Risk and Protective Factors for Physical and Emotional Intimate Partner Violence Against Women in a Community of Lima,Peru

Abstract

This article shows risk and protective factors for both physical and emotional intimate partner violence (IPV) against women. The study was carried out in a shanty town of Lima, Peru, which has a strong community organization. One hundred ninety-two women between 25 and 59 years old (M = 34.09, SD = 6.5) were interviewed; 44.3% had secondary education, 75.5% were housewives, and 94% lived with their partner. The measurement instrument was a survey especially developed for this project to explore occurrence of physical and emotional IPV and to identify factors associated with them; factors were classified in individual and relational levels according to the ecological nested model (ENM). A logistic regression analysis was used to test the associations; the results showed that for emotional IPV, men’s assertiveness was a protective factor, whereas their emotional instability and jealousy were risk factors. For physical IPV, there were no identified risks or protective factors. These results are presented and discussed.

Keywords

battered women domestic violence and cultural contexts perceptions of domestic violence

Intimate Partner Violence (IPV) is one of Peru’s main public health problems for the last decade. Only in Lima, the capital city, 47% of women had suffered some type of violence against them by their current partner (Instituto Nacional de Salud Mental Honorio Delgado–Hideyo Noguchi [INSM HD–HN], 2002).

The rates for physical or sexual maltreatment vary between 41% and 48% (Güezmes, Palomino, & Ramos, 2002; Instituto Nacional de Estadística e Informática [INEI], United States Agency for International Development [USAID], & Measure Program DHS+/ORC Macro, 2007). The Demographic Health Survey (DHS) 2004-2006 established that physical abuse is more frequently experienced by women who are 40 years or older, live in urban areas, have secondary education, and are widows, separated, or divorced. This survey considered verbal abuse practices against women as being controlled by their partners (68%), being humiliated (25%), and being physically (13%) or psychologically (21%) threatened (INEI et al., 2007).

The ecological nested model (ENM) is an appropriate framework to explain high rates of IPV (World Health Organization [WHO], 2002) as it considers several interacting factors. It has been used to provide an explanation for violence inflicted by male partners on women (Heise, 1998) and battered women who have responded with force against their male partners (Das Dasgupta, 2002; Larance, 2006).

The ENM emphasizes four levels of individual live experiences in order to encourage contextual understanding. In this sense, the WHO (2002) classifies factors involved in IPV into four levels: (1) social, such as laws, rules, and norms regarding violence; (2) communitarian, weak community penalties against violence, poverty, and low social capital among others; (3) relational, which considers family dynamic and its stressors; and (4) individual, which includes victims’ and perpetrators’ demographic and psychological characteristics.

To explain IPV prevalence in Peru, it must be considered that violence has been present throughout the country’s history; as a result, there is a political and social violence legacy, which naturalizes aggression (Flake, 2005; Flake & Forste, 2006). This legacy is expressed through cultural and social norms; therefore, IPV can be considered as a problem rooted in these norms (Taft, Bryant-Davis, Woodward, Tillman, & Torres, 2009) especially in the Latin American region (Klevens et al., 2007).

Some of these sociocultural norms became risk factors for violence: acceptance of violence and justification of abuse against women (Adams & Campbell, 2005; Mattson & Rodríguez, 1999; Raj & Silverman, 2002; Swan & Snow, 2006) and rigid gender scripts (Capezza & Arriaga, 2008; Raj & Silverman, 2002). Moreover, because violence violates women’s rights to reinstate patriarchy in intimate relationships (Stark, 2007), IPV can be considered as a manifestation of Peruvian social structure where women have a subordinated status.

In Peru, cultural beliefs to sustain violence against women are as follows: “men are better than women” (machismo), “women are defined as mothers and wives” (familialismo), and “women must suffer like Mother Mary” (marianismo). These traditional beliefs create other role expectations, which keep women in IPV situations, for example, high regard for family unity (Klevens et al., 2007) and for children’s well-being (Acevedo, 2000).

Nevertheless, other studies found that IPV is higher in families where men and women roles are incongruent with traditional expectations about them (Adams & Campbell, 2005; Klevens, 2007; Klevens et al., 2007). For example, Flake and Forste (2006) found that there was a major risk of domestic violence when woman’s decision making prevailed over her partner’s. Flake (2005) remarked that woman’s status is one of the most important factors influencing IPV in Peru: If a woman attains more education than her husband, is employed, and is the main decision maker in the family, she is more likely to be abused than a woman who has lower or equal status than her husband.

Regarding community factors, poverty, and its consequences, all have been considered risk factors all along (Flake & Forste, 2006; Gonzales & Gavilano, 1999). Peruvian inequitable economic development means that large segments of the population live in poverty. Studies have demonstrated that poverty contributes to maintain violence through different mechanisms: stress and violent behaviors are triggered by frustration caused by poverty or its consequences such as overcrowding, lack of basic services, low life quality, and lack of opportunities to improve economic resources (Flake & Forste, 2006; Gonzales & Gavilano, 1999). Likewise, poverty creates women’s economic dependence on their male partners and diminishes their access to social assistance services. Consequently, this population is excluded from adequate public services system (Swan & Snow, 2006). Other studies reflect that violence generates more poverty, diminishing women’s life quality, and increasing potentially productive years of life lost. For instance, Goodman, Fels, Borges, and Singer (2009) considered that a combination of poverty and violence produces an internal and external stress situation, feeling of losing power, and social isolation among women.

In this same community level, both moral sanctions through formal or informal networks (Almgren, 2005; Browning, 2002) and social support given by family and religious groups (Swan & Snow, 2006) are seen as protective factors for IPV.

Other studies have found specific factors associated with IPV in relational and individual levels. At the relational level, conflicts between the couple, especially those triggered by jealousy (Pisspa, 2002) and women’s control by men (INEI, 2006) are factors associated with IPV, especially in Latin American contexts (Insua & Vidal, 2006; Klevens et al., 2007; Vaiz & Spanó, 2004). In Peru, it was found that marital violence is associated with family size (Flake, 2005; Flake & Forste, 2006; INEI, 2006) and years of marriage (INEI, 2006).

At the individual level, risk factors for IPV are childhood exposure to family violence (Thompson, Saltzman, & Johnson, 2003) and several aggressor’s characteristics, such as alcohol consumption (Keiley, Keller, & El-Sheikh, 2009; Stikley, Timofeeva, & Sparén, 2008; Thompson et al., 2003), emotional dependence, impulsivity (Kaufmann & Jasinski, 1998), age, and having low levels of education and income (WHO, 2002). In Peru, women’s educational attainment, age at marital union, family background, employment, and decision making are associated with IPV (Flake, 2005). Also, at this level, aggressor’s sociodemographic characteristics such as consuming alcohol, having primary education, and working in minor jobs and services can be associated with violence (INEI, 2006).

Despite these important findings, most studies indicating associated and risk factors to IPV in Peru are based on the National DHS survey, whose primary focus is not IPV (Flake, 2005; Flake & Forste, 2006; INEI, 2006). In addition, there are no studies to associate IPV with other relational and individual factors like family dynamics, women’s and abuser’s personality characteristics, and women’s knowledge and beliefs about violence.

Likewise, there is little research on protective and risk factors differentiating physical and emotional IPV; this is important to consider because each type of violence has particular and complex dynamics, even though they tend to occur together.

For these reasons, the purpose of this study is to determine risk and protective factors in ENM’s relational and individual levels for physical and emotional IPV against women in a community in Lima, Peru.

Method

Participants

The studied community is a shanty town, established after an illegal invasion or unauthorized use of lands. Members of this community have a strong community organization (leaders in each block) because they are trying to obtain property titles of their homes. Houses have an area of 645 square feet, with mat or Eternit,¹ roofs, wood walls, and concrete or sand floor. In addition, the community roads are made of sand, and the community does not have public services such as drinking water, sewage system, or electricity. A previous research study carried out in this community found that prevalence of any type of violence during the last year of life was 43%, whereas physical and emotional violence prevalence was 13% and 38%, respectively (Nóblega & Muñoz, in press).

Participants were 192 women aged between 25 and 59 years (M = 34.09, SD = 6.5). Their education was elementary (41.7%) and high school (44.3%); the other 14% had technical education. Most of the participants (75.5%) were stay-at-home mothers and lived with their partners (94%). Their partners’ education was secondary (56.3%) and primary (31.8%), and most of them worked outside home (99%).

Interviewers visited all of the community’s households within 3 weeks (N = 606), but only 192 women participated because some of the homes were abandoned, a woman was not present in the home during the interviewers’ visit, or the woman living there did not meet established participation criteria. These criteria were as follows: (a) older than 18 years, (b) married or living with a male partner, and (c) have at least one child older than 5 years.

Community leaders are authorized researchers to conduct the study. The interviews were conducted at the front porch of each house to maintain privacy. Before being interviewed, each participant gave her informed consent. The participants’ anonymity was protected throughout the study.

Measures

A survey to explore IPV against women was elaborated for this study. It has two main sections:

Occurrence of physical and emotional violence exerted by current or former male partner during the past years. Physical violence was defined as having received blows, punches, or shoves at least once by the current or former partner in the past 12 months, whereas emotional violence was defined as having received insults, offenses, manipulations, or humiliations in the same period (Saltzman, Fanslow, McMahon, & Shelley, 2002).

Factors associated with IPV. Potential associated factors were classified according to ENM in the following levels:

Individual

Participants’ report about own and their current (or former) partner’s personality characteristics (responsibility, emphatic capabilities, impulsivity, instability, irritability, nervousness, and dependence).

Participants’ report about own and their current (or former) partner’s communication style (assertive, aggressive, passive, and passive-aggressive).

Participants’ report about current (or former) partner’s alcohol consumption.

Participants’ family-of-origin characteristics (affect and punishment received, parental conflicts, parental threats not to love or leave them, and physical and sexual abuse).

Participants’ beliefs about IPV (high regard for family unity despite ongoing violence, privacy of family problems, man’s superiority at home, violence as a way to interact with people, and man’s use of violence in the family).

Relational

Current or former partner’s behaviors toward family members (time shared, prohibition by partner for woman to study, work, and/or visit relatives and friends, participant’s description of the partner as lovely, indifferent, or jealous).

Conflicts within family (unwished or unplanned pregnancies, children’s disobedience, stepchildren, physical or mental disorders of family members, and lack of space or economic resources).

This survey was developed based on ENM and previous surveys used in IPV assessment (Güezmes et al., 2002; INEI et al., 2001, INSM HD-HN, 2002). The survey was discussed by five researchers to evaluate its content quality; then, six interviews were conducted to adequate language to target population. These two qualitative processes modified the original version into the final one used in the study.

The surveys were carried out by psychology students who received extensive training about ethical implications for the study as well as interview techniques following WHO (1999) recommendations to conduct research on violence against women.

The consistency of IPV rates provided by the women who were interviewed was determined by correlating information from pairs of questions, which assessed the same violence manifestation at different areas of the survey. In this sense, for emotional violence, the item, “In the last 12 months, have you been insulted, offended, manipulated or humiliated?,” was correlated with six questions about partner’s behavior (“Does your partner impede you from visiting relatives or friends?” “Does your partner prohibit you from studying or working?” “Does your partner ignore or is indifferent with you?” “Does your partner tell you: ‘I am tired of you, I will leave home?’” “Does your partner tell you: ‘If you go, I will take my children?’” and “Does your partner tell you: ‘you are good for nothing?’” All correlations varied from .240 to .377 (M = 0.307, SD = 0.050, p < .001).

Procedures

First, associated factors were identified correlating the presence of physical and emotional IPV with relevant variables according to the current literature on the matter. For this purpose, V Cramer coefficient was used because both variables were dichotomous.

Then, to determine risk and protective factors for both types of IPV, responses were examined using a logistic regression analysis. Only highly significant associated factors to IPV—physical or emotional—previously determined were introduced to analyze; for this, the level of statistical significance of correlations was adjusted using Bonferroni’s correction to avoid Type 1 error increased by multiple correlations calculated (Curtin & Schulz, 1998). Likely, all associated factors with p < .001 were considered. Also, potential confounding variables were analyzed using stratified analysis.

Results

Risk and Protective Factors Associated With Physical IPV

As shown in Table 1, at ENM’s individual and relational levels, six variables were associated to physical violence. Two of them in relational ENM’s level have significant levels less than .01: men’s jealousy and their involvement with family as perceived by women. Other associated variables were men’s instability, responsibility, and assertive style. In addition, children’s disobedience was the only conflict inside family associated with physical violence.

Because any factor reached statistical Bonferroni’s adjustment significance level (p < .001), it was not possible to conduct logistic regression analysis; so there were no identified risk and protective factors for physical IPV.

Table 1.

Significant Associations Between Types of Intimate Partner Violence and Explored Variables

	Type of Violence
Explored Variable	Physical	Emotional
ENM individual level
Communication Style of the Participant
Passive-aggressive style		.208**
Participant’s beliefs about violence
It is very important for men to demonstrate who is the head of the family	.184*
Perceived current or former partner’s personality traits
Impulsivity		.199**
Instability	.180*	.401***
Irritability		.196**
Nervousness		.168*
Responsibility	–.188*	–.273***
Emphatic		–.258***
Perceived current or former partner’s communication style
Assertive style	–.151*	–.270***
Passive-aggressive style		.084**
ENM relational level
Current or former partner’s behavior toward family members
Partner (former partner) is lovely		–.232**
Partner (former partner) is jealous	.219**	.315***
Partner (former partner) is involved with their families	–.198**	–.243**
Conflicts inside family
Children disobedience	.149*	.182*
Lack of economical resources		.252**
Unwished or unplanned pregnancy		.273**

p < .05. **p < .01. ***p < .001.

Risk and Protective Factors Associated With Emotional IPV

As shown in Table 1, 16 variables were associated with emotional IPV at ENM’s individual and relational level, but only five of them reached Bonferroni’s adjustment significance level (p < .001).

Regarding perceived male partner’s characteristics by women (individual level), the biggest and direct association was with emotional instability (r = .401, p < .001). In this level, another inversely associated characteristics were women’s perception about their partner’s responsibility (r = –.273, p < .001), empathic capacity (r = –.258, p < .001), and assertive communication (r = –.270, p < .001). Men’s impulsivity, irritability, nervousness, and passive-aggressive style perceived by women were weakly associated factors (correlations were between .084 and .199).

It is important to note that there were only two women’s characteristics associated with emotional IPV: Their passive-aggressive style (r = .208, p < .01) and participant’s belief about men’s superiority in the family (r = .184, p < .05).

At ENM’s relational level, partner’s jealousy was strongly associated with emotional violence (r = .315, p < .001), whereas when the partner was reported as lovely and involved with their family, emotional IPV tended to be absent and significantly associated in the opposite direction (r = –.243, p < .01). Regarding conflicts inside the family, there were weak associations with unwished or unplanned pregnancy (r = .273, p < .01), lack of economical resources (r = .252, p < .01), and children’s disobedience (r = .182, p < .05).

Only five associated factors were introduced to regression analysis because they obtained Bonferroni’s adjustment significance level (p < .001): men’s instability, responsibility, emphatic capabilities, assertive style of communication, and jealousy as perceived by women.

Table 2 illustrates risk and protective factors for emotional violence. Hence, it was found that when women perceive changes in their male partners’ emotional state (men’s instability) or when he was reported as jealous, it was more likely for them to report emotional violence as well (OR was 4.8 and 3.4, respectively, with p < .001). On the other hand, when men were perceived as having assertive communication, it was less possible that women received humiliations and manipulation from them (OR = 0.137). The other two variables considered (men’s responsibility and empathic capabilities perceived by women) were not significant. This model considering three variables explained 28% of the variance.

Table 2.

Risk Factors Associated With Emotional Violence

Variable	Exposed to emotional violence (n = 72)	No exposed to emotional violence (n = 114)	Beta coefficient	Standard error	X² Wald	Significance	OR	OR inf. 95%	OR sup. 95%
Perceived current or former partner’s personality traits
Instability	46 (63.9%)	27 (23.7%)	1.575	0.394	15.989	.000	4.833	2.233	10.461
Assertive communication style	55 (76.4%)	107 (93.9%)	–1.987	0.620	10.287	.001	0.137	0.041	0.462
Current or former partner’s behavior toward family members
Partner or former partner is jealous	47 (65.3%)	39 (34.2%)	1.235	0.398	9.653	.002	3.439	1.578	7.497

Discussion

This study was carried out to determine risk and protective factors for physical and emotional IPV in a poor community of Lima, Peru. For this purpose, several factors theoretically associated with violence in individual and relational levels of ENM were explored. Results reveal that some of them were associated factors with each type of IPV; although these associations were not strong, very few of them were identified as protective or risk factors.

For physical violence, no risk or protective factors were found. This result could be explained by low rates of such violence in the community (13% according to Nóblega & Muñoz, in press) compared with percentages obtained in National Surveys (INEI et al., 2007; INSM HD-HN, 2002; Güezmes et al., 2002). It also is possible that factors other than those considered in this study accompany physical violence in these communities; this aspect needs to be studied further in other exploratory studies.

However, it is important to highlight that factors weakly associated with physical violence (correlations between –.198 and .219) are at the individual level of ENM, and they are related to male partners’ and not to women’s characteristics. This reveals that —according to women’s report— certain aggressor’s characteristics accompany violence, whereas women have less decisive role on it. This could reflect that women’s diminished psychological sense of power and agency against violence maybe a consequence of past or current violence received or a combination of this situation with poverty (Goodman et al., 2009).

It is noteworthy that determinants of violence reported in the literature have not achieved significant correlations in this sample. For example, there is no association between women’s history of violence and physical IPV, therefore contradicting the hypothesis that early abuse received is a risk factor for ongoing violence (Thompson et al., 2003). Maybe it could show a breakdown of the history of abuse of these women.

The results also show that the partner’s consumption of alcohol is not a risk factor for physical violence, contradicting postulates from INEI (2006), Keiley et al. (2009), Stikley et al. (2008), and Thompson et al. (2003). Rather it would be a new evidence for Klevens’ postulate (2007), which considers alcohol use as having little power to explain violence in Latin communities.

For emotional violence, the proposed model considers three factors interacting with each other—two of them are risk factors and one is a protective factor.

A risk factor for emotional violence is partner’s instability as perceived by women. Instability is understood as changes in mood and unpredictability of the behavior of men. This factor may accompany IPV against women because it contributes to the cycle of violence, which alternates between tension, aggression, and harmony (Labrador, Paz, De Luis, & Fernández-Velasco, 2005).

Men’s jealousy has been found as a risk factor for emotional violence; it would mean that men’s control of women trigger violence against them, particularly in machistas countries like Peru (INEI, 2006, Insua & Vidal, 2006; Klevens et al., 2007; Pisspa, 2002; Vaiz & Spano, 2004). These results confirm that male authoritarianism is a major risk for IPV (INEI, 2006) and that coercive control is a key dynamic in spouse abuse (Stark, 2007).

It is interesting that men’s assertive communication is a protective factor for emotional IPV. Although it may be an obvious association, it reinforces the idea to intervene by enhancing the communication skills of the couple to solve existing difficulties especially in a context in which violence is naturalized (Flake, 2005; Flake & Forste, 2006).

Although the explicative power of these three factors and their interactions were adequate for emotional violence, it would be important to carry out studies with large and representative number of participants and to incorporate different communities with similar characteristics.

Weak correlations reveal some trends to associate conflicts inside family and emotional violence, one of them relating emotional violence with unwished or unplanned pregnancies. Pallitto, Campbell, and O’Campo (2005) considered that battered women lose control of their sexual and reproductive health because of fear of being maltreated by their partners. In addition, a violent situation becomes worse near the birth of a child because men could distrust their paternity (Campbell, Pugh, Campbell, & Visscher, 1995). An additional problem caused by this association is that having another child creates a sociocultural imperative to keep the family together and increases women’s economic dependence. This situation may push women to maintain an unhealthy relationship with their partner.

Other associated conflict inside the family was lack of economic resources. Despite the fact that the whole community lives in poverty, we can see that when there are financial problems at home, they tend to be accompanied by verbal violence exerted by the intimate partner against women. However, to confirm whether poverty initiates or maintains violence in this context, we need further studies.

It is noteworthy that cultural aspects expressed in women’s individual beliefs about violence are not related to any type of IPV. This result contradicts previous findings (Adams & Campbell, 2005; Capezza & Arriaga, 2008, Mattson & Rodríguez, 1999; Raj & Silverman, 2002; Swan & Snow, 2006) and need to be deepened in future studies.

It also should be considered as a limitation of this study that all variables, including those related to male partner, have been evaluated from the perspective of the women; The inclusion of male’s perspective would be useful for future research.

Also, taking into account that variables have been evaluated from few questions because of the goal of assessing several factors at once, it is important to consider further exhaustive evaluation of factors explored for this research as well as another potential risk or protective factors for physical and emotional IPV.

Despite these limitations, the results of this study illustrate the importance of psychological and relational male characteristics for IPV against women. This shows the importance of knowing the context to understand domestic violence and its nuances in a specific group. Besides, these results justify the need to design adequate prevention strategies for this and other communities living in poverty and having a strong organization. These should focus on improving adequate communicative strategies as well as providing psychological services to aggressors. Another important topic is to intervene on social and cultural factors, which justify and maintain violence against women.

We also believe that this research is a contribution on the topic because it was designed to study mainly IPV against women. Also, it is important to observe multiple interactions between factors as established by the ENM, which is a necessary comprehensive approach to a multidimensional issue, such as IPV against women. Also, it shows the particularities of physical and emotional violence sustaining the importance to study its dynamics separately.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Notes

Bio

Magaly Nóblega Mayorga is a clinical psychologist at Pontificia Universidad Católica del Perú and holds a master’s in public mental health at Public Health College at Universidad Peruana Cayetano Heredia. She is involved in research about interpersonal violence against women and children at Research Institute at Universidad de San Martín de Porres. She is associate professor in Pontificia Universidad Católica del Perú and Graduate School at Universidad de San Martín de Porres.

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