Many Women at Risk of Being Murdered Don’t Know It

Reuters Health Information 

By Alison McCook

Friday, November 28, 2003

NEW YORK (Reuters Health) - Nearly one half of women who are about to experience an attempt on their lives at the hands of a boyfriend or husband may not realize they are in danger, new research reports.

A look back at warning signs for 30 women who survived an attempted homicide by an intimate partner revealed that 14 did not know their lives were at risk, and said they were “completely surprised” by the attack.

Most attacks occurred around the time that women tried to end the relationship. And while nearly all women had experienced previous episodes of abuse and violence from their partners, not all instances had been severe.

These findings suggest that, in some cases, the warning signs that a woman’s life is in danger may be hard to read, lead author Dr. Christina Nicolaidis of the Oregon Health and Science University in Portland said.

“If I had talked to some of these women before the attack, I would have counseled them about the domestic violence, but I would not have necessarily felt that their lives were in danger,” Nicolaidis said.

“Now I am more careful to warn any woman who has experienced intimate partner violence about the risk to her life, especially around the time that the relationship is ending,” she added.

In the report, published in the Journal of General Internal Medicine, Nicolaidis and her colleagues note that homicide is the leading cause of death among African-American women between the ages of 15 and 34, and up to half of all women who are murdered are killed by an intimate partner.

Nicolaidis and her colleagues interviewed 30 women between the ages of 17 and 54 who had survived an attempted homicide by their current or former boyfriends or husbands.

All but two of the women had experienced episodes of violence or controlling behavior, such as stalking or preventing them from going anywhere alone, from the man who tried to kill them.

And while 22 of the homicide attempts occurred when women were trying to end their relationships, most women said they were breaking up for reasons other than violence.

There are many possible reasons for why women often do not recognize the danger they are in at the hands of an intimate partner, Nicolaidis said. Many women may have “normalized” former episodes of violence as part of a bad relationship, or focused on the reasons why their lovers were being violent, such as mental health or substance abuse problems, she said.

Classic risk factors for an attempted homicide by an intimate partner include escalating episodes or severity of violence, threats with or use of weapons, alcohol or drug use, and violence toward children, Nicolaidis noted. While every woman included in the report experienced at least one of these standard signs, they were clearly not all “classic” cases, she added.

“The problem is that we often expect women to come to us describing a life filled with many or all of these risk factors, when in fact there may only be a few (risk factors) buried beneath the surface,” Nicolaidis said.

In an accompanying editorial, Dr. Lorrie Elliott of the University of Chicago Medical Center writes that these findings demonstrate that counselors need to recognize that “any level” of physical violence or controlling behavior from a partner can signal a woman's life is at risk.

“Curricula on domestic violence should be revised to reflect these findings,” she notes.

SOURCE: Journal of General Internal Medicine, October 2003.