem

What are the causes and risks of the injury?

Spousal abuse happens to people of all religions, ethnic origins, and income levels. It happens in both man-woman and same-sex relationships. Women are the victims of domestic violence in 9 out of 10 cases, most often when they are between the ages of 19 and 29.

Recent studies show a man is more likely to abuse his spouse or partner if he has been violent in the past. A partnership also has a higher chance of becoming violent if one or more of the following risk factors are present.

• At least one partner has committed child abuse before.
• At least one partner has not finished high school.
• At least one partner has problems with drug abuse or addiction.
• At least one partner is a blue-collar worker.
• At least one partner is between the ages of 18 and 30.
• At least one partner is unemployed.
• The partners have different religious affiliations.
• The couple lives together but are unmarried.
• The couple has poor living conditions.
• The male partner saw his father hit his mother.

When two of these factors are present in a relationship, the risk of violence doubles. A couple with seven or more of these risk factors is 40 times more likely to have an abusive relationship.

Experts know that teens who have been abused are at higher risk for other health problems. However, we do not yet know whether the health problems came before the abuse or if the abuse increased the risk for the health problems. These problems include:

• teen pregnancy
• alcohol use, including binge drinking
• cocaine abuse
• risky sexual behaviors, including sex before age 15 and with many partners
• smoking
• suicidal attempts or thoughts
• unhealthy weight management, including eating disorders

What can be done to prevent the injury?

The best way to prevent abuse is to teach children how to solve problems without using violence. Teenagers and young adults should be taught that it is never permissible to abuse a partner.

Parents, youth leaders, pastoral professionals and healthcare professionals should provide teens with facts and statistics about dating violence. The teens should be given specific information about behaviors that are part of dating violence. They should be encouraged to discuss any issues or concerns with a parent or other trusted adult.

Since health concerns such as cocaine use are associated with a higher risk for partner abuse, healthcare professionals should address dating violence when treating teens with these health concerns. Careful screening can help identify at-risk teens and provide a chance to stop the abuse cycle.

As citizens, we can also help prevent the cycle of abuse in our society by pushing for these measures.

• Encourage judges and police enforce domestic violence laws. This tells abusers that their actions have consequences. It also helps victims feel safer about reporting their abuse.
• Provide shelters and other support programs that enable victims to leave an unsafe home and avoid further abuse.
• Teach abusers how to vent their anger without using violence. Offer drug and alcohol treatment when needed.
• Train healthcare, pastoral and education professionals to ask the individuals they are serving about abuse, if they suspect it. Professionals also need to be trained to keep careful records of any physical evidence of abuse.

How is the injury recognized?

There are not always physical signs of spousal abuse. While cuts and bruises may cause suspicion, emotional symptoms may not. Victims of abuse are often too afraid to report the abuse. If a partner behaves in a jealous, controlling, or hostile manner in public, others should consider that abuse may be occurring in the relationship. When a friend, family member, or caregiver suspects abuse, he or she should ask about it and offer to help.

What are the treatments for the injury?

Victims who are physically hurt may need treatment for their injuries. Counseling and psychiatric treatment for any victim of abuse may prevent long-term effects. This treatment may include:

• individual psychotherapy and group therapy
• job, welfare, and housing assistance to help the victim become independent
• medicine, such as antidepressants. If antidepressants are used, it may take a few weeks to a month for the full effect to be felt by the person taking them.
• support groups

The abuser may need help in the following ways:

• alcohol and drug treatment
• training in how to control his or her anger

What are the side effects of the treatments?

• dry mouth
• fatigue
• headache
• upset stomach

Some people also become more anxious or irritable. Others may develop sexual problems, such as erectile dysfunction.

None of the side effects are long-lasting. Within weeks of starting an SSRI, most people can tolerate the side effects they have. For other people, side effects go away. When they are constant and uncomfortable, a change in the medicine or dosage or the addition of another medicine often helps.

What happens after treatment for the injury?

Long-term effects of abuse can include PTSD. In this case, this disorder is a result of physical, mental, or sexual violence. The victim may have the following conditions:

• anxiety disorders
• depression
• feelings of isolation
• irritability
• nightmares and flashbacks
• a tendency to avoid other people

Even if the victim does not suffer from PTSD, he or she may have other long-term effects, such as:

• living in poverty
• poor self-esteem
• trouble staying in school or keeping a job

Studies show that half of men who abuse their partners also abuse their children. Abused mothers often have trouble holding jobs and more often need welfare benefits. This means that children from abusive homes are at a greater risk of being poor and homeless.

Local, state, and federal agencies, including police and social services, keep spousal abuse statistics. Many foundations, such as the National Coalition Against Domestic Violence and the American Bar Association, also monitor abuse. Local agencies that receive reports of abuse from healthcare professionals and other sources investigate and track high-risk families.