Book Review

Understanding Violence against Women

N Engl J Med 1997; 336:300January 23, 1997

Article

Understanding Violence against Women
(Panel on Research on Violence against Women, National Research Council.) Edited by Nancy A. Crowell and Ann W. Burgess. 225 pp. Washington, D.C., National Academy Press, 1996. $29.95. ISBN: 0-309-05425-7

The Panel on Research on Violence against Women was established by the National Research Council in 1995 to fulfill a congressional request for a research agenda to increase understanding of violence against women. The multidisciplinary panel restricted its deliberations to rape, sexual assault, and the battering of intimate partners. It struggled with many important issues, including the definitions of violence against women, primary prevention, and the outcomes of intervention. Recommendations were based on reviews of research published in peer-reviewed journals and information presented at a workshop of practitioners and researchers.

The panel's comprehensive report highlights major gaps in knowledge about violence against women. Relatively little is known about the prevalence or incidence of such violence. The report calls for the development of tools that can be applied to all ethnic groups to measure different types of violence (e.g., physical and sexual violence) in the same survey. Such methods should identify and quantitate overlap in the different types of violence women experience. Little is known about rates of victimization, and even less about the prevalence of perpetrators of violence against women. The panel recognized these deficiencies.

The report briefly reviews theories and research on the causes of violence against women. Most theories are too narrow; for example, physiology, learning, and social influences each undoubtedly contributes to violence against women, but none of these influences act in isolation. The panel concluded that multifactorial models are the most promising in the search for understanding of the causes of violence against women. Research is also needed on the childhood and adolescent experiences that could determine whether a perpetrator expresses violence through physical or sexual means. And we also need information on the initiation, maintenance, escalation, and diminution of this problem over time. Prevention and intervention programs for perpetrators will benefit greatly from a better understanding of these issues.

The report recognizes that numerous prevention and intervention programs exist, but evaluations of these programs are limited. Prevention programs tend to measure short-term changes, only rarely following up on long-term changes in behavior. Yet if prevention is the intended outcome, behavior must be measured.

An infrastructure is needed to support the research recommendations this report makes. The panel suggested that federal agencies coordinate funding for and research on the primary prevention of violence against women and intervention for perpetrators and victims. The report also calls for at least three research centers within academic or other appropriate settings to support research and training programs and to foster collaboration between researchers and practitioners.

The consequences of violence against women are far-reaching, affecting not only the health and quality of women's lives, but also the well-being and future of their children. The exposure of children to violence in the home, for example, is well established as a risk factor for both victimization and perpetration of violence later in life. Violence against women may also contribute to youth violence, family violence, suicide, and drug abuse. Consequently, an investment in the research recommended by this report may not only prevent violence against women but also mitigate its secondary effects on exposed children and other witnesses.

The panelists responsible for the report demonstrate great skill in concisely summarizing a voluminous literature, identifying major gaps in knowledge, and offering direction for future scientific endeavors.

Pamela M. McMahon, Ph.D.
James A. Mercy, Ph.D.
Centers for Disease Control and Prevention, Atlanta, GA 30333