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Battered woman syndrome

Condition resulting from emotional, physical, or sexual abuse


Summary

Condition resulting from emotional, physical, or sexual abuse

FieldValue
nameBattered woman syndrome
synonymBattered person syndrome
specialty
symptomssee Symptoms
causesviolence, depression, passivity, and lack of social support outside of the abusive situation
diagnosissee Diagnosis
treatment

Battered woman syndrome (BWS) is a pattern of signs and symptoms displayed by a woman who has suffered persistent intimate partner violence—psychological, physical, or sexual—from her partner (usually male). Although the diagnosis has mainly centered on women, it has occasionally been applied to men when employing the term battered person syndrome, especially as part of a legal defense. It is classified in the ICD-11 (code 6B40) and the ICD-9 (code ) as battered person syndrome, but is not in the DSM-5.

The condition was first researched extensively by Lenore E. Walker, who used Martin Seligman's learned helplessness theory to explain why women stayed in relationships with abusive men. Victims may exhibit a range of behaviors, including self-isolation, suicidal thoughts, and substance abuse, and signs of physical injury or illness, such as bruises, broken bones, or chronic fatigue. It may be diagnosed as a subcategory of post-traumatic stress disorder (PTSD).

The condition is the basis for the battered woman legal defense that has been used in cases of physically and psychologically abused women who have killed their male partners. As a legal defense, it may be incorporated in defenses such as self defense-, provocation-, and insanity-based defenses.

The term "battered woman syndrome" has been criticized by some survivor advocates as being outdated terminology not used outside of courts.

Concept and terminology

In 1979, Lenore E. Walker proposed the concept of battered woman syndrome (BWS). She described it as consisting "of the pattern of the signs and symptoms that have been found to occur after a woman has been physically, sexually, and/or psychologically abused in an intimate relationship, when the partner (usually, but not always a man) exerted power and control over the woman to coerce her into doing whatever he wanted, without regard for her rights or feelings."

Walker stated, "As there are significant differences between the theory underlying the construct of BWS, and to date there are no empirically supported data, it has not yet been applied to men. Therefore, the term used is BWS rather than a gender-neutral battered person syndrome (BPS) or even battered man syndrome (BMS). Of course, men are abused by women, but the psychological impact on the man does not appear to be consistent with trauma in most cases."

Occasionally, the term battered person syndrome has been used to apply to men, especially as part of a legal defense. Author John Hamel stated that although the term BWS has been replaced with battered person's syndrome in some legal circles, "and sounds more politically neutral, the new term does not improve on the former in providing a unitary syndrome, and does not account for the characteristics unique to male victimization."

It was estimated that in 2010, "roughly one woman" is "battered every seven seconds. It is estimated that one of every four American women will be physically or sexually abused by an intimate partner during her lifetime."

Diagnosis

ICD9 code 995.81 lists the syndrome under "battered woman/man/spouse/person NEC", and categorizes it as any person presenting with identified physical descriptors rather than psychological descriptors. It falls under the general heading of "Adult physical abuse", classified under "Injury and Poisoning".

The diagnosis, especially with regard to posttraumatic stress disorder (PTSD), has mainly centered on women. The DSM-IV-TR does not provide a distinct diagnostic category for reactions to battering. The diverse reactions of battered women are treated as separate diagnoses; for example, PTSD or depression. Because there are no subcategories of the diagnosis of posttraumatic stress disorder in the DSM-5, the diagnosis is absent from the manual. It may, however, be used as a classification to guide treatment plans and forensic issues.

Symptoms

SymptomsBattered woman syndromePost-traumatic stress disorder (PTSD)
The person fears for their life
Is fearful for more than 4 weeks
Performance at work or other important daily life activities is affected
Manipulated through threats of violence, unwanted sex, degradation, isolation and more
Dislike their bodies and experience somatic health issues
Sexual intimacy issues

When battered woman syndrome (BWS) manifests as PTSD, it consists of the following symptoms: (a) re-experiencing the battering as if it were recurring even when it is not, (b) attempts to avoid the psychological impact of battering by avoiding activities, people, and emotions, (c) hyperarousal or hypervigilance, (d) disrupted interpersonal relationships, (e) body image distortion or other somatic concerns, and (f) sexuality and intimacy issues.

Additionally, repeated cycles of violence and reconciliation can result in the following beliefs and attitudes:

  • The abused thinks that the violence was their fault.
  • The abused has an inability to place the responsibility for the violence elsewhere.
  • The abused fears for their life, and/or, the lives of loved ones whom the abuser might or has threatened to harm (e.g., children-in-common, close relatives, or friends).
  • The abused has an irrational belief that the abuser is omnipresent and omniscient.

Causes

The syndrome develops in response to a three-stage cycle found in intimate partner violence situations. First, tension builds in the relationship. Second, the abusive partner releases tension via violence while blaming the victim for having caused the violence. Third, the violent partner makes gestures of contrition. However, the partner does not find solutions to avoid another phase of tension building and release so the cycle repeats. The repetition of the violence, despite the abuser's attempts to "make nice", results in the abused partner feeling at fault for not preventing a repeat cycle of violence. However, since the victim is not at fault and the violence is internally driven by the abuser, this self-blame results in feelings of helplessness rather than empowerment. The feeling of being both responsible for and helpless to stop the violence leads in turn to depression and passivity. This learned depression and passivity makes it difficult for the abused partner to marshal the resources and support system needed to leave.

Feelings of depression and passivity may also be created by lack of social support outside of the abusive situation. Research in the 1980s by Gondolf and Fisher found that women in abusive situations increase help-seeking behavior as violence intensifies. However, their attempts at seeking help are often frustrated by unresponsive extended family and social services. In a 2002 study, Gondolf found that more than half of women had negative views of shelters and programs for battered women because of negative experiences with those programs.

References

References

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