Canadian Journal of Public Health, Vol. 89, No. 1, p. 43-47 (Jan-Feb, 1998)
Couple Violence and Psychological Distress
Elaine Grandin, PhDa, Eugen Lupri, PhDb, Merlin B. Brinkerhoff, PhDb
From the Department of Sociology, The University of Calgary, Calgary, Alberta
a Adjunct Assistant Professor of Sociology and Sessional Instructor.
b Professor of Sociology.
Except for anecdotal data, empirical research on the psychological well-being of abused men is scarce. This paper compares the mental health of non-victims with victims of physical and psychological violence among 562 Calgary couples. Physical and psychological violence were assessed by two subscales of the Conflict Tactics Scales and psychological distress was assessed by abbreviated anxiety and depression subscales of the SCI-90, a frequency of symptom measure. Female and male victims of either psychological-only or physical violence reported significantly higher rates of distress than non-victims. Females exhibited higher depression and anxiety scores than their male counterparts, regardless of whether they were victims or non-victims of either type of violence. Being both a perpetrator and victim of either type of violence is associated with significantly higher levels of psychological distress for both genders. The theoretical and practical implications of these findings are discussed.
Although previous studies have shown that both men and women abuse their intimate partners(1-15), most investigations have neglected to examine the effects of spousal abuse on men. Recent examples are studies by Ratner(16) and Statistics Canada(17), which limit their respondents to female victims. This paper attempts to overcome that limitation by comparing  the mental health status of non-victims and victims of intimate violence, and  the effects of physical and psychological abuse on both female and male victims.
We hypothesized that both physical and psychological violence are positively associated with psychological distress. We therefore expected female and male victims to report higher rates of depression and anxiety than non-victims. Given that the literature suggests women are more likely than men to suffer negative psychological effects of intimate violence(18-24), we also hypothesized that female victims would report higher mean rates of psychological distress than male victims.
Our third hypothesis requires a brief preface. We asked both spouses whether they had committed any physically or psychologically violent acts against their intimate partners in the year preceding the survey. Unlike Dobash et al.(18), we identified two viable types of couple relationships: symmetrical and asymmetrical. In a symmetrical relationship the respondent is both perpetrator and victim or neither perpetrator nor victim. Conversely, in couples having an asymmetrical relationship, the respondent is either a perpetrator or a victim but not both, while his or her partner reports the opposite role. Table I presents a typology of relationships by symmetry or asymmetry of the interaction.
We hypothesized that victims (also perpetrators) in symmetrically violent relationships would report higher rates of psychological distress than victims (non-perpetrators) in asymmetrical relationships. Furthermore, in asymmetrical relationships, perpetrators (non-victims) would report greater psychological distress than perpetrators in symmetrically violent relationships.
A Typology of Symmetry and Asymmetry in Intimate Couple Interactions
Type of Abuse Perpetrator/Victim* Relationship Among Couples Husband Wife Symmetrical None Neither perpetrator nor victim Neither perpetrator nor victim Bi-directional Both perpetrator and victim Both perpetrator and victim Asymmetrical ** Husband-to-Wife Perpetrator but non-victim Victim but non-perpetrator Wife-to-Husband Victim but non-perpetrator Perpetrator but non-victim * This typology applies to relationships in which there is either physical or psychological-only violence, or no violence.
** In an asymmetrical relationship, neither member of the couple is both a perpetrator and a victim. If the respondent reports being a perpetrator, the partner reports being a victim; if the respondent reports being a victim, the partner reports being a perpetrator.
A systematic random sample was drawn from a current reverse Calgary telephone directory by taking every nth residence, excluding businesses, after a random start. A letter describing the research, followed by an interviewer's visit, ascertained whether a heterosexual couple (common-law or married) resided there. Although interviews were required from both members of a couple, the refusal rate was only 18%. The random sample of 562 couples proved representative of the Calgary population with regard to family life-cycle profiles, age, employment characteristics, socioeconomic status, and level of education.
Couple data were collected by 30 trained interviewers (male and female). One member of the couple, selected at random, completed a structured interview while the other completed a self-administered questionnaire in a separate room. These roles were then reversed. This dual-faceted approach allowed questionnaires to deal more validly with potentially sensitive data such as marital power, personal distress, and couple violence, whereas personal interviews maintained rapport while gathering important background information.
Psychological distress was assessed by the anxiety and depression subscales of the SCL-90-R, a frequency of symptoms measure(25). Respondents indicated on a 5-point scale (from 0 = not at all, to 4 = extremely often) how often in the previous week they had been bothered by symptoms of anxiety and depression. Factor analysis(26) resulted in two distinct scales with factor loadings ranging from 0.54 to 0.79. The coefficient alpha for the abbreviated three-item depression scale and for the abbreviated seven-item anxiety scale were 0.68 and 0.86 respectively.
Physical violence and psychological abuse
Physical violence and psychological abuse were assessed by two subscales of the widely used Conflict Tactics Scales(4,5), considered a reliable, valid measure of the incidence of intimate violence. Respondents indicated how often in the previous 12 months they had committed acts of physical violence and psychological abuse against their intimate partners. Respondents were operationally defined as physically violent if they had reportedly committed any of eight physically violent acts, and psychologically violent if they had not committed acts of physical violence but had reportedly committed any of six psychologically abusive acts six times or more during the previous year. Alphas for the eight-item physical violence and six item psychological-only violence subscales were 0.88 and 0.83, respectively, similar to those reported by Ratner(16) and Straus(2,4,5).
Victims versus non-victims
If intimate violence, physical as well as psychological, is positively associated with psychological distress, we expect victims to report higher rates of depression and anxiety than non-victims. The means in Table II show that the lowest rates of psychological distress were reported by non-victims. Psychological distress scores were higher for victims of psychological-only abuse and highest among victims of physical violence. F-ratios associated with both depression and anxiety indicate statistically significant (p < 0.005) differences of means between victims and non-victims of physical violence. Although not all differences between victims and non-victims were statistically significant, they were in the predicted direction, regardless of both gender and type of violence that is, both male and female victims of either psychological-only or physical violence were likely to report higher levels of psychological distress than were non-victims. The means also suggest that physical violence was more distressing than psychological-only abuse.
The Relationship Between Couple Violence and Psychological Distress by Gender of Victim: Means, Standard Deviations, and F-Ratios from ANOVA
Psychological Distress Þ Gender Females Males Mean S.D. N ß Mean S.D. N Depression Scale 1. Non-violent (non-victim) 5.83 2.32 230 5.33 1.86 183 2. Psychological-only (victim) 6.04 1.98 169 5.81 2.13 208 3. Physical Violence (victim) 6.68 2.53 131 6.08 2.19 150 F-ratio ¶ =5.85***
F-ratio = 5.72***
Anxiety Scale 1. Non-violent (non-victim) 12.42 4.27 225 11.26 3.88 171 2. Psychological-only (victim) 12.58 3.41 162 11.42 3.51 198 3. Physical Violence (victim) 14.16 3.79 130 13.23 4.23 145 F-ratio = 9.08****
F-ratio = 12.22****
Þ Both variables are multiple-item scales with the parameters discussed in the text.
ß N's vary due to non-response on selected items.
¶ All F-ratios are statistically significant at < 0.005.
§ The numbers in parentheses indicate the groups which have a statistically significant (p<0.05) difference of means.
Women versus men
To test the feminist claim that women's psychological well-being is affected more severely by intimate violence than men's(22-24,27,28), we compared the average rates of depression and anxiety by gender for both non-victims and victims of both types of violence. The data in Table III show that for non-victims, there was a statistically significant difference in mean depression scores by gender with females reporting higher rates than males. Similarly, for victims of physical violence, the mean score on the depression scale was statistically higher for female than male victims. This finding supports the view that physically victimized women are more likely than physically victimized men to experience depression. Although the expected gender difference in depression scores between female and male victims experiencing psychological-only violence was not statistically significant, it was in the predicted direction.
The data in the lower half of Table III (anxiety scale) indicate that non-victimized women reported significantly (p < 0.005) higher levels of anxiety than did nonvictimized men, as we had expected. Note, however, that both types of violence were associated with increased psychological distress for both women and men, as shown in Table II.
Gender Differences on the Relationships Between Couple Violence and Psychological Distress: Difference of Means
Type of Distress Þ Type of Relationship Non-victims Victims Non-violent Psychological-only Physical violence Mean S.D. N Mean S.D. N Mean S.D. N Depression Scale 1. Female 5.83 2.32 230 6.04 1.98 169 6.68 2.53 131 2. Male 5.33 1.86 183 5.81 2.13 208 6.08 2.19 150 t-valueß = 2.38* t-value = 1.09 t-value = 2.13* Anxiety Scale 1. Female 12.42 4.27 225 12.58 3.41 162 14.16 3.79 130 2. Male 11.26 3.88 171 11.42 3.51 198 13.23 4.23 145 t-value = 2.78*** t-value = 3.02*** t-value = 1.93* Þ Both variables are multiple-item scales with the parameters discussed in the text.
ß t-values are statistically significant at: * < 0.05; ** < 0.01; *** < 0.005.
Couple symmetry versus asymmetry
Information about the same variables was obtained from both spouses, permitting a dyadic approach to data analysis. As indicated in Table IV, of the 213 couples (80 bidirectional, 58 and 75 asymmetrical) who committed and/or experienced physical violence, in 38% symmetry prevailed: both partners were perpetrators as well as victims. In 62% of the couples asymmetry prevailed: there was either husband-to-wife or wife-to-husband physical violence, but not both. The wife-to-husband rates were slightly higher.
Of the 256 couples who committed and/or experienced psychological-only violence, half were symmetrical and half were asymmetrical. Of the latter, 64% reportedly committed wife-to-husband and 36% husband-to-wife psychological-only violence.
Type of Physical and Psychological Abuse and Perpetrator/Victim Relationshipin a Sample of 562 Calgary Couples
Type of Abuse Physical Violence Þ Psychological-only Violence ß % N % N Symmetrical¶ None 62.2 349 26.6 93 Bi-directional 14.3 80 36.7 128 Asymmetrical§ Husband-to-Wife 10.3 58 13.2 46 Wife-to-Husband 13.2 75 23.5 82 Total 100.0 562 100.0 349 Þ Respondents who reportedly committed and/or experienced any of the CTS's eight physically violent acts in their intimate relationships.
ß Respondents who reportedly committed and/or experienced any of the CTS's six psychologically violent acts in their intimate relationships.
¶ Symmetrical means both partners were either violent or non-violent.
§ Among non-victims, asymmetrical means subjects were perpetrators but not victims; among victims asymmetrical means subjects were victims but not perpetrators.
Can we assume that wives and husbands of symmetrically violent couples are more likely to report problems of mental health than their asymmetrical counterparts? Table V addresses this question.
For female non-victims, the means associated with both the depression (7.40) and anxiety (15.52) scales suggested that women who were perpetrators but not victims of physical violence (asymmetrical) suffered more depression than those who were in a non-violent, symmetrical situation (mean = 5.40 for depression and 11.49 for anxiety). Both differences were statistically significant at p < 0.001.
For psychological-only violence, both depression and anxiety levels were higher (p < 0.001) among female victims in symmetrical compared with asymmetrical situations. These data suggest that wives of symmetrically violent couples were more likely to report problems of mental distress than their asymmetrical counterparts. In short, experiencing psychological-only violence as both perpetrator and victim simultaneously was more personally distressing for the female partner than were situations in which she was the sole victim.
Among those experiencing physical violence, the same pattern held. When both partners were physically abusive (symmetrical), depression and anxiety scores for these women were higher than for women who were the sole victims of physical violence (asymmetrical). However, only the mean difference in depression scores between these two groups was statistically significant (p < 0.005). Nevertheless, both the magnitude and direction of the psychological distress subscales were as expected.
The same basic patterns were found for male partners. As with female non-victims, being a perpetrator of either type of violence was associated with increased depression and anxiety scores (p < 0.005). Among male victims, being in a symmetrical situation increased psychological distress over that reported in asymmetrical situations. The statistically significant differences found in anxiety levels were not found in depression levels.
In summary, Table V shows that when both partners were psychologically or physically abusive, both female and male victims reported more psychological distress than did their counterparts in asymmetrical relationships. Regardless of gender, perpetrators in asymmetrical relationships reported significantly higher levels of psychological distress than did individuals in symmetrically non-violent relationships.
Relationship Between Couple Violence and Psychological Distress byGender and Symmetry of Relationship: Means, Standard Deviations,and F-Ratios from ANOVA
Females Symmetrical Þ Asymetrical ß Mean S.D. N ¶ Mean S.D. N ¶ F-Ratio § Non-victim Depression Scale 5.40 2.11 180 7.40 2.40 50 -5.75**** Anxiety Scale 11.49 3.75 173 15.52 4.46 52 -6.50**** Psychological-only (victim) Depression Scale 6.37 1.95 126 5.09 1.77 43 3.77**** Anxiety Scale 13.09 3.36 122 11.03 3.09 40 3.59**** Physical violence (victim) Depression Scale 7.23 2.57 75 5.95 2.31 56 2.95*** Anxiety Scale 14.61 3.74 77 13.51 3.81 53 1.63 Males Symmetrical Þ Asymetrical ß Mean S.D. N ¶ Mean S.D. N ¶ F-Ratio § Non-victim Depression Scale 5.10 1.78 142 6.15 1.91 41 -3.27*** Anxiety Scale 10.38 3.38 130 14.05 4.09 41 -5.21**** Psychological-only (victim) Depression Scale 6.02 2.12 128 5.47 2.12 80 1.86 Anxiety Scale 12.45 3.55 124 9.84 2.77 74 5.77**** Physical violence (victim) Depression Scale 6.22 2.37 78 5.93 1.97 72 0.81 Anxiety Scale 13.92 4.38 76 12.46 3.95 69 2.11* Þ Symmetrical means both partners were either violent or non-violent.
ß Among non-victims, asymmetrical means subjects were perpetrators but not victims; among victims, asymmetrical means subjects were victims but not perpetrators.
¶ Numbers vary due to non-response on selected items.
§ F-ratios are statistically significant at: * < 0.05; ** < 0.01; *** < 0.005; **** < 0.001.
This research obtained self-reports on couple violence and psychological distress from both partners. Although studies reveal that men tend to underreport sensitive issues in terms of both frequency and severity of violence, our incidence rates of physical and psychological abuse are consistent with other studies. (2,4,5,7,10,14,15)
Compared with wife abuse and its consequences for women's mental health, less research has been done on husband abuse and its relationship to men's psychological distress. Furthermore, previous research has focused almost exclusively on physical abuse, ignoring psychological abuse and its relationship to mental health. Although we acknowledge the evidence that victimized women are much more likely than victimized men to suffer from physical injury requiring medical attention (21,23,24,28), we cannot ignore the potential long-term negative consequences of verbal attacks and other psychologically and mentally degrading acts of abuse. Our results support the notion that the experience of physical and psychological couple violence is strongly associated with psychological distress for women and men. Both genders are reportedly victimized by their respective partners and, compared with non-victims, both women's and men's psychological well-being suffers from abuse, a finding contrary to a widely adopted view held by the public and experts alike. These findings point to limitations in extant views of the relationship between men's abuse and their mental health.
Another striking finding, which supports the feminist thesis, is that across the board female victims of both types of violence exhibit greater psychological distress than their male counterparts (Table III). This also holds for non-victims. It may be argued that unlike men, women's sense of self is tied more closely to expressive, experiential, and socio-emotional spheres. Thus, their self-worth appears to be more vulnerable in close relationships. While men's identities are apt to revolve around achievement and activities in the outside world, women's identities are more generally defined in relation to their intimatespartners, children, relatives, friends. (29,30)
Interestingly, this study shows that it is not necessary to be a victim of intimate violence to suffer increased levels of psychological distress: being a sole male or female perpetrator is sufficient cause for higher rates of both depression and anxiety. In symmetrical relationships, both partners' mental health is significantly affected by this bi-directional abuse. The related effect of gender symmetry and asymmetry in violence merits exploration in future studies because, unlike perpetrators and victims of violence in the streets, perpetrators and victims of couple violence are intimate partners. Over time, they are drawn into coercive processes of escalation, intensity, and reciprocity of violence. The etiology and effect of such partner abuse are grounded in intimacy: both the forming and breaking of emotional bonds are part of the ongoing dialectic of couple interaction because domination, control, and intimacy exist side by side and often become entangled.
These cross-sectional data, while consistent with findings from clinical studies that focused on female victims(21,30,32), do not prove intimate violence causes psychological distress. To establish causality requires more stringent research methodologies, such as experimental designs, longitudinal studies, etc. Therefore, these conclusions are only suggestive and must be interpreted with caution.
With respect to therapeutic efforts in prevention, the findings also appear to argue for the importance of including both partners and of addressing the deployment of non-violent conflict-resolution strategies. It appears that a significant amount of education is needed to dispel the myth that males cannot be seriously abused by females. Work on this myth would help couples more effectively deal with the destructive patterns in their relationship, help prevent violence in the first place, and reduce the tendency of helping professionals to deny this problem. Moral consistency, in this case a willingness to confront couple violence with its negative psychological consequences, would seem to speak most powerfully to the needs of both female and male victims(33).
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Received: September 16, 1996
Accepted: July 16, 1997
Research for this paper was funded by the Social Sciences and Humanities Research Council of Canada, Grant 410-77-0580.Correspondence and reprint requests: Dr. Eugen Lupri, Department of Sociology, The University of Calgary, Calgary, Alberta T2N 1N4, Tel: 403-220-6501, Fax: 403-282-9298, E-mail: firstname.lastname@example.org.