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A woman who fled her abusive boyfriend is observed sitting at a table with other women in a residential chemical dependency treatment program. Her bruised face could not be missed (Figure 10-1). The program physician asked to speak with her and learned that her boyfriend beat her when she told him that she was voluntarily entering this program. The boyfriend was also an addict and had been physically abusive to her before. The violence escalated when she said that she needed help to stop the alcohol and drugs. She left him and did not believe that he would follow her. The program management assured her that they would not let him on the premises and would do all they could to keep her safe while she was recovering. Figure 10-2 was taken 2 months later, when her face was healing along with her mind and spirit. She completed the 90-day program and is currently working and actively following a 12-step program.

Figure 10-1

Bruising caused by intimate partner violence in a woman who fled her abusive boyfriend. (Courtesy of Richard P. Usatine, MD.)

Figure 10-2

Photograph of the woman in Figure 10-1 taken 2 months later. Her facial and psychological wounds are healing. (Courtesy of Richard P. Usatine, MD.)

Intimate partner violence (IPV) is defined as an intimate partner's physical, emotional, or sexual abuse. Physical violence is the intentional use of physical force with the potential for causing death, disability, injury, or harm. Physical violence includes scratching; pushing; biting; punching; use of a weapon; and use of restraints or one's body, size, or strength against another person.1

IPV affects up to half of the women in the United States during their lifetime.2

  • An estimated 4.9 million IPV rapes and physical assaults occur each year among U.S. women (age 18 years and older) and 2.9 million assaults occur among U.S. men. Most of these assaults include pushing, grabbing, shoving, slapping, and hitting and do not result in major injury.3 In a national telephone survey of 8000 women and 8000 men, 41.5% of the women who were physically assaulted by an intimate partner were injured during their most recent assault, compared with 19.9% of men.4
  • Physical violence by an intimate partner can result in direct injury including death (1181 women and 329 men in 2005; Bureau of Justice, 2007), adverse psychological, and social consequences, and impaired endocrine and immune systems through chronic stress and other mechanisms.4
  • In the family practice setting, the lifetime prevalence of abuse of women was 38.8%, with current abuse reported by 2% to 48% of women.1
  • A national survey estimated that 503,485 women and 185,496 men are stalked by intimate partners each year....

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