original A rticle
Perception and prevalence of domestic violence in
the study population
A bstract
Sandeep H. Shah,
Kajal Rajani,
Lakhan Kataria,
Ashish Trivedi1,
Sangita Patel1,
Kedar Mehta1
Departments of Psychiatry,
1
PSM, SBKS MIRC, Sumandeep
Vidyapeeth, Piparia, and
PSM, Govt. Medical College,
Vadodara, Gujarat, India
Address for correspondence:
Dr. Sandeep H. Shah,
Department of Psychiatry,
SBKS MIRC, Sumandeep
Vidyapeeth, Piparia,
Vadodara - 39760, Gujarat, India.
E-mail: researchdirectorsvu@
gmail.com
Background: Domestic violence is a major contributor to physical and mental ill health of
the victim, and it is evident to some degree, in every society of the world. Objectives:
1) To study perception about domestic violence in the study population. 2) To compare
prevalence of domestic violence within the three subgroups of the study population (i.e.
spouses of psychotic patients, spouses of non-psychiatric patients and hospital staff).
Materials and Methods: A cross-sectional study was conducted among married men
and women coming to Dhiraj General Hospital. Interviews were conducted using a semistructured questionnaire. Inquiry was done about their perception regarding domestic
violence, own experience any time in their life, and about the form of violence. Data
was entered and analyzed using SPSS. Results: 42.7% of study participants had never
heard the words domestic violence. The overall prevalence of any form of violence
in the study population as a whole was 32.3%. There was no significant difference
found in the proportion of domestic violence among the three groups. The prevalence
of physical, emotional, sexual and economic domestic violence was 16.3%, 25.3%,
2% and 11.3% respectively. Younger age group and female sex were significantly
associated with the occurrence of domestic violence. Conclusion: Apart from the high
prevalence of domestic violence in the present era, it is evident from the study that
the participants’ perception about domestic violence was low. Efforts should be made
to raise public consciousness and reporting of domestic violence and its attendant
consequences.
Keywords: Domestic violence, India, perceptions, prevalence
D
omestic violence (also called domestic abuse, spousal
abuse, or intimate partner violence) often refers to
violence of any type, e.g. physical, emotional, sexual and
economic/financial, by a family member or one spouse
against another, but can also include violence between
concomitant and unmarried intimate partners. Domestic
violence is a major contributor to the physical and mental
ill health of the victim, and it is evident to some degree,
in every society of the world.[1,2] Popular emphasis has
tended to be on women as victims, however, with the rise
of men’s movements and rights, there is now advocacy
for men victimized by women.[3] Studies have shown that
male and female adolescents with psychiatric disorders
were at a greater risk of being involved in an abusive adult
relationship.[4] It has also been found surprisingly that three
out of five ever married women of the reproductive age
group, view wife-beating as justified in some situations.[5,6]
Several general population surveys as well as clinic-based
studies provide substantial evidence associating heavy
drinking with violent behavior in general and intimate
partner violence in particular.[7,8]
In the present study, we have made an effort to find out
about the awareness of domestic violence in our study
population of married individuals in addition to its
prevalence, association with demographic characteristics
and outcome. Attempt has also been made to find out
differences in the prevalence of domestic violence in
the spouses of patients suffering from psychotic illness,
spouses of patients with non-psychiatric illness and general
population (with reference to violence being more common
in psychotic patients). [9] So the following study was
undertaken with the objectives of – 1) To study perception
about domestic violence in the study population and 2) To
compare prevalence of domestic violence within the three
subgroups of the study population (i.e. – Group A-Hospital
staff, Group B-Spouses of non-psychiatric patients and
Group C-Spouses of psychotic patients).
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DOI: 10.4103/0972-6748.119624
Industrial Psychiatry Journal
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Shah, et al.: Perception and prevalence of domestic violence
place of the hospital to maintain privacy and confidentiality.
Participants were assured of the confidentiality of their
responses. To attain all these, care was taken to establish
rapport with every participant prior to interviews.
Women and men were interviewed by women and men
investigators, respectively. Individual verbal informed
consent was obtained from all participants by explaining
the purpose of the study. The study was carried out during
April 2010–May 2011.
MATERIALs AND METHODS
Study design
This study was a cross-sectional hospital-based study
Source of subjects
The study covered both ever-married men and women,
attending the Dhiraj General Hospital. Out of the total
sample size, an equal number of participants were selected
from three sources— 1) Hospital staff 2) Spouses of nonpsychiatric patients and 3) Spouses of psychotic patients—
in the Dhiraj General Hospital.
Outcome variables
1. Ever-married subjects above 18 years of age
2. Subjects not having any psychiatric illness at present
3. Subjects not having serious medical illness at present.
Four principal domestic violence outcome variables
considered in our analysis were: physical violence,
psychological violence, sexual violence and economic
violence. They were determined by response to a set of
questions for each outcome variable. If a woman/man (as
a victim) gave a positive response to any of the questions
in a set, it was considered as violence of that category.
In addition, the fifth variable, i.e. any form of domestic
violence was derived. If at least one of the four forms of
domestic violence (physical and/or psychological and/or
sexual and/or economic) was present, it was considered
as the presence of any form of domestic violence. During
logistic regression analyses, these outcome variables were
dichotomized into presence and absence of violence, for
each type of violence.
Exclusion criteria
Data management and analysis
Sample size
The sample size was calculated based on the available
estimated prevalence of domestic violence. Based on the
prevalence of domestic violence (27%) from the pilot study,
with a confidence level of 95% and absolute precision
of 5, the samples required were: 303 participants. Three
participants refused to participate thus, samples of 300 were
obtained (i.e. sample of 100 participants from three groups).
Inclusion criteria
1. Subjects not willing to give written informed consent
2. Subjects below 18 years of age.
Data was entered into MS Excel sheet and exported to
Epi Info (Version 3.5.1, developed by WHO CDC) and
SPSS (15.0 version) and further analysis was carried out.
Multivariate Logistic Regression was carried out to study
association between occurrence of domestic violence
(dependent variable) and demographic characteristics
(independent variables) such as age, sex, education,
occupation, income, religion, family type and domicile.
The odds ratio (OR) is the value by which odds of
the event (occurrence of violence) change when the
independent variable increases by one unit/step. And it
has been calculated by adjusting for all other independent
variables in multivariate models. A P value of less
than 0.05 was considered as the minimum level of
significance.
Interviews were conducted using a semi-structured
questionnaire (Appendix I). Perception of the participants
regarding domestic violence was studied on the basis of
their response to a set of questions for four main variables
of domestic violence (physical, emotional, sexual and
economic). Participants were also asked whether their
spouse had committed violence against them at any time
in their life, and if experienced, then in what form, its
outcome and whether reported to anyone. They were asked
whether influence of alcohol was a contributor to their
spouse perpetrating violence. In addition data on sociodemographic details of the participants were collected.
The questionnaires were piloted to check appropriateness,
clarity and flow of questions among 10 participants before
the initiation of the study, and these participants were not
included in the study.
RESULTS
Most of the study population/participants belonged to the
20-30 years’ age group (46.3%) and those from extremes
of age groups (i.e.-50 years) were the
least; 47.3% of participants were males and 52.7% were
females. Participants were selected almost equal to avoid
selection bias between the two groups and the majority
of the participants were Hindu (85.7%). The majority of
The study protocol was approved by the local institutional
review board at the Dhiraj General Hospital. Individual
informed consent was obtained from all participants.
All the interviews were conducted in the local language by
the research investigator. Interviews took place in a private
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Shah, et al.: Perception and prevalence of domestic violence
the participants (62%) had studied till school (i.e. either
primary or secondary or higher secondary). Most of the
participants (83.3%) were from middle socioeconomic
status and 24.7% were from lower socioeconomic strata.
Out of the total study population of 300 individuals, the
majority (94.7%) was presently staying with spouse, 2.7%
were divorced or separated and another 2.7% were widow/
widower. Almost equal number of participants belonged to
nuclear and joint family whereas half (53%) the participants
were from the rural area.
general population, spouses of non-psychiatric patients and
spouses of psychotic patients [Table 3].
Some additional findings of our study were that among
the participants who had experienced domestic violence,
41.2% had experienced it when the spouse was under the
influence of alcohol.
Of the study population who had experienced domestic
Table 1: Awareness about existence of domestic
violence before and after probing, among the
study population
On asking the participants about their awareness pertaining
to domestic violence, without probing them, 57% of the
study population was aware about domestic violence and
that it existed in society; 42.7% of the participants had
never heard the words domestic violence. A major finding
is that after introducing the subjects to the definition of
domestic violence, almost all the participants, i.e.99.7%
admitted that it existed in society [Table 1].
Before probing
Percent
Frequency
Percent
171
128
1
57.0
42.7
0.3
299
00
01
99.7
00
0.3
Aware
Not aware
Don’t know
Table 2: Perception about different acts as
domestic violence among the study population
Out of the different acts of domestic violence, among
the physical violence group, overburdening with
work was considered as domestic violence by 65%
of the population, which is the least perceived form
in the physical violence group. Maximum number
of participants (99.3%) considered an attempt to kill
as domestic violence. Within the emotional violence
subgroup, half the population studied believed taunting, restricting freedom of choice, not giving equal
opportunity, ignoring/indifference/not communicating,
and deprivation of sexual relation – as domestic violence.
As regards sexual violence, all the study participants
considered pressure to go for prostitution and forced
sexual relation with other family member as domestic
violence, while 18.3% participants believed that forced
sexual intercourse by spouse is not domestic violence.
In the study population, for the items categorized as
economic violence, maximum number of participants
(84.0%) believed that demanding dowry is domestic
violence, followed by act of taking away belongings
(73.7%), followed by not providing sufficient finances
(71.3%), followed by not allowing to have control over
one’s income (56.0%); the least number of participants
believed that non-involvement in financial decisions is
domestic violence (41.8%) [Table 2].
Perceived as domestic violence
Physical
Overburdening with work
Beating, pushing, kicking, pulling
hair, slapping
Attempt to kill
Forced abortion
Emotional
Taunting
Insulting
Threatening to end relationship
Threatening to throw out of house
Threatening to kill
Threatening to beat up
Humiliating
Witholding love and care
Restricting freedom of choice
Not giving equal opportunities
Ignoring/Indifferent/Not
communicating
Deprivation of sexual relation
Sexual
Pressure to go for prostitution
Forced sexual relation with other
family member
Forced sexual intercourse by spouse
Economic
Demanding dowry
Taking away belongings
Not allowing to have control over
one’s income
Not providing sufficient finances
Not involving in financial decisions
Among the four main variables of domestic violence,
occurrence of physical violence was found to be 19.6%,
emotional violence in 25.3%, financial violence in 11.3%
and sexual violence in 2% of victims [Table 3].
There was no significant difference found in the prevalence
of domestic violence (neither overall nor in individual
type) among the three subgroups of study participants, i.e.
Industrial Psychiatry Journal
After probing
Frequency (N)
Frequency
Percent
195
290
65.0
96.7
298
247
99.3
82.3
168
215
249
257
263
261
224
160
152
150
166
56.0
71.7
83.0
85.7
87.7
87.0
74.7
53.3
50.7
50.0
55.3
140
46.7
300
300
100
100
245
81.7
252
221
168
84.0
73.7
56.0
214
125
71.3
41.8
*Multiple responses
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Shah, et al.: Perception and prevalence of domestic violence
violence, 47.42% had never reported it or disclosed it to
anyone. The most common reason for not reporting was
fear of social stigma (in 63.4%). Among those who had
reported, only 1.96% had reported it to the police, the
remaining majority of the population had only shared it
with relatives or friends.
Hence, prevalence of domestic violence was more common
in females.
DISCUSSION
Violence against women is a major public health problem,
which affects physical, mental and reproductive health.[10-14]
Apart from the high prevalence of domestic violence in the
present era, it is evident from the study that the participants’
perception/ knowledge about domestic violence was rather
low and a simple discussion in person easily helped the
respondents identify domestic violence.
Sixty-six percent of the population studied preferred to
compromise with the situation, 14.4% left the house, 10.3%
negotiated with the family members, 6.6% took help of
community members for reconciliation, 2.1% retaliated
(reciprocal domestic violence) and 1% took the help of
the police.
With regard to perception or awareness about domestic
violence, findings were similar to that found in the
National Family Health Survey (NFHS), where 41% of
women thought that husbands were justified in slapping
their wives if the latter showed disrespect to their in-laws,
and a substantial 35% of women thought they deserved
a brutal beating at the hands of their spouses if they
neglected doing the household chores or looking after their
children.[8] A study demonstrates that a large percentage of
Nigerian women agreed that a man is justified in beating
or hitting his wife; 66.4% and 50.4% of ever-married and
unmarried women respectively expressed consent for
wife-beating.[15]
Out of the different demographic characteristics of
the study population, the occurrence of domestic
violence was significantly associated with the sex of the
participants in the study group. The OR of occurrence
of domestic violence in relation to the sex of the
participant was 0.2666 (with 95% C.I. 0.1431-0.4966 and
P value 0.0000), inferring that the female sex had highly
significant association with occurrence of domestic
violence [Table 4].
Multivariate logistic regression
On applying multivariate logistic regression, the present
study demonstrated that domestic violence is not
significantly associated with age, domicile, education,
occupation, family income, religion and type of family.
The overall prevalence of domestic violence in our study
population was found to be 32.3%. This is almost similar
to the findings of many studies with 37–56% women
reporting domestic violence in India.[8,16,17] In the present
study we also found that domestic violence had a significant
association with female gender and younger age. This was
similar to the results of certain population-based studies.[16]
It is due to male patriarchy, which is defined as a system
of male dominance legitimated within the family and the
society through superior rights, privileges, authority and
power.[18] No significant association was found with any
of the other demographic characteristics of the study
participants. Conversely, some community-based study
from India observed that prevalence of domestic violence
was more in women who were employed and in the lower
socioeconomic strata.[19,20]
Table 3: Prevalence of overall and individual
type of domestic violence in the three subgroups
of study population
Type of domestic
violence
Group A
Group B
Group C
Total
population
23
27
2
9
35
25
24
2
13
30
11
25
2
12
32
59 (19.6)
76 (25.3)
6 (2)
34 (11.3)
97 (32.3)
Physical
Emotional
Sexual
Economic
Overall
P value was not statistically significant for difference in domestic violence among
the three groups; Figures in parenthesis are in percentage
Table 4: Association of various demographic
details with the occurrence of domestic violence
Odds ratio
Age
Sex
Education
Occupation
Income
Religion
Family type
Domicile
1.0384
0.2666
1.1197
0.8691
0.9355
0.9425
0.8174
0.7304
Jul-Dec 2012 | Vol 21 | Issue 2
95% C.I.
1.0095
0.1431
0.8843
0.7069
0.7077
0.5310
0.4766
0.4263
1.0680
0.4966
1.4178
1.0686
1.2366
1.6729
1.4021
1.2514
On comparing the prevalence of different forms of
domestic violence in our findings to many populationbased studies, the prevalence of physical violence was
found to be the same, i.e. around 14–34% in other studies,
while that of sexual and emotional violence was found to
be less, i.e. prevalence of emotional violence was around
52% and sexual violence around 25%.[8,16] Hence domestic
violence is a worldwide public health problem existing in
all communities.[21-23]
P Value
0.0088
0.0000
0.3479
0.1834
0.6396
0.8398
0.4640
0.2528
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Shah, et al.: Perception and prevalence of domestic violence
C) Income of head of family:
(Modified for 2007)
1. >19,575
2. 9,788–19,574
3. 7,323–9,787
4. 4,895–7,322
5. 2,936–4,893
6. 980–2,935
7.
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