Understanding Intimate Partner Violence Perpetration Involving the Deaf Population

Abstract

There has been an increase in intimate partner violence (IPV) research regarding the deaf population; however, no studies to date obtained data directly from members of the deaf population who disclose IPV perpetration. This community-based participatory research study explored the social context of IPV perpetration involving the deaf population through interviews with deaf or hard-of-hearing individuals who self-identified as perpetrating either physical or sexual abuse in an intimate relationship where at least one partner was deaf. Through semi-structured interviews using video relay, an interdisciplinary research team, which included deaf investigators, explored questions which included IPV triggers, types of IPV, weapon use, childhood victimization, and interactions with first responders and response systems (e.g., criminal justice, medical). The types of IPV abuse, resulting injuries, and systems used are discussed. The team collectively identified key elements of abuse and their relationships to each other through concept mapping of each interview. Through a method of constant comparison, we identified several themes: intergenerational transmission of violence, fund of information concerns, communication barriers with family and friends and resulting frustration, and help-seeking challenges. Many of these themes are specific to the deaf population, illustrating the need for continued research to understand IPV in diverse communities. Findings are compared with IPV trends in the general (hearing) population, and prompt concerns that universal IPV interventions may not effectively address the needs of the deaf population. Recommendations for diversifying screening efforts, modifying screening tools, and tailoring interventions to better address IPV involving deaf and hard-of-hearing populations are discussed.

Keywords

deaf intimate partner violence perpetrators sign language disability community-based participatory research

Introduction

The evolution of the intimate partner violence (IPV) prevention field began in the mid-1970s, with a proliferation of research studies occurring within the past 20 years. These studies have focused on victims,¹ including how violence affects mental and physical health, as well as prevalence rates and severity of violence. Studies focused on those who perpetrate violence have emphasized IPV perpetrator typology and interventions, such as evaluations of batterer intervention programs (BIPs). However, limited research explores victimization and perpetration involving the deaf² population, with notable exceptions (see M. L. Anderson & Leigh, 2011; Mastrocinque et al., 2017; Pollard et al., 2014; Porter & McQuiller Williams, 2011a, 2011b). This study employed qualitative semi-structured interviews with individuals who identified as deaf or hard-of-hearing, and as having self-disclosed perpetrating IPV against their partners.³ The research goals were to understand the social context of violence involving the deaf population relative to intimate partners, compare these findings with the general (hearing) population, and strategize potential interventions.

Literature Review

According to the World Health Organization (2013), IPV is a global health problem with 35% of women having “experienced either physical and/or sexual intimate partner violence or non-partner sexual violence” (p. 2). Research in the United States found 35.6% of women and 28.5% of men “experienced rape, physical violence, and/or stalking by an intimate partner in their lifetime” (Black et al., 2011, p. 2). While IPV affects all demographics, there are risk factors for victimization (e.g., low education, community poverty, having adverse childhood events including witnessing adult IPV, and having an alcoholic or incarcerated parent; Cunradi et al., 2000; Whitfield et al., 2003). Violence has long-lasting physical and mental health effects, such as depression and anxiety (Carlson et al., 2003; Kimerling et al., 2007). Female victims utilize health care at a greater rate than nonvictims for myriad concerns, including gynecological, mental health, and respiratory issues (Bonomi et al., 2009; Plichta & Falik, 2001). Men and women experiencing IPV report greater rates of depression, post-traumatic stress disorder (PTSD), and suicidal thoughts than nonvictimized groups (Cerulli et al., 2014; Rhodes et al., 2009). Among male and female perpetrators, interpersonal violence and victimization increased the odds that the participant would report suicidal ideating symptoms (odds ratio [OR] = 3.29, confidence interval [CI] = [1.39, 7.79]; You et al., 2011). Among victims seeking protection orders at court, while their insurance profiles are the same as national samples, they have a higher proportion of emergency department use and 40% reported delaying their medical care (Cerulli et al., 2010).

There is a concern that perpetrators use physical and mental health symptoms as excuses for perpetration and as a ploy to manipulate victims, especially threatening suicide if the victim leaves (Rockefeller, n.d.). Such actions are commonly used in psychological abuse to coerce and control others, consistent with the power and control dynamics in abusive relationships (National Center on Domestic Sexual Violence, n.d.). However, perpetrators do in fact have higher rates of suicidal ideation and attempts (Conner et al., 2002). This mental health concern may result from co-morbid alcohol and substance abuse, or a child and/or adolescent abuse history (Desai et al., 2002; Dube et al., 2001, 2002).

Violence does not just affect those experiencing or perpetrating violence, it can also negatively impact family members. For example, aggression within the family (emotional, psychological, sexual) can cause children exposed to violence to experience higher rates of victimization and perpetration—often called the intergenerational transmission (IGT) of violence (see Desai et al., 2002). Meta-analyses reveal that the correlation between childhood abuse and neglect is related to future abuse involvement (both victimization and perpetration; Capaldi et al., 2012; Stith et al., 2000), but one study indicates the relationship varies based on the frequency and type of childhood abuse (Renner & Slack, 2006). Related work urges continued research on the effects of child abuse, noting it can increase individuals’ experiences of IPV in complex ways (Widom et al., 2014), and that victims are more likely to experience both more IPV and more types of IPV.

Much remains to be learned regarding the IGT of violence within the general population. While there is limited research on IGT of violence involving the deaf population, existing research reports deaf children are often abused by their family of origin, school mates, and others who the children encounter (Kvam, 2004; Schrӧttle & Glammeier, 2013). Recently, there has been an increase in research exploring both IPV and the IGT of violence involving deaf persons.

Studies examining the deaf population and IPV note deaf victims experience diverse types of IPV, including communication/technological abuse (Mastrocinque et al., 2017; Southworth et al., 2007), physical abuse (Mastrocinque et al., 2017), emotional abuse (Pollard et al., 2014), sexual abuse (Mastrocinque et al., 2017; Pollard et al., 2014), and financial abuse (Mastrocinque et al., 2017). Related studies with college students support that being deaf or hard-of-hearing increases the chance of psychological and physical abuse (M. L. Anderson & Leigh, 2011; Porter & McQuiller Williams, 2011a, 2011b) as well as sexual abuse (M. L. Anderson & Leigh, 2011). Such work includes the concern that female undergraduates are not properly identifying certain behaviors as abusive, criminal, or IPV (M. Anderson, 2014; M. L. Anderson & Kobek Pezzarossi, 2012; Smith & Pick, 2015). There is also an increased risk for victimization in institutions, including schools for the deaf (Kvam, 2004; Schrӧttle & Glammeier, 2013). When IPV does affect the deaf population, consequences include mental health effects and the need for medical attention (Mastrocinque et al., 2017).

IPV often arises from unhealthy or imbalanced power and control dynamics. It is a novel perspective to apply this model to the deaf population, given unique issues such as circumstances where partners’ communication abilities differ (e.g., where one partner is hearing or hard-of-hearing and the other is deaf, especially when the deaf partner does not have clearly intelligible speech; relationships where one partner is fluent in sign language or written English and the other is not). Such situations can create power and control dynamics that may be unique to how IPV manifests or is addressed in the deaf population. Which partner can utilize a voice telephone and who interacts most effectively with first responders are common examples of these types of situations. The ease with which first responders and IPV service providers can communicate with hearing, hard-of-hearing, or deaf persons with intelligible speech or clear writing can easily lead to bias and/or inequities in gathering information from a deaf partner with poorer hearing, speech, or literacy abilities.

Risk factors for IPV in the deaf population include communication barriers which can lead to abuse in both intimate and parent–child relationships (M. L. Anderson & Kobek Pezzarossi, 2014; Durity et al., 2004; Knutson et al., 2004). While research exists regarding the IGT of violence in the general population, limited research explores this issue in the deaf and hard-of-hearing population, except for one study of college students stating that witnessing or experiencing abuse did not correlate with perpetrating physical violence (McQuiller Williams & Porter, 2015).

There is little research about IPV perpetrators’ interactions with response systems (e.g., the police), or resources, in the deaf population (e.g., effectiveness of interventions). Much of the existing research is on the general (hearing) population; therefore, we are unaware of how it applies to IPV perpetration in the deaf population. For example, literature exists on developing and testing perpetrator typologies (Holtzworth-Munroe et al., 2000; Holtzworth-Munroe & Stuart, 1994; Johnson, 1995; Walsh et al., 2010), and how psychopathic traits in people who have experienced childhood abuse could increase one’s propensity to IPV perpetration (Swogger et al., 2012). In addition, IPV court-mandated programs have been tested, such as BIPs (Labriola et al., 2005; Saunders, 2008) and the risk of reoffending (Williams & Houghton, 2004). However, the application of this research to the deaf population is unknown. Although studies reveal that BIP completion, which varies among programs, can reduce the risk of rearrest for IPV (Bennett et al., 2007) and noncompliance with BIPs is a risk factor for rearrest for IPV (Kindness et al., 2009), these studies do not focus on deaf persons who participate in BIPs; neither study mentions participants’ hearing status.

In their review article, Cattaneo and Goodman (2005) stress that interventions and research consider the bioecological model, noting “a variety of interrelated factors that operate in the individual’s immediate and more distal environment” (p. 170). Because research supports that victim services may need to be better tailored for the deaf population (Cerulli et al., 2015; Mastrocinque et al., 2017), the same is potentially true for deaf perpetrators, who often have co-morbid childhood abuse histories, and perhaps substance use or abuse.

It is important that IPV research involving the deaf population use culturally and linguistically appropriate measures. For example, the Power and Control Wheel used to identify IPV (National Center on Domestic Sexual Violence, n.d.) was modified for deaf populations to better communicate about IPV in this unique linguistic and cultural minority group (DeafHope, 2006). Researchers have administered surveys to estimate prevalence rates and the effects of IPV with survey instruments created by and for hearing populations. While some epidemiological research has been conducted with deaf populations, such studies have yet to fully explore IPV involving deaf persons through interviewing those who perpetrate violence.

Current Study

The current study had the following attributes: (a) It was a qualitative study which explored perpetrators’ perspectives on and experiences of violence, including childhood histories; (b) it was a community-based participatory study which included researchers and practitioners, both hearing and deaf, as well as those with a lived experience of IPV to inform the study instruments (Barnett et al., 2017; Israel et al., 2001); and (c) the interviews assessed perpetrators’ interactions with court and criminal justice responses, and use of IPV resources (including treatment). This approach provided the opportunity to better understand interventions and compare these findings with those known about hearing perpetrators. These data can be used to create culturally tailored IPV interventions specific to couples in which at least one partner is deaf. It compares and contrasts risk and protective factors associated with IPV perpetration involving the deaf population to the general population. The study also better understands needed assistance from response systems in relation to IPV perpetration involving the deaf population.

Method

The authors report on the final phase of an iterative, three-phase study. Phase 1 utilized semi-structured interviews to assess IPV service providers’ perceptions on the etiology of abuse among deaf individuals (Cerulli et al., 2015), particularly providers who frequently work with deaf persons. Phase 2 assessed deaf IPV victims’ self-reported experiences through semi-structured interviews (Mastrocinque et al., 2017). Phases 1 and 2 informed a revised interview script for this third phase, focused on individuals who self-reported as having perpetrated violence in a relationship where at least one partner was deaf or hard-of-hearing. Our study team brought a multidisciplinary perspective, including psychology, criminal justice, IPV, law, social work, anthropology, American Sign Language (ASL), sign language interpreting, and Deaf sociocultural and psychological issues. We involved victims and experts from the Deaf IPV community in all steps of this study, such as developing the field guide and analyzing the data. The ASL-fluent team members who conducted the interviews received training about the guides and piloted the guides. The interviewers and larger team provided feedback which was incorporated into the guides. The final guide yielded data regarding various aspects of participants’ experiences pertaining to IPV and the perpetrators’ and victims’ characteristics (e.g., hearing status, sign language fluency, education). All participants were ASL fluent and responded to interviews via videophone (VP)⁴ or in person in ASL during visits by members of the research team to treatment programs. The interviews were between 1 and 1½ hours.

Recruiting

We used a purposeful sampling frame to ensure the inclusion of a broad range of experiences from different geographic areas. Recruitment methods included sending an informational letter to approximately 25 organizations around the United States that specialize in serving deaf individuals who experience IPV. IPV service providers working with the deaf population commonly serve survivors as well as perpetrators (which is not as common among IPV providers working with hearing victims) because of the rarity of ASL fluency among IPV-trained providers. Because of their ASL accessibility, providers of many disciplines commonly serve a wide array of deaf people presenting with myriad psychosocial needs. IPV perpetrator treatment programs specifically designed for deaf individuals received information letters. We included a study flyer for potential participants to view along with the letter sent to providers. We also sent deaf IPV service organizations a copy of our informed consent letter, to distribute to individuals who expressed interest in study participation.

We posted the two letters (without names or addresses) on the Deaf Wellness Center’s⁵ website so individuals could find them. We also translated the letters and informed consent document into ASL which were filmed, featuring a deaf member of our research team signing the exact same information contained in the IRB-approved letters, and posted on our study website. Information regarding how to access study information on the Deaf Wellness Center website was posted on the Deaf Wellness Center’s Facebook page as well. A video blog (vlog) in ASL featuring similar content, but briefer than the aforementioned letter to deaf IPV service agencies, was posted on the listserv used by members of the Justice for Deaf Victims National Coalition (JDVNC), an organization comprised primarily of IPV service providers and advocates who work with deaf persons. An email message regarding the study, directing readers to the study website, was distributed via the JDVNC listserv. The recruitment materials included information on the screening process and interview length. The documents included the phone number and email contact information for research personnel. Interested participants were then to contact study personnel to set up an appointment for the screening and interview.

Our sampling strategy was to recruit participants who were able to converse at length about the topic and experiences. Our sampling goal is consistent with qualitative research design: it is not intended to assess the frequency of a trait in a population, but to document a range of experiences. We determined the sample size for this study using two criteria: capture of a variety of experiences and opinions and saturation of themes (Charmaz, 2006, pp. 96–122; Hardesty et al., 2019; Patton, 1990/2002, Purposeful sampling, pp. 230–247). Our sample size of 15 meet both criteria.

Eligibility Criteria

Individuals who expressed interest in the study were screened for eligibility, which included being over the age of 18 years, residing in the United States, self-disclosed having perpetrated physical or sexual abuse against an intimate partner, the relationship involving at least one deaf or hard-of-hearing partner, and the participant was not currently in an abusive relationship.

If eligible, a research team member requested the participant’s mailing information and arranged an interview. The participant’s contact information was used to provide study-related consent documents, information needed to schedule the interview, and sought an address to mail the participant’s US$40 compensation. The individual who maintained the contact information and mailed checks did not know the interview filename eventually associated with the completed interview. The address and phone number for the participant was kept separate from the transcripts (which were later de-identified). The informed consent information included how we protect any identifying information, Health Insurance Portability and Accountability Act (HIPAA) concerns, and the contact information for the institution’s Human Subject Safety personnel. The informed consent plan utilized (a) a written (in English) consent document, (b) the video record of the subject discussing informed consent information with the interviewer, (c) conveying their consent in sign language, and (d) affixing their signature to the written consent document. The University of Rochester’s Institutional Review Board approved all aspects of this study which obtained a Certificate of Confidentiality.

Data Analysis

The transcription team, of certified ASL interpreters, translated the recorded ASL interview videos into English creating a hard copy transcription. The ASL-fluent individual who interviewed the participant audited the transcript for accuracy. A third team member de-identified the transcript, and then provided it to the analysis team. Each member of the analysis team read the transcripts and created concept maps.

Analysis of qualitative data involved engaging in the data in multiple ways—through a theoretical framework provided by a socioecological model, the creation of matrices, and concept mapping—to identify patterns (Humble & Radina, 2019). Concept mapping, a visual representation of the key features of the interview data, provided a method for fully utilizing the multiple perspectives of our interdisciplinary, deaf/hearing team (Conceiçãoet al., 2017; Daley, 2004). Each team member generated a concept map of the individual interviews using categories of IPV (physical, sexual, emotional, communication, or controlling behaviors) and characteristics of victims and perpetrators (hearing status, weapon use, injury, childhood abuse history). We organized the concept maps to display clustering of elements and relationships between subject characteristics and forms of abuse. The team met weekly to compare concept maps. The maps allowed the team to compare patterns across interviews as well as highlight the unique features of the individual cases. Following the methods of Miles and Huberman (2014), we then constructed a matrix juxtaposing perpetrator characteristics with elements from the conceptual maps. In this way, we could further identify relationships among elements. Patterns derived from mapping and matrices were interpreted through team discussions in the context of both social and cultural barriers faced by deaf individuals and comparing them with the existing IPV literature (Denzin & Lincoln, 1994).

Findings

Fifteen participants comprise the study: 14 deaf people and one hard-of-hearing person. A majority of participants were male (n = 10) and White (n = 7). Four self-identified as being more than one race, whereas others self-identified as Black (n = 1), Asian (n = 1), or another race. Three participants self-identified as Hispanic or Latino. The sample was essentially split between people who were employed (n = 7) and unemployed (n = 8), and a majority of the participants stated their highest level of educational attainment was having completed some college (n = 8), including participants currently attending college. Four participants held 2- or 4-year college degrees, whereas one person finished high school, and two people did not graduate from high school. All participants were proficient in sign language.

Most participants grew up with two hearing parents (n = 13), two had two deaf parents, and one had one deaf parent. Most participants experienced child abuse (n = 13), with five of the reported abusers being a family member, five being a nonfamily member, and three being both family and nonfamily members. The abuse often involved forced sex by older youth or adults, physical abuse, and bullying in schools. Some participants attributed their later IPV behavior to this childhood abuse⁶:

But everything I did to this person I did because I was bullied by my friends while I was growing up. I was never able to retaliate until this relationship. The tables were finally turned, and I was able to get my revenge from this bullying. I was bullied by a group of people and I transferred it onto him.

Participants discussed their victims and relationship dynamics. There were 20 victims; two participants had more than one victim. The majority of victims were deaf (n = 16), three victims were hearing, and one victim was hard-of-hearing. In most relationships, both partners were deaf (n = 15), but other relationships involved a deaf perpetrator and a hearing victim (n = 3), a deaf perpetrator and a hard-of-hearing victim (n = 1), and a hard-of-hearing perpetrator and a deaf victim (n = 1). Most of the relationships had a male perpetrator and a female victim (n = 14), but five relationships had a female perpetrator and a male victim. One relationship involved a male perpetrator and a male victim. A majority of the relationships (n = 14) had bidirectional violence, where both partners were abusing the other person and also being abused in the relationship. Cheating qualified as bidirectional abuse in cases where both parties were cheating.

The types of IPV were categorized as physical, emotional, communication, financial, and sexual. Participants commonly disclosed physical abuse (n = 14) in their relationships, which often involved hitting (usually the face), slapping, pushing, or pulling their partner’s hair. It is important to recall that the screening criteria included physical or sexual abuse, thus influencing these findings. Emotional abuse included cheating, prevalent in the relationships discussed, especially as a way to get revenge on a partner. Six participants admitted to cheating and several made negative statements toward the victims, including telling one victim she was “ASL stupid.” Communication abuse (n = 11) would often manifest itself as snooping through communication devices (e.g., reading through text messages) or throwing the victim’s phone away. Some participants admitted to intentionally signing very quickly so their partner could not understand the communication. Four participants disclosed engaging in financial abuse, commonly manifested as controlling the use of money in the relationship, while four disclosed perpetrating sexual abuse. Sexual abuse often involved manipulating, pressuring, or forcing a partner to have sex.

Many participants admitted to substance abuse (alcohol only, n = 3; alcohol and drugs, n = 6) and discussed barriers in trying to access substance abuse help. There were some commonalities in the characteristics of the victimized partner, with participants commonly discussing victims’ mental health issues, substance use, lack of parental support, and children from other relationships. This information may inform how perpetrators select victims and take advantage of perceived vulnerabilities, for example, a person without a support system might be targeted because a perpetrator might believe that person is easier to control and isolate. A person with a strong support system might be more likely to have family or friends intervene, and might be more difficult to isolate. In addition, one participant stated that her ex-husband was “pea brained” and “soft hearted” making it easy for her to manipulate him, illustrating her taking advantage of her victim’s perceived vulnerabilities and potential deficit in fund of information (see below for elaboration).

In further exploring the health risks of abusive relationships affecting the deaf population, the research addressed weapon use and injuries. Four participants noted weapon use in the relationship, with two involving a knife as the weapon. In one relationship, the knife was for a suicide threat, while in another relationship involving bidirectional violence, the participant’s boyfriend threatened her with a pocketknife. Two people discussed other items used as weapons, including a car, a stove, and shoes. Of the 20 relationships discussed, participants admitted to injuring their victim in 11 of the relationships. These injuries were commonly bloody or broken noses, visible bruises and scratches, and victims who complained of head trauma (e.g., dizziness, headaches) due to being punched in the face or head. One victim had broken teeth, and another was bleeding from his scalp after the perpetrator pulled his hair.

Because a high number of these relationships had bidirectional violence, many participants also discussed their injuries in the relationship. In seven of the relationships, participants stated their partner injured them. These injuries were commonly bruises and black eyes, and in one circumstance, a female participant disclosed that forced sex resulted in vaginal, anal, and oral injuries, including anal bleeding. This same relationship had bidirectional violence which included the female participant also raping her partner.

Related, we assessed participants’ interactions with the criminal justice and medical systems. A large majority of the sample (n = 12) interacted with the police or public safety and with mental health services (n = 13). More than half interacted with the court system (n = 9) and several participants were incarcerated (n = 7). Only two participants interacted with the medical system. Interactions with the police were diverse. Some participants stated the police did not do much, and in some situations, the police were called multiple times.

Four themes emerged which were consistent across many of the interviews. These themes were IGT of violence, fund of information, communication barriers and resulting frustration, and help-seeking.

IGT of Violence

The IGT of violence describes the dynamic that growing up in an abusive environment may, in some cases, result in one’s own perpetration of violence against others or future victimization. One participant illustrated this experience:

Really I think that was from my family background . . . I learned most of that behavior from my mom. . . . When I was a kid my mother . . . would abuse me and that’s exactly the behavior I then applied to my ex. I think it’s from kids’ bad experiences. You grow up with it and it sticks with you, you know, and then you transfer it on to someone else and do the same thing. So, I think that hair pulling thing came from my mother.

Consistently, another participant noted,

. . . he [stepfather] beat me all the time—6 to 16. Then later on when I was 18, I got married to my ex-wife and I did the same thing . . . I continued it—I beat her . . . I think I got it from my family. They beat me and I beat her—I just continued it, and the same thing—we never called the cops, never sat down and talked about it, and I was wrong. I know that.

Fund of Information

Several studies of the deaf population discuss the concept of fund of information, a theme that emerged in this study (Graybill et al., 2010; Pollard, 1998; Pollard & Adams, 2004; Pollard et al., 2009). Fund of information (Pollard, 1998) refers to the entirety of accumulated knowledge one has at their disposal. It is common for deaf persons to manifest deficits in fund of information due to lack of access to information via radio, TV and movie soundtracks, “overheard” conversations (including within the family), and limitations in English literacy (see Hauser et al., 2010). Generally speaking, people gather much information from ambient discussions, for example, a conversation parents are having in another room to solve a conflict, or, information one receives from a television in the background. In situations where a child is deaf, the child is unlikely to learn information not directly communicated to the child, for example, how to peacefully solve a conflict.

Fund of information concerns are critical when discussing abusive relationships because they relate to healthy relationship education in a variety of forms (e.g., solving conflict, sexual education, defining abuse). These concerns are apparent in deaf research literature (Graybill et al., 2010; Joseph et al., 1995; Pollard, 1998; Pollard & Adams, 2004; Pollard et al., 2009) and this study is no exception. As one participant stated,

I learned everything . . . about relationships from my parents. I saw the things that they did with one another, but I was never privy to their conversations. I saw that my mother cooked for my father, so I cooked for my husband, but I didn’t know how to interact. I knew I had a lot of wants, and I acted out to get what I wanted. I’ve done a lot of research on my own behavior and other people’s behavior in criminal justice, and now I understand what deaf people lack in so many ways because of their language deprivation.

The fund of information issue is also apparent in properly identifying abuse, which can relate to remorse. While four participants expressed remorse over their abuse, some deaf perpetrators failed to identify abusive behavior: “I never killed anyone or hurt anyone. Mostly verbal abuse. Slapping, pushing, that’s it. But not abuse or anything like that.”

Communication Barriers and Resulting Frustration

Another theme was frustration from communication barriers, an experience often prevalent during childhood. Given that most participants had two hearing parents (which is also common for the general deaf population regardless of abuse perpetration), they commonly referred to strained family relationships. Examples included hearing parents who would, likely due to frustration over not being able to communicate with their child, throw objects, or physically grab their children. One participant stated,

My mother was impatient because she couldn’t just call my name when I was in another room . . . She wanted to call me but I couldn’t hear her. I didn’t have a hearing aid at that time so of course I couldn’t hear her call me, and she would get mad. She was so impatient. She would take a light, . . . She threw it at me . . .

Perpetrators, not immune to experiencing the same frustrations, discussed the inability to communicate feelings, sometimes resulting in physical violence. As one participant stated,

I think this has a lot to do with the language and the emotions that I experienced while I was growing up. I didn’t have the language to tell my parents what I was experiencing, but I was getting picked on and bullied.

Another participant discussed a family communication breakdown between a man and his family: “Because he didn’t have good communication. He wasn’t very close to his family. He tried to communicate but his parents didn’t really work at it and communication just fell apart.” These points relate to strained relationships with parents, few avenues to communicate and express emotions, and negative relationship behavior that may carry into other relationships.

Help-Seeking

Many participants discussed challenges in help-seeking, including families discouraging the couple to contact help, namely, the police. Families encouraged contacting family members instead, telling one participant, “. . . it just costs too much money to involve the police . . . we should work it out in the family.” Participants also discussed how language barriers negatively affected access to appropriate care, such as ASL-fluent counselors and correctional programs: “They had programs in jail. There weren’t any interpreters so I didn’t get a lot of information.”

Discussion

Some of our findings are inconsistent with some stereotypes regarding the etiology of IPV in the general population. First, a third of our participants (n = 5) were female perpetrators with male victims. These female participants tended to be very controlling and physically violent, with one participant admitting to raping her partner in retaliation to his abuse, stating to him, “See how I feel?” In addition, most of these relationships had bidirectional violence. These findings reinforce that education, programs, services, and materials about IPV must not perpetuate gender stereotypes (e.g., that IPV always involves a male perpetrator and a female victim; that females who perpetrate IPV are always acting in self-defense; see Scarduzio et al., 2017).

Notably, while about half of the relationships resulted in injuries, partners rarely sought medical attention. While screening in a medical setting for abuse is extremely important and effective, it is important that providers diversify their efforts to detect abuse. Such efforts can include using accessible language and screening tools, or the use of pictures to help identify different types of abuse. This is especially important in relationships where there might be a failure for a person to identify abuse, due to factors like limited fund of information.

Childhood abuse histories were extremely prevalent in our sample, including abuse by many different people. It is important to have a larger perspective on the multiple factors that can increase the risk that a person who is abused may perpetrate future abuse. Factors such as fund of information may prevent identifying abusive or unhealthy behaviors in relationships. In addition, communication barriers, especially frustration in not being able to express the occurrence and effects of abuse (e.g., bullying), may result in frustration and later perpetration.

Related, education is key. Many participants grew up in abusive environments which taught abuse was acceptable, or grew up in environments where families and schools did not directly provide education about healthy relationships and conflict resolution. While communication barriers are immeasurably difficult to overcome when hearing people who are not ASL fluent are in a relationship with a deaf person, this research proposes that addressing such communication barriers to decrease frustration, providing a way for children to express their experiences, and educating children about healthy relationships, may decrease both frustration in these relationships and perhaps later IPV perpetration.

These findings also explore concerns in the general perpetrator literature regarding whether perpetrators select victims thought to be vulnerable (see, for example, Wheeler et al., 2009). Given the number of participants who discussed characteristics of their victims that might be perceived vulnerabilities, and therefore more attractive targets, more research needs to be done in this area. As noted, perpetrators commonly discussed victims’ mental health issues, substance abuse, children from previous relationships, and lack of family support. Because IPV centers on controlling a person, which many participants knowingly did, it seems intentionally targeting a person with perceived vulnerabilities is consistent for hearing (Cattaneo & Goodman, 2005) and deaf perpetrators alike.

Limitations

As with most studies, there are several limitations to consider when interpreting these results. While the principal investigator was male, the remainder of the research staff was female. There is the possibility that male participants might have shared different information with male interviewers. Also, the information provided was based on participant unverified self-report and recollection. Despite these limitations, our interdisciplinary team offered a unique lens on the etiology of abuse involving deaf persons. We engaged a nationally diverse sample with an array of participants who provided important information relevant to creating, implementing, and testing future interventions with deaf individuals who are reporting IPV.

Conclusion

It is important to focus on both the identification of IPV perpetrators in the deaf population and the design of interventions to address deaf IPV perpetrators. At the conclusion of the third phase of this study, it is evident that communication abuse was very prevalent in both the perpetrator and victim phases of this study. Based on this finding, discussions about power and control, and identifying such behavior, should specifically include communication abuse. The definition of communication abuse should include snooping through, confiscating or destroying communication devices, preventing people from communicating with others, and intentionally signing quickly or refusing to sign.

BIPs need to be substantially tailored for deaf IPV perpetrators. Such BIPs need to consider this study’s themes, namely, fund of information concerns and communication barriers. There are several challenges in creating such tailored programs. First, there are often not enough deaf perpetrators in a given locale to justify a separate, unique BIP for them. In addition, if many perpetrators are in relationships with bidirectional abuse, it might be difficult to coordinate enough BIPs to allow for perpetrators and victims to be in separate programs. Failing to do so could create more of a mediation format, which is controversial in IPV research (see, for example, Imbrogno & Imbrogno, 2000). A potential remedy might be creating an arm of telemed, commonly used for mental health issues, to address IPV among deaf victims and perpetrators using video conferencing between an IPV specialist and the perpetrator. This of course would need careful implementation with safety planning procedures.

Another challenge is getting deaf perpetrators to seek help. In this study, often when participants sought help, it was because the criminal justice system required it. Help seeking might be impeded by both a lack of specifically tailored services and a fear of stigma. Interestingly, in our earlier work (Cerulli et al., 2015), we learned that because providers offering care to deaf IPV victims and perpetrators are “deaf” specialists offering an array of services, from mental to physical health care, we did not identify the same demonization of perpetrators. Providers seemed to have a broader understanding of how the violence is linked to a series of risk factors (Cerulli et al., 2015). It is important for deaf service providers to screen for IPV that may not be readily disclosed.

Finally, there is a concern about limited resources to create deaf-specific BIP groups, and a major concern in having ASL-fluent service providers specifically trained in IPV service provision with both cross-cultural legitimacy and a deep understanding of Deaf culture. Underlying issues (e.g., substance abuse) also need to be addressed, requiring ASL-fluent providers. Innovative approaches may assist in these needs. For example, in one community, the mainstream IPV provider has recently linked with a deaf IPV provider to offer an array of services for deaf IPV victims (e.g., safety planning, shelter; Willow Domestic Violence Center, 2020). Thus, both organizations are collaborating to offer ASL clients an array of needed services.

Footnotes

Acknowledgments

We thank Lori DeWindt, MA, Sharon Hayes, MSW, Amanda O’Hearn, PhD, and Christina Raimondi for their assistance with this project, and Miriam Kohn.

Authors’ Note

We presented preliminary findings at the American Society of Criminology Conference in Philadelphia, PA, in November 2017.

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) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the National Center for Injury Prevention and Control (a branch of the Centers for Disease Control and Prevention) Grant 5 R01 CE001871 (Pollard). J. M.M. was supported by the National Research Service Award, National Institute of Mental Health Grant NIMH T32 MH 18911 (Caine), and the Faculty Development Committee Grant, York College of Pennsylvania (Mastrocinque). D.T. was supported by the National Institutes of Health Grant 2 T32 HL793711 (Pearson) and the National Center for Injury Prevention and Control (a branch of the Centers for Disease Control and Prevention) Grant 5 R01 CE001871 (Pollard).

ORCID iDs

Jeanna M. Mastrocinque

Catherine Cerulli

Notes

Author Biographies

Jeanna M. Mastrocinque, PhD, is an assistant professor in the Law and Justice Studies Department at Rowan University. Her research focuses on the intersection of victimization and health with attention to specific underserved populations, including families and friends of homicide victims.

Catherine Cerulli, JD, PhD, is a professor of psychiatry at the University of Rochester and directs the Laboratory of Interpersonal Violence and Victimization as well as the Susan B. Anthony Center. She is interested in research on homicide, suicide, and interpersonal violence prevention, as well as how these issues intersect.

Denise Thew, PhD, is an associate professor at Western Oregon University and coordinator of the Rehabilitation and Mental Health Counseling program. Her research interests involve mental and public health, and social justice with the Deaf, Hard-of-Hearing, and DeafBlind population.

Nancy P. Chin, PhD, MPH, is an anthropologist and public scientist. Her work focuses on higher-order social structures and community health with attention to the effects of gender dynamics. Her recent research focuses on community trauma recovery involving projects in the Dolomites and Himalayas.

Robert Q Pollard, Jr., PhD, is professor and associate dean of research at the National Technical Institute for the Deaf in Rochester, NY, and clinical professor of psychiatry at the University of Rochester School of Medicine. There, he founded the Deaf Wellness Center, a clinical service, research, and training program.

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