Family-Only Perpetrators of Intimate Partner Violence: A Systematic Review

Checklist for methodological quality

The checklist consisted of 11 criteria used to rank the studies according to methodological quality. Nine criteria were rated on a scale of 0–1, and two criteria were rated on a scale of 0–2. Sample size was scored as 0 (N < 50), 1 (N = 50–100), or 2 (N > 100), and source of IPV information was scored as 0 (perpetrator self-report), 1 (victim report, or victim report and perpetrator self-report), or 2 (official records). The remaining criteria of representativeness, standardized assessment of IPV, standardized assessment (of at least 50%) of additional constructs, subtypes based on Holtzworth-Munroe and Stuart’s (1994) dimensions, explicit comparisons to Holtzworth-Munroe and Stuart’s (1994) family-only subtype, appropriate statistical analysis (e.g., not using statistical analyses rendering a significant proportion of perpetrators as unclassifiable), relevant methodological discussion, and inclusion of a nonviolent control group were scored as 0 (criteria did not apply) or 1 (criteria applied). Finally, study design was scored as 0 (cross-sectional design) or 1 (experimental or longitudinal design).

Using our constructed checklist, a study could receive a maximum score of 13 points, with the following cutoffs for methodological quality set as: low (0–4), moderate (5–9), or high (> 9). The authors of this article determined these cutoffs arbitrarily. Of the 31 studies subjected to a quality review, 17 were deemed as having high quality, 13 studies as having moderate quality, and one study (Rhodes & Iwashyna, 2009) was deemed to be of low quality and was thereby excluded from this review. Altogether, a total of 30 studies were included in this review.

High pro-social personality traits

Family-only perpetrators were defined as demonstrating moderate-to-high levels of several pro-social personality traits, such as agreeableness, extraversion, and conscientiousness (Walsh et al., 2010). Such perpetrators also evidenced moderate levels of perspective taking and having healthy and adaptive views of marital relationships (Johnson et al., 2006). Finally, family-only perpetrators also scored moderate-to-high levels of traits related to self-esteem (Johnson et al., 2006) and presenting oneself in overly positive terms (Johnson et al., 2006; Langhinrichsen-Rohling, Huss, & Ramsey, 2000; Lawson et al., 2003).

Low-to-moderate negative personality traits

Overall, family-only perpetrators were described as presenting low levels of stereotypical masculine behaviors (Langhinrichsen-Rohling et al., 2000; Lawson et al., 2003), low levels of hostility in general (Cunha & Gonçalves, 2013; Graña, Redondo, Muñoz-Rivas, & Cantos, 2014), and low levels of social introversion (Langhinrichsen-Rohling et al., 2000; Lawson et al., 2003). However, Johnson et al. (2006) reported that such perpetrators displayed moderate levels of traits related to a macho personality such as acceptance of interpersonal violence, hostility toward women, sex role stereotyping, and hypermasculinity.

Violence

Overall, the reviewed studies consistently demonstrated that family-only perpetrators used low levels of physical and psychological IPV (Babcock et al., 2008; Chiffriller & Hennessy, 2006; Cunha & Gonçalves, 2013; Delsol et al., 2003; Huss & Langhinrichsen-Rohling, 2006; Huss & Ralston, 2008; Johnson & Goodlin-Fahncke, 2015; Serie, van Tilburg, van Dam, & de Ruiter, 2015; Stoops, Bennett, & Vincent, 2010; Waltz et al., 2000). Such perpetrators also demonstrated low levels of sexual coercion toward their partners (Chiffriller & Hennessy, 2006; Graña et al., 2014). Furthermore, family-only perpetrators rarely inflicted injury to their partner (Graña et al., 2014). These perpetrators were also described as evidencing low levels of general violence (Babcock et al., 2008; Chiffriller & Hennessy, 2006; Delsol et al., 2003; Holtzworth-Munroe et al., 2000; Huss & Langhinrichsen-Rohling, 2006; Huss & Ralston, 2008; Johnson & Goodlin-Fahncke, 2015; Serie et al., 2015; Waltz et al., 2000).

Aggression

In line with previous results of levels of violence, family-only perpetrators were described as low-level aggressive. This held true for both physical aggression (Graña et al., 2014) and psychological aggression (Chiffriller & Hennessy, 2006; Graña et al., 2014) toward a partner. Furthermore, family-only perpetrators were also reported to demonstrate low levels of both general physical aggression (Cunha & Gonçalves, 2013; Delsol et al., 2003; Graña et al., 2014) and general verbal aggression (Delsol et al., 2003; Graña et al., 2014). Relatedly, such perpetrators displayed low levels of anger (Graña et al., 2014; Johnson et al., 2006; Stoops et al., 2010), anger expression and control (Graña et al., 2014), and passive aggressive-negativistic traits (Hamberger, Lohr, Bonge, & Tolin, 1996).

Criminality

Serie et al. (2015) reported that family-only perpetrators demonstrated low levels of general criminality.

Personality disorder

Family-only perpetrators demonstrated low levels of traits related to personality disorders across the reviewed studies, including mainly cluster B personality disorders (Babcock et al., 2008; Graña et al., 2014; Hamberger et al., 1996; Holtzworth-Munroe et al., 2000; Huss & Langhinrichsen-Rohling, 2006; Huss & Ralston, 2008; Johnson et al., 2006; Stoops et al., 2010; Waltz et al., 2000), sadistic personality disorder (Johnson et al., 2006), and impulsiveness (Graña et al., 2014).

Psychopathy

Overall, family-only perpetrators showed low levels (i.e., not reaching clinically relevant scores) of psychopathy on several different measures (Babcock et al., 2008; Cunha & Gonçalves, 2013; Graña et al., 2014; Langhinrichsen-Rohling et al., 2000; Lawson et al., 2003; Walsh et al., 2010).

Delusions

Family-only perpetrators reportedly displayed low levels of paranoia and paranoid ideation (Cunha & Gonçalves, 2013; Johnson et al., 2006; Langhinrichsen-Rohling et al., 2000; Lawson et al., 2003), schizophrenia (Langhinrichsen-Rohling et al., 2000; Lawson et al., 2003), schizoidal–asocial traits (Hamberger et al., 1996), hypomania (Langhinrichsen-Rohling et al., 2000; Lawson et al., 2003), and low levels of psychopathology (including delusional traits) in general (Chiffriller & Hennessy, 2006; Johnson & Goodlin-Fahncke, 2015; Serie et al., 2015).

Substance abuse

Across the reviewed studies, family-only perpetrators were found to display low levels of alcohol and drug abuse (Delsol et al., 2003; Graña et al., 2014; Johnson et al., 2006; Lawson et al., 2003; Serie et al., 2015).

Anxiety

Family-only perpetrators demonstrated low levels of anxiety (Johnson et al., 2006), neuroticism (Chiffriller & Hennessy, 2006; Walsh et al., 2010), dependent-submissive traits (Hamberger et al., 1996; Huss & Langhinrichsen-Rohling, 2006), avoidant (Hamberger et al., 1996), trauma (Stoops et al., 2010), hysteria (Langhinrichsen-Rohling et al., 2000; Lawson et al., 2003), hypochondriasis (Langhinrichsen-Rohling et al., 2000; Lawson et al., 2003), psychasthenia (Langhinrichsen-Rohling et al., 2000; Lawson et al., 2003), fear of abandonment (Holtzworth-Munroe et al., 2000), and fearful attachment (Johnson et al., 2006). However, family-only perpetrators demonstrated moderate levels on preoccupied attachment (Johnson et al., 2006).

Depression

Overall, family-only perpetrators evidenced low levels of depression (Cunha & Gonçalves, 2013; Delsol et al., 2003; Huss & Langhinrichsen-Rohling, 2006; Huss & Ralston, 2008; Langhinrichsen-Rohling et al., 2000; Lawson et al., 2003) and dysthymia (Waltz et al., 2000). However, Chiffriller and Hennessy (2006) reported that such perpetrators had moderate levels of denying mood and interpersonal problems.

Studies comparing family-only and generally violent/criminal perpetrators (n = 9)

As can be seen in Figure 3, the latent thematic analysis revealed five themes on which family-only and GV/criminal perpetrators have been compared: violent, aggressive, and antisocial behavior; attitudes and values; treatment; psychopathology; and sociodemographic characteristics. Additionally, several subthemes were identified where the results were contradictory and could not accurately characterize the family-only perpetrators. As such, no clear results were reported in terms of violence exposure in the family of origin (Boyle, O’Leary, Rosenbaum, & Hassett-Walker, 2008; Fowler, Cantos, & Miller, 2016; Herrero, Torres, Fernández-Suárez, & Rodríguez-Díaz, 2016; Wang, Horne, Holdford, & Henning, 2008), family of origin functioning (Herrero et al., 2016), or ethnicity (Cantos, Goldstein, Brenner, O’Leary, & Verborg, 2015; Goldstein, Cantos, Brenner, Verborg, & Kosson, 2016; Petersson, Strand, & Selenius, 2016).

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Figure 3.

Themes and subthemes of characteristics related to family-only perpetrators in the studies using a deductive approach (n = 9).

Violence

In terms of physical IPV, several studies have reported nonsignificant differences between family-only perpetrators and GV perpetrators (Boyle et al., 2008; Goldstein et al., 2016; Petersson et al., 2016). However, family-only perpetrators evidenced lower levels of psychological IPV (e.g., threats: Boyle et al., 2008; Petersson et al., 2016). Family-only perpetrators have further demonstrated being less likely to escalate their violent behavior (Petersson et al., 2016). Moreover, such perpetrators have also displayed lower levels of abuse toward family members (Boyle et al., 2008) as well as outside of the family (Theobald et al., 2016).

Aggression

Family-only perpetrators demonstrated lower levels of aggression toward a partner (Wang et al., 2008), as well as aggression in general (Boyle et al., 2008).

Antisocial behavior

Family-only perpetrators displayed lower levels of general antisocial and criminal behavior (Boyle et al., 2008; Petersson et al., 2016). They were also older by the time of the first arrest and imprisonment (Cantos et al., 2015; Herrero et al., 2016) and received shorter sentence time (Cantos et al., 2015). Family-only perpetrators also had a fewer number of previous convictions and self-reported offences (Cantos et al., 2015; Theobald et al., 2016).

Recidivism

Studies generally found that family-only perpetrators had a lower risk, assessed as well as actual, for IPV recidivism (Cantos et al., 2015; Goldstein et al., 2016; Petersson et al., 2016). However, Fowler et al. (2016) found no significant differences between family-only and GV/criminal perpetrators.

Low-to-moderate negative attitudes

Studies showed that family-only perpetrators demonstrated lower levels of violent attitudes (Petersson et al., 2016) and sexism (Herrero et al., 2016). However, Goldstein et al. (2016) reported that nearly 60% of the family-only perpetrators in their sample denied engaging in IPV.

High levels of pro-social attitudes and values

Family-only perpetrators demonstrated several pro-social attitudes and values such as higher levels of community participation and integration (Herrero et al., 2016) and scoring high on the “life success score” (e.g., satisfactory employment and cohabitation history) measured by Theobald et al. (2016).

High treatment compliance

Family-only perpetrators displayed higher levels of treatment completion and compliance (Cantos et al., 2015; Stalans & Seng, 2007).

Personality disorders

Family-only perpetrators demonstrated lower levels of personality disorders such as cluster B personality disorders (e.g., antisocial and borderline personality disorders: Herrero et al., 2016; Theobald et al., 2016). They also demonstrated lower levels of temperament disinhibition (e.g., being less likely to act impulsively: Boyle et al., 2008).

Psychopathy

Theobald et al. (2016) found family-only perpetrators to score lower on all facets (i.e., interpersonal, impulsive/antisocial, lifestyle, and antisocial), as well as on total score, of the Psychopathy Checklist Screening Version (PCL:SV).

Substance abuse

In general, family-only perpetrators displayed lower levels of both alcohol and drug abuse (Cantos et al., 2015; Herrero et al., 2016; Petersson et al., 2016; Theobald et al., 2016; Wang et al., 2008).

Mental health problems

In general, among studies using a wider measure of mental health problems, family-only perpetrators were found to have lower levels of such problems (Petersson et al., 2016; Theobald et al., 2016). Cantos et al. (2015), however, did not find any significant differences between family-only and GV/criminal perpetrators.

Demographic characteristics

Family-only perpetrators were consistently reported to be older than GV perpetrators (Cantos et al., 2015; Goldstein et al., 2016; Herrero et al., 2016; Petersson et al., 2016).

High-level socioeconomic characteristics

Overall, family-only perpetrators displayed higher levels of education (Cantos et al., 2015; Goldstein et al., 2016) as well as employment status (Cantos et al., 2015; Goldstein et al., 2016; Petersson et al., 2016; Theobald et al., 2016). Such perpetrators were also reported to, to a higher extent, have a satisfactory accommodation history (Theobald et al., 2016), a higher income (Cantos et al., 2015), and to come from more socially stable communities (Herrero et al., 2016).

Positive relationship characteristics

Family-only perpetrators were reported to have a higher level of satisfactory cohabitation history (Theobald et al., 2016), less intimate relationship problems (Petersson et al., 2016), more likely to be married (Cantos et al., 2015; Goldstein et al., 2016), and less likely to be single (Cantos et al., 2015). Herrero et al. (2016), however, found that family-only perpetrators were more likely to be divorced compared to GV/criminal perpetrators.

Inductive-deductive studies validating their typologies (n = 16)

Figure 4 illustrates the themes and subthemes that emerged from the thematic analysis of the deductive parts of the inductive–deductive studies. Several different subtypes were identified in these studies including family-only, GV/antisocial, borderline/dysphoric (BD), low-level antisocial (LLA), narcissistic, psychologically violent, pathological, and sexually violent. However, the family-only and GV subtypes were consistently identified in all 16 studies. As such, the comparisons below are mainly focusing on these two subtypes. Differences between the family-only subtype and other subtypes is explicitly stated. Additionally, subthemes with contradictory results were identified. As such, mixed results were found for denial of personal problems (Chiffriller & Hennessy, 2006; Lawson et al., 2003) and sociodemographic characteristics (Delsol et al., 2003; Hamberger et al., 1996; Holtzworth-Munroe et al., 2000).

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Figure 4.

Themes and subthemes of characteristics related to family-only perpetrators from the deductive parts (i.e., validation) of studies using an inductive–deductive approach (n = 16).

Personality disorders

Family-only perpetrators displayed lower levels of cluster B personality disorders (Holtzworth-Munroe et al., 2003; Walsh et al., 2010; Waltz et al., 2000). Moreover, family-only perpetrators were less likely than the BD subtype to display borderline (Hamberger et al., 1996; Holtzworth-Munroe et al., 2000; Walsh et al., 2010); obsession compulsion (Cunha & Gonçalves, 2013); and depressive, passive-aggressive, or self-defeating personality disorders (Holtzworth-Munroe et al., 2000).

Substance abuse

Family-only perpetrators consistently displayed lower levels of alcohol and drug abuse (Cunha & Gonçalves, 2013; Graña et al., 2014; Holtzworth-Munroe et al., 2000, 2003; Huss & Langhinrichsen-Rohling, 2006; Stoops et al., 2010; Waltz et al., 2000). Only one study reported findings in the opposite direction (Lawson et al., 2003), and one study (Walsh et al., 2010) found no significant differences. Family-only perpetrators also had lower levels of alcohol and drug abuse than the BD (Graña et al., 2014; Hamberger et al., 1996; Holtzworth-Munroe et al., 2000, 2003; Stoops et al., 2010; Waltz et al., 2000) and the LLA subtypes (Holtzworth-Munroe et al., 2003). Finally, Langhinrichsen-Rohling et al. (2000) reported higher levels of substance abuse among family-only perpetrators than BD perpetrators.

Psychopathy

Family-only perpetrators consistently showed lower levels of psychopathy (Cunha & Gonçalves, 2013; Holtzworth-Munroe et al., 2000, 2003; Huss & Langhinrichsen-Rohling, 2006; Lawson et al., 2003). This difference also held true for comparisons with the BD (Cunha & Gonçalves, 2013; Holtzworth-Munroe et al., 2003; Huss & Langhinrichsen-Rohling, 2006; Lawson et al., 2003) and the LLA subtypes (Holtzworth-Munroe et al., 2003; Huss & Langhinrichsen-Rohling, 2006).

Delusions

Family-only perpetrators evidenced lower levels of delusions including schizotypal (Waltz et al., 2000), schizophrenia, and familial alienation (Lawson et al., 2003). Such perpetrators also displayed lower levels of the following traits compared to the BD subtype: schizophrenia (Lawson et al., 2003), schizotypal (Hamberger et al., 1996; Waltz et al., 2000), thought disorder (Holtzworth-Munroe et al., 2000), psychotic delusions, psychotic thinking, and psychotic depression (Hamberger et al., 1996), as well as paranoia and hypomania (Hamberger et al., 1996; Lawson et al., 2003).

Anxiety

Overall, family-only perpetrators showed lower levels of traits related to anxiety (Delsol et al., 2003; Lawson et al., 2003; Walsh et al., 2010). This was also true compared to the BD (Cunha & Gonçalves, 2013; Hamberger et al., 1996; Holtzworth-Munroe et al., 2000; Lawson et al., 2003; Walsh et al., 2010) and the psychologically violent subtypes (Chiffriller & Hennessy, 2006).

Depression and suicide

Lawson et al. (2003) found that family-only perpetrators displayed less depression. This was also true compared to the BD (Hamberger et al., 1996; Holtzworth-Munroe et al., 2000; Huss & Langhinrichsen-Rohling, 2006; Walsh et al., 2010) and the LLA subtypes (Huss & Langhinrichsen-Rohling, 2006). However, Waltz et al. (2000) found no significant differences between subtypes and a control group in terms of major depression. Related to major depression, family-only perpetrators were reported as less likely than the GV, LLA, narcissistic, and the BD subtypes to have attempted suicide (Johnson et al., 2006) and less likely to have displayed suicidal ideation than the BD subtype (Lawson et al., 2003). However, Langhinrichsen-Rohling et al. (2000) found no significant differences in suicide ideation between family-only, GV, and BD perpetrators.

General mental health problems

Family-only perpetrators evidenced lower levels of general mental health problems compared to the BD subtype (Cunha & Gonçalves, 2013; Hamberger et al., 1996) and lower levels of pathology than the sexually and the psychologically violent subtype (Chiffriller & Hennessy, 2006). However, they displayed higher levels of psychopathology than the psychologically violent subtype (Chiffriller & Hennessy, 2006).

Less problematic attachment

Family-only perpetrators showed lower levels of fear of abandonment (Holtzworth-Munroe et al., 2003). This relationship held true also for the BD subtype, along with several other attachment traits, such as angry withdrawal (Waltz et al., 2000), fearful attachment (Holtzworth-Munroe et al., 2003), preoccupied attachment, and spouse-specific dependence (Holtzworth-Munroe et al., 2000, 2003). However, the family-only perpetrators displayed higher levels of compulsive care seeking than a nonviolent control group (Waltz et al., 2000).

Less violent attitudes

In general, family-only perpetrators had lower levels of attitudes condoning IPV (Delsol et al., 2003; Holtzworth-Munroe et al., 2000, 2003) and lower levels of hostility toward women in general (Holtzworth-Munroe et al., 2003). The same relationship held true compared to the BD and the LLA subtypes (Holtzworth-Munroe et al., 2003). However, such attitudes were still more frequent among family-only perpetrators than among a nonviolent control group (Holtzworth-Munroe et al., 2000).

Higher emotion recognition

Overall, family-only perpetrators displayed higher levels of accuracy in labeling a spouse’s expressed emotions (e.g., happiness and anger,) as well as making less mistakes in identifying such emotions (Babcock et al., 2008).

Pro-social personality traits

Family-only perpetrators showed lower levels of interpersonal sensitivity than the BD subtype (Cunha & Gonçalves, 2013). Other studies found no significant differences between subtypes in terms of likeability and frustration tolerance (Langhinrichsen-Rohling et al., 2000; Lawson et al., 2003).

Low negative personality traits

Overall, family-only perpetrators displayed lower levels of negative personality traits such as anger (Hamberger et al., 1996; Huss & Langhinrichsen-Rohling, 2006; Huss & Ralston, 2008), jealousy and impulsivity (Holtzworth-Munroe et al., 2000, 2003; Waltz et al., 2000), and social introversion (Lawson et al., 2003), than the GV and BD subtypes. They also evidenced lower levels of hostility compared to the BD subtype (Cunha & Gonçalves, 2013). However, the family-only perpetrators displayed higher levels of social desirability than both the GV and the BD subtypes (Hamberger et al., 1996; Holtzworth-Munroe et al., 2000).

General IPV

Family-only perpetrators consistently demonstrated lower levels of general IPV than the GV (Delsol et al., 2003; Hamberger et al., 1996; Holtzworth-Munroe et al., 2000, 2003; Huss & Langhinrichsen-Rohling, 2006; Huss & Ralston, 2008; Lawson et al., 2003; Stoops et al., 2010), the BD (Delsol et al., 2003; Hamberger et al., 1996; Holtzworth-Munroe et al., 2000, 2003; Lawson et al., 2003; Stoops et al., 2010), the LLA (Huss & Langhinrichsen-Rohling, 2006), and the sexually violent, the psychologically violent, and the pathological subtypes (Chiffriller & Hennessy, 2006). However, Walsh et al. (2010) reported higher levels of IPV among family-only perpetrators compared to a nonviolent control group.

Low psychological violence

Family-only perpetrators displayed lower levels of psychological violence compared to the GV (Delsol et al., 2003; Holtzworth-Munroe et al., 2000, 2003; Huss & Langhinrichsen-Rohling, 2006; Waltz et al., 2000), the BD (Delsol et al., 2003; Holtzworth-Munroe et al., 2000; Huss & Langhinrichsen-Rohling, 2006; Waltz et al., 2000), the LLA (Huss & Langhinrichsen-Rohling, 2006), and the psychologically violent and the pathological subtypes (Chiffriller & Hennessy, 2006).

Low sexual violence

In line with the results of general and psychological IPV, family-only perpetrators were in general less likely to be sexually violent with a partner (Holtzworth-Munroe et al., 2000, 2003; Huss & Langhinrichsen-Rohling, 2006).

Low risk of recidivism

In general, family-only perpetrators evidenced lower IPV recidivism rates and took longer time to recidivate (Huss & Ralston, 2008), as well as being assessed with a lower risk of such recidivism (Langhinrichsen-Rohling et al., 2000). However, studies found such perpetrators to be more (Stoops et al., 2010) and less likely (Huss & Ralston, 2008) to recidivate in IPV compared to the BD subtype.

Low general criminality

In terms of criminal behavior (e.g., previous criminal records), family-only perpetrators showed lower levels than the GV (Cunha & Gonçalves, 2013; Graña et al., 2014; Hamberger et al., 1996; Holtzworth-Munroe et al., 2000, 2003; Stoops et al., 2010; Walsh et al., 2010), the BD (Cunha & Gonçalves, 2013; Graña et al., 2014; Hamberger et al., 1996; Holtzworth-Munroe et al., 2000), and the LLA subtypes (Holtzworth-Munroe et al., 2000).

Low antisocial behavior

Several studies reported family-only perpetrators as displaying lower levels of antisocial behavior, such as general violence and associating with delinquent peers, compared to the GV, the BD, and the LLA subtypes (Graña et al., 2014; Hamberger et al., 1996; Holtzworth-Munroe et al., 2000, 2003; Huss & Langhinrichsen-Rohling, 2006; Johnson et al., 2006; Walsh et al., 2010). Family-only perpetrators also demonstrated lower levels of conduct disorder compared to the BD and GV subtypes (Stoops et al., 2010).

Witness IPV as a child

Several reviewed studies demonstrated that family-only perpetrators were less likely than the GV and the BD subtypes to have witnessed parental IPV during childhood (Cunha & Gonçalves, 2013; Graña et al., 2014; Hamberger et al., 1996; Stoops et al., 2010; Waltz et al., 2000). However, several other studies found no significant differences between subtypes (Delsol et al., 2003; Holtzworth-Munroe et al., 2000; Johnson et al., 2006; Lawson et al., 2003) in witnessing such violence.

Physical victimization

Several studies showed that family-only perpetrators experienced lower levels of physical victimization during childhood than other subtypes (Cunha & Gonçalves, 2013; Hamberger et al., 1996; Johnson et al., 2006). However, other results demonstrated no significant differences (Delsol et al., 2003; Holtzworth-Munroe et al., 2000; Waltz et al., 2000) or that family-only perpetrators experienced higher levels of childhood abuse than the GV subtype (Langhinrichsen-Rohling et al., 2000).

Marital stability and skills

Family-only perpetrators displayed higher levels of marital satisfaction as reported by both the perpetrator (Delsol et al., 2003) and the partner (Holtzworth-Munroe et al., 2003). Family-only perpetrators also had more stable relationships and lower divorce rates than both the GV and the BD subtypes (Holtzworth-Munroe et al., 2003). Finally, family-only perpetrators were also found to display lower levels of response incompetency in both marital and nonmarital situations than the GV and BD subtypes (Holtzworth-Munroe et al., 2000; Waltz et al., 2000).

Treatment compliance

Overall, family-only perpetrators showed higher levels of both treatment attendance and treatment completion than the GV and the BD subtypes (Huss & Ralston, 2008; Stoops et al., 2010), as well as being less likely to have received psychiatric or psychological help in the past (Holtzworth-Munroe et al., 2003). Langhinrichsen-Rohling et al. (2000) found no significant differences between subtypes in terms of treatment program success.